Thousands of German doctors’ offices and small clinics are staying shut this week — during a spike in COVID-19 and flu cases. General practitioners and specialists are protesting the government’s health policies, which they say are increasing costs, lowering earnings and burdening them with more and more bureaucracy.
Patients are urged to seek emergency medical care, as more than 20 doctors’ associations have joined the three-day strike. As 1 January is a public holiday in Germany, the consultations for maximum participation will not be open until 2 January.
“I don’t understand why there is a strike,” said Health Minister Karl Lauterbach, speaking with public broadcaster ZDF on Wednesday evening. “We have a huge wave of sickness in the population at the moment. The doctors’ demands for more money are also well-known — this strike doesn’t get us anywhere.”
That sentiment was echoed by Eugen Brysch, chairman of Deutsche Stiftung Patientenschutz, a foundation that advocates for the interests of patients. “Every profession can go on strike for its interests, but this strike is hitting the wrong people,” Brysch told DW.
“In rural areas in particular, the actions mainly affect the old and vulnerable. The doctors need to take their issues where they can actually change something — to the ministries, to Karl Lauterbach, or to the insurance companies.”
The associations that participated in the strike argued that the closure was aimed at protecting the long-term well-being of patients and called the existing action a “lesser evil. ” They argue that more and more practices are being forced to close their doors and that more and more doctors are retiring early than those applying for low salaries, basically as a result of the “budget” imposed on them by fitness insurers.
This budgetary measure, adopted in 1992, sets in the formula a budget for all types of fitness expenses, so that fitness insurers withhold their payments. Doctors’ associations, calling for the 1992 measure to be repealed, have claimed that if they spend more time with each patient and continue to treat other people beyond a certain budget, especially in crises such as pandemics, they will have to work for free.
“The situation in doctors’ offices has become very dramatic indeed because the limitation by budget means that many practices can’t afford to pay their specialist staff as much as they should,” said Dirk Heinrich, an ear-nose-throat specialist and chairman of the Virchowbund association, which is leading the campaign.
“At the same time, we are forced to reduce salaries because we don’t have enough money. This causes long waits and patients can’t find doctors who can treat them,” he told DW.
But the Health Ministry has shown little sign of giving in on this point, pointing out that doctors are relatively well-paid in Germany, compared with elsewhere in Europe.
“I don’t think it’s justified to ask for more money,” Lauterbach said, adding that a reform of the budget measure among general practitioners will be discussed. “There are other professions in the fitness system, such as healthcare workers, for which the desires are greater. “
Lauterbach is more receptive to the other main challenge doctors must solve: the burden of bureaucracy. Some doctors said they were so overwhelmed by bureaucracy filling out the fitness insurance budget that it didn’t make sense to open all the letters.
“De-bureaucratization is a justified call that has been fulfilled for years,” Lauterbach told ZDF. “For months we have been presenting a law to reduce bureaucracy. “
Lauterbach promised a summit with doctors in the new year to address their concerns, but cautioned that simply injecting more money into formula is not an option.
Despite the nearing communications, Heinrich insisted that the strike was necessary. “It also says that the disorders are all known; Well, I’m sorry, if they’re well known, why didn’t you do anything?” he said. “It helps to keep pronouncing something, and we communicate and communicate, but nothing happens. So we have to keep the pressure on. “
Germany’s non-hospital physical care formula is based on a network of general practitioners and specialists who run personal practices, but charge through fitness insurers, whether public or personal. This sets it apart from formulas in other European countries such as the UK, where the main physical care formula runs statewide and wait times for appointments are getting longer and longer.
Heinrich said the German system worked comparatively well, but said doctors at the front lines needed more support so that system can be maintained.
“It’s not that our formula doesn’t work: our German formula works very well,” he said. “We have very simple and fast access to general and specialized medicine, we have a dense network of specialized consultations. This is a must. ” It’s a feature of the German healthcare formula and we’re fighting for it. “
Edited by: Rina Goldenberg
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