Private entrepreneurship in Russia is developing and conquering new sectors of the service market every year. It is no longer new to use a private bank, security agency or ambulance. Open yours ambulance difficult, since this type of activity requires licensing and large investments. But if you are not afraid of difficulties and you have a certain amount in your stash, then you can try. Let’s talk in more detail about the specifics of the business of providing medical services and organizing private ambulance services.
Business specifics
State bodies have transferred into private hands those areas that were previously inaccessible to entrepreneurs. These include housing and communal services, ambulance, education, medical services. Of course, complaints about high cost There are many services that people are used to receiving for free, but positive reviews prevail.
For example, by calling an ambulance by phone 03, you can wait for doctors no earlier than 20-30 minutes later. A private ambulance will rush to the scene at the earliest short time– 5-10 minutes. It’s the same distance to travel to a patient in a state ambulance, but the staff is not always motivated, and they have a lot more challenges. IN private company specialists receive a salary and a percentage for each call and service provided, so a good goal and prosaic nature are intertwined. The doctor will rush to the patient and provide all the services he needs.
In addition, the Ministry of Health is receiving less and less funding, and high-quality modern equipment can only be found in private clinics. And a third of the success of treatment depends on its quality. Patients prefer to pay and receive help high level than using the policy and wasting time in queues.
According to statistics, 70% of entrepreneurs who are engaged in medical business in Russia do not have a medical education at all. Therefore, everyone will be able to open their own medical care service to the population.
Private ambulance services are provided to the public the following types services (the list in each private company can be expanded or narrowed):
- Examination and consultation of the patient, diagnosis of the disease – 500–800 rubles.
- Transporting a patient to a hospital or for diagnostics – 600-1000 rubles.
- Providing first aid on site for a diagnosed disease – 500-1500 rubles.
- Patronage and observation of a patient who needs constant monitoring - 2500 rubles/day.
- Detoxification of patients (measures necessary to withdraw from drugs or alcohol intoxication) – 2500-4000 rub.
- Accompaniment by medical staff mass events or trips for schoolchildren - 3500-6000 rubles.
- Additional services at the central ambulance office (ultrasound, ECG), consultation with specialists, massage - from 1200 rubles.
Target audience - any person with average and high income. People who want to get help incognito (for example, drug addicts or alcohol addicts) also often turn to a private emergency room.
A private ambulance can receive additional income, concluding agreements with the same entrepreneurs who provide medical services. But the patient is given a choice of which hospital to be taken to – private or public.
The technical side of the business
To organize a medical business, you must have a license. But it is difficult to obtain a document from Roszdravnadzor. You will have to undergo a number of checks from various public services, based on the results of which you will be given written conclusions. Only an LLC can obtain a license to provide emergency medical services. Therefore, a limited liability company is initially registered. When registering, select a type code OKVED activities– 85.14.4 “Activities of emergency medical care institutions.”
A package of documents is submitted to Roszdravnadzor:
- Statutory documentation of the company.
- Application for a license. The form can be viewed on the Roszdravnadzor website.
- Certificate.
- Copy of passports and TIN of all founders.
- Certificate of ownership or lease agreement for the premises where the emergency center is located.
- Certificates of conformity for tools and equipment.
- A copy of the conclusion from Rospotrebnadzor.
- Copies of documents that confirm the education and qualifications of each employee of the company.
A detailed list of documents and requirements for medical equipment can be found in the SanPiN documents “On approval of the Licensing Regulations medical activities" You can download the list.
Red tape with documents can drag on for six months. It will take more than one week until the field commissions check you and each makes its own conclusion. Then a council meets, where a decision on issuing a license will be made.
Ambulance equipment
The most minimal equipment of a private ambulance will cost you at least 5 million rubles. Of course, you can start working with one car and a mobile team of several people, but such an “ambulance” may not be able to respond to all calls. Plus, if the team is busy doing field work, there will simply be no one to send to your clients.
The best option is to start working with four machines:
- Reanimation vehicle.
- Pediatric team car.
- Two line lines, for traveling to regular calls.
Each vehicle contains the following standard equipment:
- Defibrillator – 78-100 thousand rubles.
- Cardiac monitor – 150-300 thousand rubles.
- A device for artificial ventilation of the lungs – 60-100 thousand rubles.
- Perfusor (electronic syringe pump), 2-3 pcs for each machine, – 100-150 rub./pc.
- Oxygen apparatus – 30-150 thousand rubles.
- Mini-refrigerator for medicines – 20-40 thousand rubles.
A stationary refrigerator for storing medicines is installed in the company's office - 60-100 thousand rubles, a safe for storing drugs containing drugs - 50-100 thousand rubles. Each car is equipped with a walkie-talkie, a station is placed in the office - 90 thousand rubles. The most high costs when equipping the center, they will spend on a resuscitation vehicle; its price on the market in Moscow depends on the brand.
A car based on a foreign car like Mercedes-Benz Sprinter will cost 2 million 850 thousand. A car based on a GAZelle will cost a little less - from 1 million 500 thousand. We do not recommend buying used equipment, since the quality of equipment in your ambulance will The reputation of the company and the lives of patients will depend.
Selecting staff
For travel, personnel with medical education and experience of at least 5 years are hired. Newbies can screw things up, and one misdiagnosis can jeopardize the reputation of a startup company.
The doctors’ work schedule does not differ from the state one – every day or three. You can hire part-time specialists from large public clinics. But a license is issued subject to permanent employees, so you must have 3 doctors on a permanent basis: the head physician, the deputy and the paramedic.
In addition to medical personnel, drivers with knowledge of the city and suburbs are required. How quickly the on-call team will arrive depends on their experience. For major project an accountant is hired who will manage the financial part of the business, and dispatchers who take calls. Students of medical universities are suitable for the role of the latter. Young professionals are theoretically familiar with the symptoms of diseases and will be able to select the right field team.
Eventually
When opening your own emergency room, you should understand that you will have to invest a lot in the business. The company will pay for itself no sooner than in 2-3 years. It is difficult to recruit regular clients, since trust in doctors comes with time. When investing 5-10 million rubles into a business, do not forget that ambulances should first of all serve people. Therefore, any savings can cost you the collapsed reputation of the company, and for someone - their life.
Paid ambulance in Moscow and the region. Call within Moscow - 3450 rubles.Commercial ambulance in Moscow - always in touch
Paid ambulance SkyMed LLC is an independent specialized service that provides pre-medical and medical care in Moscow and the region. We are always in touch; you can call a team any day and time of day.
Despite the fact that calling a private ambulance is paid, if on the way to the client someone needs medical assistance, the doctors will provide it immediately and free of charge. In addition to standard services, you can order from the company:
- ambulance duty at holidays and competitions;
- transportation of patients.
The paid ambulance service includes 20 teams, including intensive care units specializing in neurological, traumatic and childhood diseases. The carriages are equipped with modern equipment to provide emergency medical care and resuscitation. The transport used by private ambulance doctors to make paid calls regularly passes Maintenance, which eliminates the possibility of breakdowns along the way.
High-quality paid ambulance services in Moscow and the Moscow region
For all doctors of SkyMed LLC
Very often in Lately from funds mass media we began to hear about the development of private business in our country. About the conditions created for this, about supported projects, successful startups, etc. Is this how things really are? Private security services, private banks, private emergency medical services. What else can we expect in the future?
The state continues to transfer into private hands those types of businesses that, until recently, seemed to be considered under the “cap” of its monopoly. This is the case, for example, in the housing and communal services sector, the educational sector, the insurance system, the provision of medical services, and many other industries. What came of it? In some ways, people began to benefit from this, but in others, on the contrary, it became much more difficult. Everyone decides this for themselves. But one undoubted advantage is still immediately visible - the development of private business.
If we look at the same area of medical services: ordinary ambulances are often in no hurry to respond to calls (unfortunately, even emergency ones) to the sick. But private emergency medical care (rest assured!) will be at your place within a few minutes after the call. But in most cases the road is exactly the same. The only difference is in the motivation of the staff. Well, in organizing a business, from the point of view of which we will consider this type entrepreneurial activity.
What is private emergency medical care?
I think we need to admit that the healthcare system we “inherited” from “another” country is on the verge of decline. In private medical clinics The most modern expensive equipment that meets international standards has been installed, private medical institutions employ more qualified personnel who take their direct responsibilities more responsibly, as I already said, even private ambulances respond to incoming calls faster. I am writing all this not as a reproach to those people who selflessly work in government institutions. Thanks to them for their work!
Basically, private structure practically no different from the municipal one. It’s just that here a noble goal - helping sick people, saving lives - is organically intertwined with a more prosaic goal - making a profit. By the way, almost a third of private medical institutions belong to people who are very far from medicine. It is not at all necessary to have medical education to organize such a business.
Private emergency medical services look something like this (the differences between different institutions are minor):
- Providing medical consultations, examining patients, making a diagnosis.
- Providing emergency medical care according to the diagnosis of the disease.
- Transportation of patients who are unable to move independently.
- Observation of persons requiring constant medical attention.
- Carrying out procedures aimed at detoxification (withdrawal from alcohol binge, assistance to drug addicts).
- Servicing public events.
- Providing additional medical procedures at the emergency center (conducting an ECG, ultrasound, appointment with medical specialists, testing, some types of therapeutic massages, etc.).
Who uses private ambulance services?
How to determine target audience of your business you can read. The main clients of the private ambulance service are people with high and middle incomes. This also includes those who are dissatisfied with the quality of services provided by the government structure. Plus those citizens who do not want their illness to be disclosed (alcohol and drug addicts fall into this category).
And of course, people who want to be sure of the quality of medical services turn to “private providers”. Among other things, private emergency medical care may have contracts with many private clinics, so the patient can choose which “hospital” to take him to: private or public. Now let’s move directly to the “technical” aspects of organizing a business.
Obtaining a license to carry out medical activities
Medical services are a very sensitive “field” for doing business, so you need to prepare for thorough checks by regulatory licensing authorities. Form of doing business in in this case Only an LLC is acceptable (you can find out how to register a limited liability company).
Obtaining a perpetual license to provide medical services in our country is carried out by Roszdravnadzor. Required package documents includes:
- Licensing Application.
- Charter papers of the LLC, registration certificate, and other documents related to organizational and legal activities.
- Certificate, confirming the right to own the premises for an emergency care center.
- Register of medical special equipment, inventory, and tools, and certificates of conformity for all this.
- A copy of the conclusion issued by Rospotrebnadzor.
- Documentation, confirming education, qualifications, etc. for each employee.
- Certificate of ownership for a car space.
- Payment receipt state duty.
Complete list of all necessary documents, requirements for equipment, maintenance, and operation of medical institutions can be found in the resolution “On approval of the Regulations on licensing of medical activities” and in the SanPin document “ Hygienic requirements to the placement, design, equipment and operation of hospitals, maternity hospitals and other medical hospitals."
Organizational and technical aspects of a business idea
Without going into details of the purchase of specialized medical equipment installed at private stations medical centers ambulance, I’ll tell you about the minimum equipment for the fleet of private ambulance teams. You can start your own business with just one car in the garage, with the ability to quickly convert it for a specific call to a patient with a specific diagnosis.
But the best option is three cars: an ambulance, a pediatric one, and a line brigades, intended for general calls. The “standard” set of equipment for each ambulance contains:
- Apparatus for artificial lung ventilation.
- Mandatory defibrillator.
- Modern cardiac monitor.
- Perfusor (electronic syringe pump) in the amount of two or three pieces.
- Oxygen devices.
In addition to special equipment, you need:
- Mini refrigerators for medicines.
- Safes for storing drugs, subject to strict accounting.
- Walkie-Talkie, which should be installed in every car.
A complete list of tools can be viewed in the “List of Equipment for the Mobile Ambulance Team.”
Workers at a private ambulance station
Typically, the work schedule of a private medical service does not differ from colleagues “in the shop” in state system health care: in three days. In addition to doctors: medical specialists, nurses, paramedics, etc., who, by the way (this most often happens) can combine work in government medical institutions and private medical institutions, you will need:
- Drivers with excellent knowledge of the city (the best option is candidates who have worked in a taxi or in an ambulance).
- Chief physician. This position requires knowledge business administration, management skills and extensive experience in this field.
- Accountant. There’s no way without him.
- Dispatcher, receiving and recording calls. Junior medical staff and medical students are ideal for this position.
- Orderlies and nurses.
Private ambulance: legal aspects, license, equipment, personnel, “kitchen”.
Private ambulance - a structure for round-the-clock emergency medical care for emergencies en route to medical institution or directly at the scene of the disaster.
This service serves as a popular way to enter medical business. Everything is explained simply - the well-functioning system left as a legacy after the USSR is falling into decay, and the emerging middle class and the elite cannot meet their needs in the public sector. Private ambulance began to develop from the moment the whole private practice, approximately from 95-98 of the last century, but everything was formalized legislatively only in 2007, with the adoption of the law on licensing of medical services in the final reading.
Key difference no from the state SMP, but due to the presence of an excellent material and technical base, high motivation employees and less workload on the average crew during the day, the patient can count on more individual approach, and in case of emergency, gets access to modern resuscitation equipment, which is not always possible in government structure. In addition, if the patient has the means, the ambulance can perform the functions of a local or family doctor, as well as provide consulting services - in essence, the client receives a large package on one hotline.
Legal points
Depending on the various situations the stage of formal creation of an ambulance can last up to six months. Most often, these are bureaucratic issues, for example, the license is signed personally by the head of Roszdravnadzor, and it requires decisions from Rospotrebnadzor, a sanitary and epidemiological conclusion on the strict compliance of work and services, tests, physical factors, water quality, washes for sterility - all this can take quite a long time.
The only option under necessary tasks OOO - entity, limited liability company. An LLC can recruit employees only after obtaining a license.
Optimal taxation - simplified tax system income minus expenses, 15%. OKVED - Health and social service provision, activities in the field of health care, paragraph 85.14.4, activities of emergency medical care institutions.
The method of payment with patients is only receipts; cash register is impossible in an ambulance carriage; receipts must be registered in a special journal for strict reporting forms.
How to get a private ambulance license
Licensing takes place in accordance with the requirements of Resolution No. 30 “On approval of the Regulations on licensing of medical activities” dated January 22, 2007. Deals with permitting papers Roszdravnadzor, licensing is unlimited. It is necessary to collect a package of documents and pay the price for services and fees, in case positive decision.
- A copy of the LLC charter and registration certificate.
- A copy of the conclusion from Rospotrebnadzor.
- Lease agreement or property documents.
- Lists of medical equipment and certificates of conformity.
- Papers for each employee, excluding the driver and accountant - diploma, post-graduate training, internship or residency, certificate and category rating.
- Application for consideration of the case and a check for the services of consideration and work on your issue.
Room for machine base
SanPiN requirements for the size of the premises and a mandatory bathroom must be met already at the stage of renting the premises. SanPiN 2.1.3.1375-03 “Hygienic requirements for the placement, design, equipment and operation of hospitals, maternity hospitals and other medical hospitals”
We need a base that will combine functions logistics center, garage and rest room, later you can expand the range of services, introduce several inpatient wards and a manipulation room, although it is optimal to do this at the opening stage in order to form a favorable opinion about the brand. There will also be a help desk, which also needs to be allocated a separate office - it will work with clients and guide crews; these employees also need a place to rest.
Equipment
It is quite possible to start even with one special car, especially considering the prices, approximately 900,000 rubles for a Gazelle chassis and 2 million for a Mercedes chassis. You can transport patients and go out on single calls, gaining experience client base. But Desired minimum: three cars- two linear and pediatric, one specialized cardio and resuscitation.
Of the equipment they usually put on each resuscitation kit (oxygen, manual ventilator, perfuser, defibrillator and cardiac monitor- its cost may vary, depending on the manufacturer, but preferably German and Italian manufacturers, if the budget allows). This is necessary for logistics purposes; sometimes a specialized team may be on call, and resuscitation measures should be carried out by the usual line personnel.
Technology and PBX with several channels, walkie-talkies for cars and the costs of their registration - also need to be taken into account. The initial costs for refrigerators for medications, safes for storing the A list, and, in fact, the medications themselves can be quite significant. Acquainted with necessary equipment and consumables can be found in the “List of equipment for the visiting team” ( Appendix 1.13 of the order of the Ministry of Health Russian Federation dated March 26, 1999 N 100).
Staff
- Drivers, who must have excellent knowledge of the city - best of all, with experience in a state ambulance or taxi.
- Accountant- he can be hired before licensing, there will be enough work, especially in terms of reporting.
- Chief physician - administrator, director and person who controls all operational issues, with experience in management work.
- Crews- usually a doctor and a paramedic, preference for men who can carry a patient and get him out of a car. Usually there must be an obstetrician, a surgeon and a cardiologist; a narcologist is also often included in the team; calls to relieve withdrawal symptoms are not uncommon. Crews are staffed on a daily basis - three for each ambulance.
- Dispatching service- usually younger medical staff who can adequately assess the situation and make a decision about the need for a particular team to leave and, in general, about the advisability of calling.
- Sales Manager- a person who works with private insurance companies, with a corporate client, negotiates with city authorities to conduct city holidays and sporting events, offers services to individuals for monitoring and managing patients.
To start work, you usually need a fairly large team - from 20 people, in the case of 3 cars, in addition, you will need a nurse and a mechanic who can fix any problem in the car in emergency mode.
Private ambulance services
Typically, following the letter of the law, a private ambulance provides the following services.
- Maintaining remote advisory assistance and monitoring of seriously ill patients.
- Providing emergency medical care when indicated.
- Transportation of bedridden patients and people who, according to indications, require constant medical supervision.
- Detoxification activities at home - withdrawal from binge drinking and various abstinence.
- Call anyone narrow specialist at home, for guidance or consultation.
- Servicing corporate events and celebrations.
- Additional medical services at the station - massage, exercise therapy, various courses.
- Segment health insurance- a promising and broad topic that goes beyond the scope of this review.
The target audience services - wealthy people who are dissatisfied with the quality of public ambulance services, people who need supervision and monitoring (bedridden and chronically ill patients). These are also young people with drug or alcohol addiction who does not want publicity or feels the need for medical supervision, a corporate client who needs to provide adequate medical care for mass events, the middle class who uses insurance medicine.
How does the structure of private ambulance work?
To call a private ambulance, you need to make a call to the dispatcher - anyone who wants to can call it, not only a client of a private clinic and someone using an insurance policy. After receiving an incoming call on a landline phone, with a conversation recording function, the dispatcher carries out initial work with the patient - interviews him about symptoms, writes down the address, enters it in a strict reporting journal and in a special computer program. Payment is made after medical care is provided, since the “check” can “float” depending on the drugs used. It is worth paying attention to the fact that the standard package usually includes diagnostics, including a cardiogram.
After assistance, the patient is sent to the hospital according to indications. Typically, urgent patients and people who are unconscious end up in emergency hospitals and specialized departments, while chronic patients have a choice between private medicine and state aid. If the client uses insurance medicine, the certificate usually indicates the desired place of hospitalization, even if the patient is unconscious, you can easily navigate.
Reception department points to route sheet The crew arrives at the time of arrival, makes a preliminary diagnosis and signs that the patient has been admitted to the hospital. This is where all relationships between a private ambulance and a hospital institution end, the hospital is not responsible either to the private owner or to third parties, just as private owners are not responsible after they have admitted a patient.