112th German Doctors' Conference: agreed on basic convictions
Heinz Stüwe Editor-in-Chief
Some delegates were noticeably unsettled. Finally, during the 112th German Medical Day, the headwind to the storm seemed to increase: Anmaend and The doctors' greed for money were headlines from newspaper comments. The statements from health insurers, employers and associations did not sound friendlier. Federal Minister of Health Ulla Schmidt (SPD) even went so far as to say that the ideas of the President of the German Medical Association (BK) regarding the prioritization of medical services were quite inhuman. This reaction only shows that sensitive point has been hit, was then discussed in the Plenary of the doctor's day correctly remarked. In fact, it was made clear by the top representatives of the medical profession and in decisions of principle of the representative assembly of the National Association of Statutory Health Insurance Physicians and the German Medical Association, why the medical profession is seething. An almost unlimited promise of benefits from politics and the financial resources in outpatient care are increasingly gaining ground, stated KBV CEO Dr. med. Andreas Khler firmly. And the President of the Medical Association, Prof. Dr. med. Jrg-Dietrich Hoppe emphasized: We doctors do not want any rationing or the cancellation of medical services, but we also do not want to be held responsible for the state-prescribed shortage. So far, politicians have often succeeded in dismissing the evil word rationing. Hopefully that will be more difficult for them in the future. They should be countered by the multitude of specific examples of secret rationing that came up in Mainz, from the hospital outpatient clinic designed for three doctors, which is regularly manned by only one doctor, to the health insurance scheme stipulating that the contract doctor should not pay more than 7 on average , May prescribe 23 euros per person in remedies. Critical commentators at the rztetag also explicitly admitted that the question of how much society is prepared to spend on health must be discussed. It threatens to be forgotten that the grand coalition has not kept its promise to put the financial basis of the statutory health insurance on future-proof basis. It was already postulated in the Ulm paper of 2008 that the specific rationing decision should not be made on the individual doctor, because this would undermine the patient's trust.Hoppe's proposal to establish ranking of indications, patient groups, care goals and procedures in societal consensus is intended to show possible way out of this dilemma without being able to remedy the deficiency himself. Despite all of Hoppe's assertions that no one should go untreated, the approach has been misunderstood, by some on purpose. Of course, there is still no closed concept for prioritizing medical services. But the discussion is necessary. It is already being used in science (accompanied by series in the German rzteblatt), it must now also reach politics. It must also be clarified how prioritization can be implemented in free health system. What is certain is that it cannot continue like this in the healthcare sector. The Mainz rztetag showed that. With gratifying unity, the BK and KBV have documented that the medical profession will continue to adhere to the principles of the independent profession and thus to common basic convictions in the future. This includes the commitment to self-government that deserves its name and that must therefore be given real scope for action again. The core element of the liberal profession is that no doctor, whether self-employed or employed, may be subject to instructions from non-doctors on medical issues. Patients must be able to rely on this for all problems. Only then will you maintain trust.