Ensuring the current health insurance coverage Medical care and the threatened economization of medicine were the focus at this year's meeting of internists in Berlin.
The Professional Association of German Internists (BDI) has spoken out against practice closings in the ongoing fee dispute with the health insurance companies. "In order to enforce our legitimate demands, we should not do anything that is carried out on the back of the patient," said BDI President Dr. med. Wolfgang Wesiack at the 5th German Internist Day, which took place from September 27th to 29th in Berlin. There are also other forms of protest. The BDI is expressly behind the plan to question contract doctors and psychotherapists across the board about the security order (see “Köhler tears apart health insurance offer”). The doctors in the dispute are not primarily about fee increases, but about adequate financing of medical care. The care-oriented treatment of the sick is taking back seat anyway, criticized Wesiack. "In the meantime, economics dominates medicine."
Bonuses are immoral
From one The ongoing conflict between the well-being of the patient and the economic interests of the hospitals spoke to his colleague on the board, Prof. Dr. med. Petra-Maria Schumm-Draeger. In the meantime, target agreements for patient care about the number of cases, the length of stay and the severity of the disease are being set, which are more reminiscent of specifications from the industry. The more services must also be provided with fewer and fewer staff. "This situation is hostile to patients," said Schumm-Draeger. Older multimorbid patients can no longer be met under such conditions. She also heavily criticized bonus contracts to increase efficiency that are concluded with chief physicians. These are in stark contrast to adequate patient care. "The BDI rejects bonus contracts," explained Wesiack. “The medical professional code includes the fact that such contracts are immoral.” The BDI President appealed to the German Medical Association to advocate such change . There is an objective problem in general practitioner care. The number of general practitioners is steadily declining, while that of internists is steadily increasing. This is why GP care must be restructured. "We have to rethink the focus on general medicine," demanded the BDI President.
Ensuring the current health insurance coverage Medical care and the threatened economization of medicine were the focus at this year's meeting of internists in Berlin.
The Professional Association of German Internists (BDI) has spoken out against practice closings in the ongoing fee dispute with the health insurance companies. "In order to enforce our legitimate demands, we should not do anything that is carried out on the back of the patient," said BDI President Dr. med. Wolfgang Wesiack at the 5th German Internist Day, which took place from September 27th to 29th in Berlin. There are also other forms of protest. The BDI is expressly behind the plan to question contract doctors and psychotherapists across the board about the security order (see “Köhler tears apart health insurance offer”). The doctors in the dispute are not primarily about fee increases, but about adequate financing of medical care. The care-oriented treatment of the sick is taking back seat anyway, criticized Wesiack. "In the meantime, economics dominates medicine."
Bonuses are immoral
From one The ongoing conflict between the well-being of the patient and the economic interests of the hospitals spoke to his colleague on the board, Prof. Dr. med. Petra-Maria Schumm-Draeger. In the meantime, target agreements for patient care about the number of cases, the length of stay and the severity of the disease are being set, which are more reminiscent of specifications from the industry. The more services must also be provided with fewer and fewer staff. "This situation is hostile to patients," said Schumm-Draeger. Older multimorbid patients can no longer be met under such conditions. She also heavily criticized bonus contracts to increase efficiency that are concluded with chief physicians. These are in stark contrast to adequate patient care. "The BDI rejects bonus contracts," explained Wesiack. “The medical professional code includes the fact that such contracts are immoral.” The BDI President appealed to the German Medical Association to advocate such change . There is an objective problem in general practitioner care. The number of general practitioners is steadily declining, while that of internists is steadily increasing. This is why GP care must be restructured. "We have to rethink the focus on general medicine," demanded the BDI President."We internists have the next generation to ensure family doctor care."
The subject is sensitive one. For years there has been dispute between internists and general practitioners about who is the better family doctor. In order to be able to reintroduce the internist without focus in 2007 after short interruption, both specialist groups had negotiated laborious compromise that tied these general internists to the hospital. "We stand by the word," said Wesiack. "But since 2007 it has become apparent that general practitioners alone cannot guarantee general practitioner care." Therefore, the previous concept must be rethought and other specialist doctors close to the patient also involved.
It is also important to ensure comprehensive care in the reform of the requirements planning, which is currently being drawn up in the Federal Joint Committee (G-BA). In contrast to the fee negotiations, the National Association of Statutory Health Insurance Physicians (KBV) and the National Association of Statutory Health Insurance Funds work together well and constructively, as Henning Horst from the Association of Substitute Funds emphasized. KBV department head Dr. med. Bernhard Gibis is optimistic that the new guideline will be ready on December 31st.
Doctors distributed according to purchasing power
What is certain is that in the future planning will no longer be rigidly based on district boundaries, but will be narrower or broader depending on the specialization of specialist group. It is important for the internists that the G-BA has taken up their request and plans the specialist group as whole and not the individual priorities. How many doctors are required to provide adequate patient care, however, is matter of negotiation. Although there are legal requirements to take morbidity and demographics into account, there is no scientific data for the appropriate ratio of doctors to residents. "The question is how many doctors can we afford," Gibis explained. “On this point, however, we have great basic consensus with the health insurers.” The primary goal of the requirements planning is to ensure better distribution of doctors in the area. “Because today doctors are distributed according to purchasing power. Most of them are where they are least needed. “
Heike Korzilius
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