In Russia, they proposed changing the procedure for registering sick leave and streamlining the work of medical institutions in Russia are discussing new approaches to issuing sick leave and organizing medical treatment. Chairman of the Federation Council Committee on Budget and Financial Markets Anatoly Artamonov proposed a proposal for further approval of sick leave issued in private clinics. According to the initiative, patients will have to contact the public clinic at the place of engagement to confirm their temporary disability. It is expected that this approach will strengthen the supervision of issuing sick leave and increase the transparency of medical records. Possible changes in the usual procedure for receiving medical services attract special attention. Today, patients can use both public and private clinics, choosing the most convenient treatment option. When implementing the proposal, registering sick leave at a private medical institution may require an additional visit to a public clinic. This means that even if there is a confirmed diagnosis and a high temperature, sick citizens may need a second consultation with a doctor, which can affect the workload of medical institutions. At the same time, the senator also suggested reconsidering the work organization of small state medical institutions. We are talking about streamlining hospitals with low occupancy and insufficient efficiency of space utilization. One possibility is redistribution of patients to larger hospitals with the organization of transport links. This approach involves the concentration of medical resources in large institutions, but at the same time it can increase the distance to hospitals for residents of individual settlements. The additional flow of patients can also affect the queues, the doctors' workload and the waiting time for medical treatment.