The population is increasingly concerned about the quality of medical care. This is shown by a representative survey by the General Practitioners Association: 81 percent say that good general medical care has a decisive influence on the quality of life in their region.
This dissatisfaction also has an impact on basic political attitudes. 51 percent of citizens say that ensuring primary care has an impact on their voting decision - 14 percent more than two years ago. According to the survey, the future prospects are also bleak: a large majority expects a further deterioration as a result of the austerity laws passed in statutory health insurance.
62 percent expect longer waiting times. 60 percent fear that family doctors have less time for them. "People have long since recognized what is at stake and are increasingly concerned. We urgently need a signal from the federal government that politicians are supporting general practitioners' practices instead of continually shaving them," says Nicola Buhlinger-Göpfarth, co-federal chairwoman of the General Practitioners Association.
The community in Rhineland-Palatinate has become active itself
In the family doctor's practice in Monsheim in Rhineland-Palatinate, three doctors care for their patients. Unlike other rural doctors, however, they are not self-employed but are employed by the municipality. The community has been running the practice for two years, providing equipment, cleaning and staff contracts.
Exactly the tasks that prevented family doctor Verena Proissl from setting up her own practice. "Because everything depends on you when you're self-employed and you spend a lot of weekends or evenings organizing all the things," she says.
Black numbers, but no pressure to win
Proissl always wanted to work as a family doctor in the country. But running her own business with 60-hour weeks was never an option for her. And the costs of setting up her own practice also put her off, she says.
The mayor of Monsheim, Ralph Bothe (SPD), has also observed that many doctors prefer to work as employees rather than spend decades in debt with their own family practice. Despite the rural location of his community of 10,000 residents, it was no problem finding staff for the municipally run practice. Since then, two administrative employees have taken over the management.
Around 2,500 patients are now being treated in the practice. Last quarter the practice was in the black for the first time. Previously, the community had to make an advance payment of around half a million euros, for example to buy equipment and set up the practice. “Now it’s about working the investments back,” said Mayor Bothe. Of course the practice shouldn't make any losses, he says. "But then it's enough for us if we end up a little above zero."
More time for patients
Patients in particular benefit from this. Brigitte Glaser comes from nearby Worms. She knows how tense the situation is there and had been looking for a family doctor for a long time. That's why she's happy to have found a practice like the one in Monsheim. "The doctors take their time, they listen. You really feel well cared for."
Overall, the survey by the General Practitioners Association shows a clearly negative trend regarding patient satisfaction in recent years. 44 percent of those surveyed say that primary care in their region has recently deteriorated, according to the survey. There are big regional differences: In Bavaria, 40 percent complain about declining supplies, in Saxony-Anhalt 55 percent and in Saarland even 58 percent.
“For the people in our country, ensuring primary care is an absolute priority - which can also influence elections,” said Markus Blumenthal-Beier, co-federal chairman of the General Practitioners Association. "If 81 percent of people say that ensuring primary care has a decisive impact on the quality of life in their region, then it must stop acting as if primary care is a 'nice to have'."
General practitioners are pushing for legal reform
As a countermeasure, the association is therefore calling for changes to the so-called Contribution Rate Stabilization Act. The reform package was only approved in July. It is intended to slow down the rapidly increasing expenses of statutory health insurance (GKV) and stabilize the contributions of those insured. Increases in expenses for medical practices were also capped and special allowances were canceled.
However, many savings projects endanger supplies, especially in rural areas, according to the association. Family doctors say that this is particularly alarming given the survey results. The general practitioners' association sees ways to effectively save costs without restricting service to patients in reducing bureaucracy and documentation requirements. Specifically, some of the health insurance companies' testing procedures should be deleted.
