Berlin (dpa) – Overcrowded waiting rooms and admission stops for patients should become less common in general practitioner practices in the future. Federal Health Minister Karl Lauterbach (SPD) announced corresponding improvements before a crisis meeting with doctors and health insurance companies in Berlin.
“We will ensure that far fewer people have to come to the practice, that bureaucracy is reduced and that the practice will also become more attractive as a place to work,” said Lauterbach on ZDF’s “Morgenmagazin”.
Elimination of fee caps
To date, there has been an upper limit on the money that doctors receive for treating those with statutory health insurance. These budgets are intended to prevent costs from getting out of hand. The chairman of the Association of General Practitioners, Markus Beier, criticized that today general practitioners’ practices are not always paid for all services provided. Medical associations such as the Virchowbund complain that it often makes no economic sense to accept new patients because of budget constraints. “More patients trigger costs in the practice that the doctor has to finance out of his own pocket.”
Lauterbach announced: “We will de-budget to make this clear to the family doctors.” The traffic light coalition had already announced the step in the coalition agreement. The cap on payment that also existed for other groups of doctors had already been lifted for pediatricians last year.
“Debudgeting alone is not a magic formula for all problems,” said Eugen Brysch, board member of the German Patient Protection Foundation, to the German Press Agency. He calls for quality checks to be carried out among doctors in private practice in Germany. “Above all, patients need reliable and good outpatient medical care.” But quality and therapeutic success are not checked in the private sector. “The same money is paid for good and bad performance.” As a result, doctors would not benefit if they were particularly committed – for example by making many home visits. “This is where the system, which costs over 46 billion euros, suffers.”
By telephone for prescriptions and sick notes
Lauterbach said: “So far the practices are overcrowded because many patients come to the practice to have a prescription extended or to get a sick note.” This will soon be done by telephone from people known to the practice. “Then there will be far fewer patients in the practice.”
Prescriptions and certificates in paper form then do not have to be sent. Since the beginning of the year, practicing doctors have had to issue prescriptions for prescription drugs electronically – the e-prescription is stored on a central server and the pharmacy is authorized to retrieve it from there when the health card is inserted into a reader. Lauterbach admitted some teething problems, but said: “It will take a few weeks for things to settle down.”
Since the beginning of 2023, employers will no longer need to print out sick notes – the certificates will be accessed electronically directly from the employees’ health insurance companies. According to the National Association of Health Insurance Funds, employers accessed a total of almost 82 million certificates of incapacity for work electronically in 2023.
Further improvements for the practices
According to Lauterbach, insured people should also have to go to the practice less often because they no longer necessarily have to be billed for every quarter. “This logic that there is a quarterly certificate so that people can come to the practice, so that the doctor gets his money, so that the health card can be swiped, we will abolish that and make an annual flat rate,” said the politician.
“We will also allow a lot more telemedicine,” announced Lauterbach. In principle, telemedicine ranges from video calls to measuring devices for patients that the doctor has access to.
According to Lauterbach, “a torture for many practices” is the threat of recourse if too much medication is prescribed. Doctors are monitored and have to justify themselves to the health insurance companies and the Association of Statutory Health Insurance Physicians if they have prescribed more medication than intended – there is a risk of fines amounting to thousands of euros. Lauterbach announced that these drug recourses would be significantly reduced.
End of the protests?
Lauterbach does not want to comply with all doctors’ demands. The Virchow Association of practicing doctors once again called for the general lifting of the fee cap – even if this means that contributions increase. “Basic care is more than what family doctors do,” said association boss Dirk Heinrich on Deutschlandfunk. Otherwise, many older doctors would retire prematurely at the age of 62 or 63. “Of course, the health insurance contributions will then have to increase slightly,” admitted the doctor. Lauterbach responded to the demand that had already been made several times by saying that many of the services provided by specialists were not in the budget – so it was not true that they worked for free from a certain day in the quarter.
It remains to be seen whether the minister can generally satisfy the medical profession with his measures. Between the years, thousands of practices had closed after medical associations called for people to express their protest against health policy. On a bridge day in October, many doctor’s practices remained closed in protest.
The head of the General Practitioners Association, Beier, warned that it should not just be a matter of declarations of intent. Without concrete legislative steps in the coming weeks and months, the situation risks getting worse, he told the German Press Agency. “In concrete terms, this means that more and more patients can no longer find a family doctor’s practice that can still accept them, and at the same time the waiting times are becoming longer and longer.”
2024-01-09 15:47:28
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