Health policy: Practices closed: Doctors protest against health policy

At the beginning of the week, many medical practices in Germany remained closed. On Bridge Day, practicing doctors gathered to protest against the federal government’s health policy.

At a central demonstration in Berlin, doctors symbolically placed their coats in front of the door of the Federal Ministry of Health to point out “that more and more practices will die if the planned austerity policy is implemented unchanged,” as it was said in a protest call. The actions were met with criticism from health insurance companies and patient advocates.

The Virchowbund, an association of practicing doctors, had called for closures and demonstrations with drastic words under the heading “Practice in Need”. People are “bleeding dry”, “starving” and more and more practices are closing without a successor. The association was initially unable to quantify how many practices across Germany took part in the protest because there was no precise feedback on participation. It was previously assumed that there would be a five-digit number of closed practices. Almost 20 medical associations and statutory health insurance associations joined the protests, as did pharmacies.

Closed practices “permanent across the country”?

The doctors criticize both short-term and “long-term undesirable developments”, as a spokeswoman for the Virchowbund said when asked: burdens caused by a lot of bureaucracy, for example when documenting treatments, increased energy costs, crashes and IT errors in digital applications such as e-prescriptions the e-patient records, which would be “forced” by the state, a lack of young talent and skilled workers. “As painful as it may be, the scenario of massively closed practices like today threatens to become a permanent situation throughout the country,” warned the head of the National Association of Statutory Health Insurance Physicians, Andreas Gassen, who showed understanding for the protests.

Virchowbund calls Lauterbach “Hospital Minister”

Specifically, these were directed against the health insurance companies and also directly against Health Minister Karl Lauterbach: the SPD politician was a “hospital minister”. “Billions in aid are being provided for clinics to combat the price explosion. There is no government aid for medical practices,” was the criticism. A constant annoyance from the practice owner’s perspective is the issue of budgeting. There are fixed amounts for treatments. The system was introduced in the mid-1990s to curb healthcare costs.

It is repeatedly criticized that the money is used up before the end of the quarter and that doctors therefore continue to work without being paid, for example when more patients arrive. In the coalition agreement, the traffic light coalition had decided to abolish budgeting in the family doctor sector. So far this has only happened in the area of ​​pediatricians. In Marburg, Lauterbach said on Monday that he also thinks this makes sense for family doctors.

Lauterbach counters with contribution rates

Lauterbach had already criticized the practice closures in advance: “Many practices close on Bridging Day; like the pharmacists, they also want more money. On average (median), after deducting all costs, they earn around 230,000 euros per year,” he wrote on the Internet. Platform X (formerly Twitter). And he asked – obviously meant to be rhetorical: “Should the contribution rate for employees increase so that the fee continues to rise?”

CSU health politician Stephan Pilsinger accused Lauterbach of “arrogant behavior”. Instead of doing something about the shortage of doctors, bureaucracy and underfunding, or at least seeking discussion, it escalates by accusing resident doctors of greed for money, Pilsinger told the Bavaria media group.

On average, a good 85,000 net for practice owners

The Virchowbund accused Lauterbach of not being able to calculate. The net income of a practice is not profit. The association gave other figures: On average, a doctor’s practice generates a surplus of 172,903 euros per year. After deducting taxes, pension plans, health and nursing care insurance, the net amount was 85,555 euros – 7,130 euros per month. “Taking into account the average working hours of practicing doctors in 2020, this results in a net hourly rate of 41 euros.”

Health insurance companies and patient advocates criticize closures

The practice closures were met with a lack of understanding by the statutory health insurance companies (GKV). “It was less than three weeks ago that the medical profession and health insurance companies agreed on a fee increase of 1.6 billion euros, which ultimately has to be paid for from the health insurance contributions of the insured people. And today these insured people are standing in front of closed doors as patients, because the medical associations now have even more extensive demands,” said the spokesman for the National Association of Statutory Health Insurance Funds, Florianz Lanz, to the dpa. The German Patient Protection Foundation also criticized the actions. “Every professional group can fight for better pay. But practice closures primarily affect sick and weak people,” said board member Eugen Brysch.