The Doctor and the Zemstvo

On the basis of archive documents and various published materials, the article examines the interrelations between zemstvo administration and zemstvo doctors, which is an insufficiently researched subject in the history of zemstvo healthcare in Russian historiography. The mutual understanding of these two main parties in the area of zemstvo healthcare could account for the success in providing the population with available healthcare in the after-reform Russia. The key problem was caused by the zemstvo administration underestimating the complexity of tasks in the healthcare system and unwilling to engage doctors to participate in their implementation. Zemstvo doctors, in their turn, striving to improve the health of the population, fought for the promotion of their professional status and better economic conditions. Moreover, they sought equal partnership with zemstvo administration. The author focuses on the complicated and controversial process of consensus achievement on the vital problems of zemstsvo healthcare, for example, collegiate medical bodies, such as the assemblies of zemstvo doctors, local sanitation bodies, as well as the isolation of the zemstvo from tackling entirely medical issues. The author comes to the conclusion that the relations between zemstvo administration and zemstvo doctors were formed under the influence of socio-political situation in the Russian Empire, the political views of the zemstvo administration and their competency level in the area of healthcare, and the doctors’ objective assessment of the Zemstvo’s fairly modest financial means.