A debate has emerged over the right to choose one’s own doctor as Germany’s healthcare system is set to undergo reform. Andreas Gassen, the chairman of the Federal Association of Statutory Health Insurance Physicians, has spoken out against the government’s plans to introduce a binding primary care model. Under the new system, patients would typically be referred to specialists by their primary care physician only in cases of medical necessity.
Gassen told the Bild am Sonntag that if a binding primary care system were to be introduced, it would logically mean the end of the freedom to choose one’s own doctor. He added that he does not believe the government will implement the plan, as the majority of people value the freedom to choose their own doctor, according to many surveys.
Nicola Buhlinger-Göpfarth, co-chair of the Association of Family Doctors, countered that patients would still have the freedom to choose their primary care physician and specialist, but not the freedom to choose a specialist group without the primary care physician’s involvement.
Buhlinger-Göpfarth emphasized that despite a shortage of doctors, family doctors could handle more patients. She cited new figures from the Central Institute of the Statutory Health Insurance Physicians, stating that a binding primary care model would mean an additional two to five contacts per day for family practices. “We can show that patients in a primary care program are better cared for, especially those with chronic illnesses” she said.
Gassen believes a binding primary care model could be effective for certain patient groups, such as older, multimorbid patients who require a coordinating hand in the primary care setting and targeted referrals to specialists.
He did not propose a specific age limit for the model, but suggested that it could be relevant from around the age of 50, when many people have already developed health issues. As for patients who do not want to be involved in the healthcare system, Gassen did not rule out the possibility of co-payments, stating that people who do not engage with the healthcare system and instead seek the specialist of their choice might need to be considered for co-payments in the future.