Strategies against the shortage of physicians are being examined

What change in medical care patients expect

03/03/2014

Demographic change brings with it considerable challenges for the health system, which also require new organizational models to ensure adequate medical care for the population in the future. „With the previous focus on the classic private practice and the politically initiated fee increases, the supply problems could not be solved“, emphasized Johann-Magnus v. Stackelberg, Deputy Chairman of the GKV-Spitzenverband, in a recent press release from the association.

The new opportunities to improve patient care must be actively expanded and used, explained the vice-chairman of the GKV-Spitzenverband. In addition, should „Also in the outpatient care more cooperation and more employment opportunities are offered, so that young doctors the way to practice and the country is facilitated“, so Johann-Magnus v. Stackelberg continues. As more and more patients have a very complex clinical picture, be further „multidisciplinary team structures also in the field of contract medicine“ required. One possible approach here is so-called telemedicine, the application of which is currently being tested in a study at the Berlin Charité. The participating patients, for example, measure their blood pressure and heart rate at home and then transfer the data digitally to the hospital. If necessary, consultation with the responsible doctor can be held by telephone and the therapy or medication can be adapted. In case of emergency, an emergency doctor will be contacted directly. But this should not be the only change in medical care that patients can expect to see today.

General medical care at risk?
According to the GKV-Spitzenverband, significant changes in the medical landscape are preprogrammed especially in the field of general practitioners. Because today are „Around 40 percent of general practitioners work as family physicians“, but „At the same time, in 2012 only 11 percent of all specialist recognition in the field of general medicine took place.“ The general practitioner shortage of tomorrow is thus predetermined. Johann-Magnus v. Stackelberg stressed that „in Germany far too few family doctors trained“ become. Here would have „the Länder did not do a good job in university education and self-administration in organizing continuing education and in designing demand planning and licensing legislation.“ In his view, the training at the universities must in the future give basic primary care a central place in order to avoid a further escalation of the problem.

Less specialists, more general practitioners
The medical self-government should not only rely on more and more specialization, explained v. Stackelberg. Because „Well-trained generalists with a wealth of knowledge and experience are needed for outpatient care in the area“, the vice-chairman of the GKV-Spitzenverband continues. In addition, increasingly flexible offers for patient care are needed to ensure care, which is why the GKV-Spitzenverband „the promotion of branch practices and mobile practice offers, the use of temporary approvals, the possibility of converting admission into employment contracts with the KV (Kassenärztliche Vereinigung) and the establishment of KV practices“ call.

Worse care despite more and more doctors
In its latest press release, the GKV-Spitzenverband also announces a few swipe in the direction of the medical profession, which is provoking increased resentment at the National Association of Statutory Health Insurance Physicians (KBV). For example, Johann-Magnus v. Stackelberg that „We have more and more doctors who have been earning more and more money, and yet there are sometimes long waiting times for patients and, for the first time, a shortage of care in a few regions in primary care.“ In addition, be „clear hints“ to recognize it, „that the quality of the documented diagnoses is insufficient.“ For example, would be „On the basis of the diagnoses written down by the doctors, the number of diabetics has increased by eight percent per year“; whereas the data of the Robert Koch Institute (RKI) show that the increase was actually only about two percent. „It is completely unacceptable for diagnoses to be overstated in order to get more medical fees“, criticized the vice-chairman of the GKV-Spitzenverband.

Medical profession demands constructive contribution of the health insurance companies
Outgoing KBV Chairman, Dr. Ing. Andreas Köhler, explained in view of the statements of the GKV-Spitzenverbandes zur medizinische Versorgung in Deutschland, that „the problem of a lack of doctors in the society and in politics has arrived - but not at health insurance.“ The impending shortage of physicians must be understood as a challenge for the whole society, with the Kassenärztlichen associations in turn already very much, said Köhler. The municipalities are also „Often already doing an attractive location marketing for the establishment of medical practices.“ Moreover, it has long been a requirement of KBV, „that outpatient care must be introduced early to medical studies.“ The GKV Spitzenverband did not have much more here than „Plattitudes and mostly false claims to offer.“ Köhler called for the health insurance on, „finally to make a constructive contribution in order to provide the established physicians and psychotherapists with reliable conditions with fixed prices.“ (Fp)