A network of practices and clinics is important everywhere. But in some places there is already a shortage of doctors, and this is getting worse. Should patients therefore be guided more specifically through the system?
Medical President Klaus Reinhardt has warned of growing problems for health care due to a shortage of skilled workers. “The shortage of doctors is no longer a forecast, but has long been a reality in many regions of Germany,” said the head of the German Medical Association of the German Press Agency before the German Doctors’ Day in Mainz. Around 4,800 family doctor seats are unoccupied, and the shortage of staff in hospitals is similar. In addition, almost every fourth working doctor today is 60 years old or older. “So we’re facing a massive wave of retirements that will further exacerbate the problem.”
Reinhardt warned: “If politicians do not take these developments seriously, we will be heading towards a real supply crisis, with serious effects on almost all areas of society.” At the same time, the need for treatment is increasing due to the aging of society.
Doctors’ Day is looking for ways to achieve greater efficiency
The Doctors’ Day, which opens this Tuesday with Federal Health Minister Karl Lauterbach (SPD), is therefore also about ways in which capacities can be used more effectively. The focus is on stronger control – that is, guiding patients through treatments in a more targeted manner in order to avoid overload and unnecessary multiple examinations.
Lauterbach has already made it clear that in many rural areas and poorer districts it will not be possible to find a family doctor in the future. In order to secure on-site care, a planned law is intended to provide better working conditions so that more young doctors become family doctors. Among other things, upper limits on remuneration (budgets) should be eliminated for general practitioners.
Many family doctors over 60
For the first time in several years, there had recently been no decline in the number of general practitioners. At the end of last year, according to the Federal Medical Register, there were 51,389, 75 more than at the end of 2022. Ten years earlier, however, there were 52,262. And if more and more retire, there is a risk of a shortage of family doctors, especially in western Germany, explained the National Association of Statutory Health Insurance Physicians (KBV). Among general practitioners, the proportion of people over 60 is particularly high at 37 percent. KBV boss Andreas Gassen warned that due to too much bureaucracy, those in the area were in danger of becoming patients themselves.
Before the Doctors’ Day, Medical President Reinhardt is campaigning to tackle fundamental reforms. The German healthcare system, like few others, is characterized by barely controlled access and unstructured utilization. “That needs to change.” In fact, many patients sometimes look for contact points themselves – and then hope for an appointment. The goal must be to use resources in a coordinated and efficient manner so that they meet the need for treatment, said Reinhardt. Overall care costs would not be reduced, but the money could be used more specifically for the benefit of patients. Because unnecessary visits to the doctor would be eliminated.
Shorter waiting times as an incentive
“The right to freely choose a doctor must of course be preserved,” explained Reinhardt. However, insured persons should have the opportunity to bindingly choose a practice that will provide basic care and coordinate further treatments. Patients would then have to adhere to these “care pathways”. “For this to happen, commitment has to be worth it,” emphasized the medical president – for example through reliably short waiting times and smooth access to specialists.
Lauterbach has already spoken out in favor of breaking down boundaries between practices and clinics. “In order to make the system fit for the treatment of the baby boomer generation, we need to better coordinate outpatient and inpatient care.” In the medium term, a government commission proposed a “primary doctor system” made up of general practitioners, internists, pediatricians, gynecologists and psychiatrists. It could then also take over patient control through care.
