The German County Association (DLT) believes that the controversial government plans for a primary care system to manage patients in congested doctor’s practices do not go far enough. In an article in the “Neue Osnabrücker Zeitung” (NOZ), DLT President Achim Brötel called for the new federal government to consider even more radical measures. “In the future, fewer and fewer doctors will have to take care of more and more people. The new federal government should therefore have the courage to think about even further-reaching steps” he said. “Just from Scandinavia, we could learn a lot. I would even go so far as to question the doctor’s monopoly altogether.”
In Scandinavia, patients only see a doctor if the experienced nursing staff or medical assistant in the reception area cannot provide assistance on their own. “Why can’t we at least consider such a model in Germany?” asked Brötel. For example, during large cold waves, people sit in full waiting rooms and cough on each other while waiting for the doctor. “Isn’t that also the case when it’s just about a regular prescription? Couldn’t that be designed much more efficiently?” he asked in the “NOZ”.
Brötel reacted to the plans of the new federal government. In the coalition agreement of Union and SPD, it says: “In order to provide patients with targeted care and to speed up appointment bookings, we will rely on a binding primary care system with free choice of general practitioners and pediatricians.” Primary care physicians or the Kassenärztliche Vereinigungen-run hotline 116 117 should determine the medical need for a specialist appointment and set the necessary time frame (appointment guarantee).
The background is the very frequent doctor’s appointments in Germany compared to other countries. The Federal Chamber of Medicine and the statutory health insurance companies support the plan, while the Federal Association of Statutory Health Insurance Physicians and patient advocates have criticized it.
DLT President Brötel said: “The goal of using a primary care system to better manage patients is absolutely sensible and should be welcomed. The same goes for the suggestion of the Federal Chamber of Medicine to contribute to the cost if you insist on seeing a specialist against medical advice.” Such a discussion “is not pleasant, but we have to be honest.” However, Brötel questioned the negotiation mechanisms in the healthcare sector in general. Almost everyone calls for cross-sectoral care. “In the end, it fails because people are defending their fiefs and in the end it’s the patients who suffer” he said. “That’s why I would really like to see our healthcare system much more aligned with the actual needs of patients instead of the interests of the loudest lobby representatives.