FELDSHER

Medical assistant.

Feldshers first appeared in Russia during the eighteenth century, when they served as medical assistants in urban hospitals or as army corpspeople. During the nineteenth century they played a major role in rural medical systems. The law restricted them to practice under a physician's direct supervision; many were nevertheless assigned to run remote clinics on their own because of the dearth of physicians in the countryside. Forced by circumstances to tolerate such independent feldsher practice, known as "feldsherism," leading physicians adamantly opposed granting it legal sanction. "Feldsherism" remained a contentious issue as well as a widespread practice well into the 1920s.

During the 1870s, many provincial zemstvos established feldsher schools in order to raise feldshers' overall qualifications. Opening feldsher practice to women in 1871 brought growing numbers of urban women with gymnasium training into these schools. By the twentieth century, the qualifications of these newer feldshers and feldsher-midwives had improved dramatically. As of 1914 there were more than 20,000 civilian feldshers in Russia. Most served in rural areas, but one-third worked for urban hospitals, railroads, schools, and factories.

The publication in 1891 of the newspaper Feldsher sparked the appearance of a feldsher professional movement. In 1906, local feldsher societies formed a national Union of Societies of Physicians' Assistants, which published the newspaper Feldshersky vestnik (Feldsher Herald) and lobbied on feldshers' behalf. During the revolutions of 1905 and 1917, most feldshers identified with moderate socialist parties. In 1918 the Union was dissolved; its members entered the industrial medical union Vsemediksantrud.

The Soviet regime ceased training feldshers altogether in 1924, focusing instead on midwives and nurses. Feldsher training was resumed in 1937, and feldshers continue to serve as auxiliary medical personnel in Russia.

See also: health care services, imperial; health care services, soviet

bibliography

Ramer, Samuel C. (1976). "Who Was the Russian Feldsher?" Bulletin of the History of Medicine 50:213–225.

Ramer, Samuel C. (1996). "Professionalism and Politics: The Russian Feldsher Movement, 1891–1918." In Russia's Missing Middle Class: The Professions in Russian History, ed. Harley D. Balzer. Armonk, NY: M. E. Sharpe.

Samuel C. Ramer