Weaponized patriotism As patients use denunciations to get their way, Russian doctors are keeping quiet on politics and the war in Ukraine
In mid-November, Moscow pediatrician Nadezhda Buyanova was sentenced to five and a half years in prison for allegedly spreading “disinformation” about the Russian army. The case stemmed from a complaint by Anastasia Akinshina, whose ex-husband fought in Ukraine and is now missing. Akinshina claimed that during an appointment, Buyanova made critical remarks about Russian soldiers and the conflict. There’s no evidence supporting the allegation, but a social media post accusing Buyanova was enough to secure a conviction. Russian doctors say they rarely discuss the case among themselves — they don’t know which colleagues they can trust, and one wrong word could lead to prison. Novaya Gazeta Europe interviewed medical professionals about how they’ve learned to watch their words since the full-scale war began. Meduza shares an abridged English-language version of their reporting.
The names of the individuals in this story have been changed for their safety.
A typical neighborhood clinic in Moscow hums with quiet chatter. Patients waiting their turn swap stories about their ailments and gripe, as usual, about the state of healthcare. Officially, each consultation is supposed to take 12 minutes, but the doctor inevitably runs over time. The line grows, and appointments are now delayed by nearly an hour. One frustrated patient storms off, only to return triumphant, announcing she’s filed a complaint. It doesn’t speed things up.
Maria, the doctor on duty, doesn’t react — at least outwardly. “Sure, sometimes you fall behind schedule,” she says with a shrug. “But I don’t even have time for a bathroom break.”
She works like a well-oiled machine: a question to the patient, an answer, a note in the system. Another question, another answer. She checks a patient’s blood pressure, places her stethoscope to his chest, and moves on — no wasted words. Meanwhile, her patient, a man in his seventies, seems eager to chat. He grumbles about being prescribed a new medication instead of his usual one, complains about the high cost of drugs, and laments how hard it is to see a doctor these days.
“And why is that?” he asks, raising his voice. “Why don’t they prescribe me the medicine anymore? We used to have everything, and now we don’t…”
Maria glances at him briefly. “I prescribed you an alternative — it’s a good medication,” she replies, her eyes already back on the computer.
“There’s no other way these days,” she tells Novaya Gazeta Europe. Maria has been in medicine for about 20 years and says she’s always had a good rapport with her patients. Her interactions often go beyond the standard medical questions, and she’s always willing to listen.
“But lately,” she admits, “I’ve been keeping quieter during appointments. Who knows how your words might get twisted later? It feels like we’re always under scrutiny.”
Maria lowers her voice. “The department head reminds us at every staff meeting: no talk about the war — it’s not our concern.”
Patriotic complaints
Medical professionals have always been under scrutiny, but now oversight extends far beyond treatment methods. Everything is monitored — whether a doctor wore shoe covers, how they greeted patients, or even how they knocked on a door.
Doctors describe what feels like a growing “cult of complaints.” Medical facilities prominently display detailed instructions on how to report any perceived issue with staff — by phone, online, or directly to the head of the institution.
“Let’s be honest — doctors in Russia aren’t respected,” says Roman, a department head at a private clinic. “Over the 15 years I’ve been in medicine, I’ve seen us treated more and more like service staff, with complaints expected and encouraged. It’s the state’s way of deflecting attention from deeper problems in healthcare.”
Complaints have long been a way for patients to get what they want, but recently, people have realized that invoking pseudo-patriotic rhetoric can yield even greater results.
Roman says he’s seen this attitude often in a federal hospital repurposed for military patients. Patients act as though the medical staff owes them something, warning that they’ll file complaints if their expectations aren’t met. And they follow through — whether it’s to the chief physician, the regional health department, or the Health Ministry. According to Roman, this is the lesser evil, as such complaints typically result in a reprimand, a formal warning, or, at worst, dismissal.
The real danger comes when complaints go viral on social media. Even minor issues can snowball into public scandals, turning simple grievances into full-blown denunciations. In such cases, doctors have little chance to defend themselves.
“Today, this is essentially a legal way to take revenge on a doctor you didn’t like,” Roman says. “The scariest part is that the state encourages this behavior. In the end, a ‘nice’ girl who filed a complaint ends up destroying someone’s career. We all know that the pediatrician’s public humiliation was a message to ensure everyone stays silent.”
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In many Russian medical institutions, unwritten rules dictate that conversations with patients must focus solely on their health — no politics, no mention of the “special military operation.” While there’s no formal ban, management frequently reminds staff that such topics have no place in the workplace.
“I don’t discuss political issues at work, and I’ve forbidden my employees from doing so as well,” says Roman. “I made that decision back in 2022, when everything started. At first, it was to avoid conflicts among colleagues, but it quickly became clear that it’s also a safety concern. So, no discussions in the clinic. We treat people. Period.”
Larisa, a paramedic with nearly 30 years of experience, takes a similar stance. “Of course, when I’m with a patient, I’m always wary of saying something ‘wrong.’ I stay friendly but keep my distance — like during the pandemic,” she jokes grimly. “Some new [doctors] joined us recently and were surprised by how I communicate with people — everything vague, nothing specific, just carefully worded generalities.”
The first red flag for many doctors came in 2023, when some medical facilities began installing cameras in examination rooms. In Moscow, a pilot project was launched to record audio of doctor–patient conversations. Officially, these measures are meant to ensure professional behavior on both sides.
But doctors are skeptical. They believe the recordings are unlikely to be used against patients and more likely to be used to target medical staff. For many, the case of Nadezhda Buyanova is a stark reminder that no one is looking to hold patients accountable for inappropriate behavior. But proving a doctor’s guilt is always welcomed.
Unfortunately, there’s little hope that anyone will stand up for a doctor accused of misconduct. Doctors who spoke to Novaya Gazeta Europe say management is primarily focused on protecting its own interests and is quick to distance itself from any staff member deemed politically problematic to avoid any stain on the clinic’s leadership or reputation.
‘I just stay quiet’
“If you want to keep your job, you have to act a bit deaf and mute,” Larisa says. “Like in the movies: anything you say can and will be used against you. Recommend an expensive medication because it’s more effective? You’re in the wrong. Prescribe a cheaper one? Still wrong. Say the wrong thing, give the wrong look. And now, it feels like some people are deliberately trying to provoke us.”
She recalls an elderly patient who fixated on her last name, asking, “Is it Ukrainian?” Larisa pretended not to hear and quickly shifted the conversation to his high blood pressure. “My surname is very Russian,” she says, “but engaging in that discussion just isn’t worth it.”
Maria has noted a growing trend of patients recording their consultations. On the surface, it seems harmless — even practical. Patients can revisit the doctor’s instructions later or share them with a relative. But it also feels like an improvised tool to keep doctors in check.
“One time, a colleague warned me that a patient was coming in with a recording device,” Maria recalls. “She told me to watch my words because he’s known for nitpicking. I answered all his questions professionally. At the end, he even got emotional, saying, ‘All these problems are because of the war.’ I just told him, ‘Let’s change the subject.’”
This unwritten rule of silence extends beyond conversations with patients. Doctors told Novaya Gazeta Europe they’ll talk about anything with colleagues — just not the war. Roman recalls an incident at a regional hospital where doctors were discussing politics. One of them spoke critically about the situation, and not long after, their home was searched.
Igor, a specialist at a federal hospital with nearly 20 years of experience, says the current climate reminds him of what he’s heard about Soviet times: you have to say what’s expected of you, not what you truly think.
“Whenever we have a meeting, management delivers these over-the-top patriotic speeches,” Igor explains. “You can’t tell if they genuinely believe it or are just sticking to the official narrative. They’re always organizing something — raising money for soldiers or, now, for the wounded, since we’ve got an entire ward for them.”
Participation in these activities is supposedly voluntary, but Igor says refusing only draws unwanted attention. “They start asking questions — why didn’t you donate? Are you against it? It’s easier to just hand over a couple of thousand rubles so they leave you alone.”
“In a way, it’s actually easier with patients,” Igor admits. “If someone starts [a political tirade], I can shut them down by saying, ‘You’re in a doctor’s office, not on a political stage.’ You can’t do that with management. Then again,” — he pauses for a moment and sighs — “stopping someone from ranting in favor of the war is just as good a reason for them to file a complaint against me. So, most of the time, I just stay quiet.”
