Medical Professionals Advocate for Enhanced Patient Decision-Making Rights

Health Care Renewal: GP's Plea for More Patient Empowerment and Streamlined Care

Medical Professionals Advocate for Increased Patient Autonomy - Medical Professionals Advocate for Enhanced Patient Oversight

The Association of Statutory Health Insurance Physicians in Rhineland-Palatinate has called for a swift financial reform, simplification, and de-bureaucratization of the healthcare system, as well as increased patient accountability and improved patient care. "Our ailing healthcare system direly needs a boost," said deputy chairman Andreas Bartels in an interview with the German Press Agency in Mainz. Otherwise, it's teetering on the brink of collapse.

KV urges urgency

"We've been delayed at the red light long enough," said Bartels, reflecting on the last federal government. The new health minister, Nina Warken (CDU), faces immense pressure, stated Bartels, highlighting the myriad issues that desperately need to be addressed quickly. Some changes, like the emergency care reform, are largely ready and just await execution.

"A revitalization in ambulatory care is a necessity," Bartels insisted. "The funds are already in the system." Integrating hospitals into ambulatory care isn't the solution, he said, pointing out that it's a misuse of funds. "We're funding a system that won't meet the ambulatory care needs that independent physicians like myself can readily provide."

Budgetary constraints, planning, and excessive bureaucracy for independent physicians should be abolished, Bartels argued, being a specialist in anesthesiology. "Right now, a patient might have to wait half a year for a gastroscopy appointment in Rhineland-Palatinate, but we have at least 10 to 15 large practices that would gladly hire additional physicians. However, this isn't possible due to needs planning and supposed over-supply."

A shift in resources would be beneficial

Bartels criticized the state government's plans for regional clinics, asserting, "If hospitals are replaced by regional clinics providing ambulatory services, no doctor would settle there." Because then, he'd face a competitive disadvantage, as the structures and equipment provided by hospitals would be funded publicly, yet he'd have to pay for them privately. The focus on hospitals is also misguided, particularly in times of new, costly treatment methods, such as individual cancer therapy.

Patients should be financially investedInstead of embracing the "full coverage or flat-rate mentality" some patients have, more financial responsibility and co-payment should be incentivized, Bartels argued. One percent additional co-payment of the gross income for each service, except for preventive care, seems reasonable to him. He also favors the SPD's proposal to raise the contribution assessment limit. "Better-off individuals should contribute more," Bartels emphasized.

Health education should be emphasized to decrease unnecessary doctor-patient contacts, as patient uncertainty has escalated. For instance, parents often visit pediatricians for each cough and cold, partly due to the need for certificates for school, kindergarten, and workplaces.

Reintroducing waiting days for employees could also be considered.

Appointment scheduling through 116 117 has improved significantly and can manage urgency, even using AI and telemedicine. However, it only offers appointments for the next 35 days. "Doctors don't provide enough appointments," Bartels contends. The reason: many patients book appointments but never show up. According to Bartels, each doctor should offer 25 appointments per quarter via 116 117, with health insurers covering this flat rate.

General practitioners acting as gatekeepers creates new hurdles

Bartels opposed controlling patient contacts through general practitioners as the gatekeepers, creating a fresh, expensive bottleneck. Currently, 223 out of 2,427 general practitioner positions are vacant, with the trend increasing. "Practices are already full."

A survey by the KV revealed that this would result in an average of 400 additional patients per year per general practitioner, who are currently visiting specialists without a referral. Regional differences are significant, with figures ranging from 180 to 900. Bartels estimated the cost of the gatekeeper function in these cases alone in Rhineland-Palatinate to be around 27 million euros per year.

In the broader German context, reforms and regulations impact the accessibility of healthcare, specifically for vulnerable populations like asylum seekers, who currently experience limited access to comprehensive care for the first 36 months. Changes in legislation can indirectly influence patient management practices in the region.

Additional Insights:

Rhineland-Palatinate is a significant hub for pharmaceutical and biotech companies, with significant investments from firms like AbbVie and Eli Lilly, expanding research and production facilities in the region. This underlines the region's strategic importance in medical innovation and biotech development, potentially contributing to future improvements in patient care and management through advanced medical technologies and treatments.* In the context of digital health, there are ongoing efforts to improve patient management, reduce doctor-patient contacts, and promote telemedicine and integrated care models, which could indirectly impact Rhineland-Palatinate’s health care system.
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