Countries demand a say in doctor approvals

Lack of doctors: federal states demand a say in approvals

06.04.2011

In the future, the states will demand a say in the licensing of medical practices. The Federal Minister of Health Philipp Rösler (FDP) and the health ministers of the federal states want to discuss appropriate possibilities at their special meeting in Berlin today.

The previous awarding of practice authorizations by the Association of Statutory Health Insurance Physicians is, in the opinion of numerous state politicians, not suited to remedy the looming lack of doctors in rural regions. Therefore, for example, the Minister of State for Social Affairs Mecklenburg-Western Pomerania, Manuela Schwesig (SPD) calls for a say of the countries in future decisions on planned practice approvals. The physicians strictly reject such intervention in self-government.

Lack of medical care in rural areas serious problem
The shortage of doctors in rural areas is, according to the Minister of State for Social Affairs of Mecklenburg-Vorpommern, a problem that should not be underestimated. Versus tagesschau.de Manuela Schwesig said that the causes of the lack of doctors „complex“ and the countries have already made several proposals to address the known difficulties. For example, according to Schwesig, partial admissions would not only help to make the medical profession more attractive again, but also offer female doctors better opportunities to combine work and family life. „For young women, it is not very attractive to run a country doctor's surgery around the clock“ emphasized the Minister of National Social Affairs. In her opinion, young female doctors need „even after the birth of a child, the option to be represented for twelve months and not just six months“.

Regional physician planning to ensure medical care
However, according to the politician, the core problem with the admission award by the Association of Statutory Health Insurance Physicians lies in the admission criteria applied equally everywhere. Regional differences are not adequately taken into account, because „The population situation in a rural region with many old people, as in Mecklenburg-Western Pomerania, is quite different from that in a metropolis like Berlin“, emphasized Manuela Schwesig. In order to be able to plan more precisely and purposefully, the minister demanded regional medical planning, in which politics has a clear say. The federal states agree that new legal regulations are urgently needed, because so far they have too little insight into the planning of the Association of Statutory Health Insurance Physicians, explained Schwesig. In Mecklenburg-Western Pomerania, the threat of a shortage of doctors is particularly grave, with around 40 percent of local doctors and specialists retiring there by 2020. Even today, many land physicians find it difficult to find a successor, and according to the latest reports, more than 100 family practices are already vacant in the northeast of the state. The Schwesig in view of these numbers calls for a say in the award of practice permits, seems only legitimate, but the physicians of Mecklenburg-Western Pomerania reject this.

Kassenärzte Mecklenburg-Western Pomerania against the say of politics
According to Manuela Schwesig, the Kassenärztliche Vereinigung at the federal level was, however, open to a say by the Länder. The physicians of Mecklenburg-Western Pomerania, however, speak out despite the threat of lack of doctors against further government regulations. „A centralistic planning and steering we had in the GDR. And yet the doctors did not stay where they were sent“, emphasized the vice-chairman of the Kassenärztliche Vereinigung Mecklenburg-Western Pomerania, Dieter Kreye. In his view, should be „restrict the policy (...) to creating a reasonable framework for doctors“. Kreye also sees the responsibility for the impending lack of doctors at least partially in politics, because being a doctor in Germany is not fun anymore. „We spend 40 percent of our working time filling out forms“, By ganging, recourse threats and over-bureaucratization a large part of the daily work of the physicians will be determined. With his criticism, Kreye also turned to the National Association of Statutory Health Insurance Physicians, because, according to the Vice-Chancellor of the Kassenärztliche Vereinigung Mecklenburg-Vorpommern, in their agreements with politics, they usually ignore the concrete problems in the regions.

Lack of doctors - Is medical care at risk?
Why do the physicians in Mecklenburg-Western Pomerania, despite the onset of medical shortage so massive against a say in the countries in the award of approvals, is hardly comprehensible to outsiders. Actually, the highest priority should always be the medical care of the population and if this can no longer be adequately ensured with the conventional model, alternatives must be considered. However, in the past, the Kassenärztliche Vereinigung Mecklenburg-Vorpommern has kept extremely low and made few proposals to remedy the shortage of physicians. It may have simply been assumed that, statistically speaking, there are enough physicians available throughout Germany, and that they automatically opt for a rural practice in the event of imminent unemployment in urban centers. However, as the figures from Mecklenburg-Vorpommern make clear, relatively few doctors are available for a practice takeover in rural regions, so that numerous doctors' practices close and medical care seems to be endangered. „If things continue as they used to, medical care in Germany is no longer secure“, warned Manuela Schwesig. (Fp)

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Picture: Rainer Sturm