The Soviet legacy in diagnosis and treatment: Implications for population health.

This article reviews diagnosis and treatment in the Commonwealth of Independent States in three clinical areas: tuberculosis, substance misuse, and neurological disorders in children. While the specific problems in each of these areas differ greatly, commonalities emerge, pointing to the continued influence of the Soviet past. Although progress in developing evidence-based medicine is being made, the isolation of Soviet science from Western developments has resulted in the widespread use of outdated diagnostic procedures and treatment protocols, while finance mechanisms still encourage unnecessary hospitalizations and treatments. A hierarchical medical system, as well as underdeveloped patient rights and medical ethics, mean that patients have little information and ability to participate in decision-making. The continued use of outdated approaches to diagnosis and treatment contributes to poor population health outcomes in the region.