Health: Better conditions for family doctor practices in the cabinet

On-site care for patients, especially in general practitioners’ practices, should be more secure. This is the aim of the legislative plans from Health Minister Karl Lauterbach (SPD), which the Federal Cabinet is now supposed to initiate. Among other things, upper limits on remuneration should be eliminated and flat rates introduced in order to avoid overloads. The better working conditions are intended to help maintain the network of family doctor practices with a view to the coming wave of retirements. Lauterbach has excluded some aspects for the time being, but they will be brought up later.

Family doctors are usually the first point of contact for insured people and guides in the health system, according to the draft. “They are able to treat the majority of medical complaints competently and quickly.” They also help to reduce the use of more expensive structures such as emergency rooms in hospitals. The area should therefore become “financially more attractive in the long term” in order to meet the increasing need for young family doctors. Key points of the plans at a glance:

compensation

For general practitioners – as with pediatricians – usual upper limits on remuneration should be lifted. This means that they will definitely get paid for extra work, even if the budget is exhausted. The ministry estimates that this will result in additional costs for statutory health insurance companies in the “lower three-digit million range”.

New flat rates

There will also be an annual “flat rate” for practices to treat chronically ill people who constantly take medication. This is intended to avoid visits to the practice every quarter just to get prescriptions and create more freedom overall. Practices that meet certain criteria that have yet to be determined will receive a new “reserve fee” – for example for home and nursing home visits or opening hours including evenings and Saturdays.

The retirement wave

There has been no recent decline in the number of general practitioners. At the end of last year, according to the Federal Medical Register, there were 51,389, 75 more than at the end of 2022. Ten years earlier, however, there had been 52,262. And if more and more people retire, there is a risk of a shortage, especially in western Germany, warned the National Association of Statutory Health Insurance Physicians. Among general practitioners, the proportion of people over 60 is particularly high at 37 percent.

teenagers

According to the draft, psychotherapeutic offers for children and young people should also be improved. For this purpose, a new group of doctors should be formed to plan needs. This enables “more targeted control of branch options” for corresponding practices.

transparency

A digital information and comparison service is to be created for those with statutory health and nursing care insurance, as the draft states. Numbers on approvals, rejections and objections to certain health insurance benefits should be available there – but also on processing times and the quality of advice and support offers.

Medical care centers

It should become easier for municipalities to set up medical care centers (MVZ) in which doctors work under one roof – among other things, by easing the amount of security deposits required.

In the waiting line

In order to get the project going, Lauterbach has identified some points that were controversial within the coalition. However, they should be called upon again in parliamentary deliberations. These include “health kiosks”, i.e. easily accessible advice centers for treatment and prevention in areas with many socially disadvantaged people. Lauterbach also wants to campaign for an end to homeopathic services at health insurance costs. These were treatments that didn’t work, he argued. The health insurance companies shouldn’t pay for that either.