2024-04-29 04:55:25
Patients are already feeling the shortage of doctors and nursing staff. Government advisors are calling for fundamental reforms. In fact, supply is likely to change noticeably in the future.
In the future, patients in Germany are likely to receive more outpatient care and video and telephone care so that the shortage of personnel in the healthcare system does not worsen. Today, according to a new report from the Expert Council for Health and Care, doctors and nursing staff are often deployed inefficiently. Health Minister Karl Lauterbach (SPD) warned in Berlin of a gap of 50,000 doctors alone in the next ten years.
Many doctors and nurses in Germany
Germany actually has “a relatively large number of skilled workers at work,” said Council Chairman Michael Hallek. In this country there are around 1.2 million people in nursing, around 700,000 in geriatric care, around 700,000 medical assistants and around 500,000 doctors. However, as the report highlights, more patients are treated in hospitals in Germany than in other industrialized countries.
Today, inpatient is often preferred over outpatient
The number of hospital occupancy days in Germany is among the highest in Europe – the reason: high case numbers and still long lengths of stay in the clinic. The medical results in Germany are no better, and life expectancy is no higher than elsewhere, said Hallek. According to the report, the high importance of inpatient care in Germany is not only due to the above-average number of older people with multiple illnesses, but also to the fact that clinics compensate for the “lack of care options in other areas”. Lauterbach: “There are already 5,000 general practitioners’ practices that are not occupied. This is clearly increasing.”
Doctor shortage – or not?
Lauterbach blamed a lack of preventive care for the absence of tens of thousands of doctors. “For the last ten years we have had a shortage of around 5,000 medical study places – that is, per year.” The shortage has so far been largely compensated for by an increasing number of foreign doctors. According to the German Medical Association, the number of doctors without German citizenship reached a new high last year at almost 64,000. But now Germany is increasingly competing with other countries, said Lauterbach. “This cannot continue like this.” Hallek, however, did not want to speak of a “dramatic shortage” among doctors; the popularity of medical studies was also high.
The situation threatens to get worse
But Lauterbach and the seven-member expert committee agree on the basic finding: the situation overall is in danger of getting worse. “We have to expect a significant shortage of skilled workers, which has not yet been adequately addressed,” said the minister. According to the experts, the general shortage of skilled workers and the aging of society are likely to mean that there are no more nurses, doctors and other health professionals, but the population’s need for care is increasing. Lauterbach said the number of skilled workers needed in nursing was much larger than the number of trained workers. With regard to the hospitals, he said: “We don’t have the doctors or nursing staff to keep the 1,720 locations online.”
Geriatric care is at a disadvantage in competition with clinics
The minister also described the number of skilled workers needed in nursing as being much larger than the number of trained workers. According to the German Patient Protection Foundation, old people’s homes and nursing services are falling behind in competition with clinics. Many care facilities can already only staff shifts minimally or not at all with skilled workers, said board member Eugen Brysch of the German Press Agency. It is questionable whether many fully qualified people will decide to care for the elderly after the standardization of nursing training. “After all, hospitals pay significantly more after you graduate. The working hours here are also more reliable.”
Experts call for an end to the waste of resources
“We are burning an awful lot of money,” criticized Hallek. Germany has one of the most expensive healthcare systems in the world, but skilled workers are overworked and patients are often not provided with optimal care. “As a democratic citizen, you can’t be satisfied,” said the Cologne medical professor. The researcher urgently warned: “We must start to stop wasting resources.” In the opinion of the Expert Council, patients should receive more outpatient care rather than inpatient care. The Hamburg researcher Jonas Schreyögg identified the goal of fewer occupancy days in hospitals as the key to improvements. Otherwise, so many doctors and nursing staff would be needed there that they would be missing altogether.
What should be done
Today, according to the experts, every second patient in an emergency room ends up as an inpatient in the hospital; internationally, that’s a lot. It just so happens that Lauterbach wants to launch his emergency reform “before the summer break,” as he announced. It stipulates that those seeking help over the phone or on site in the hospital are increasingly sent to a nearby practice. In the future, the emergency rooms are to be merged into new emergency centers, which will also include outpatient emergency services practices nearby.
According to the SPD politician, several laws should help in nursing to make the profession more attractive. For family doctors, among other things, the announced exemption from strict budgets should provide relief for treatment reimbursement. Digitalization should save doctors and nursing staff across the country time that is now spent on documentation. Telemedicine should be used more frequently. Prevention of strokes and heart attacks should be greatly expanded. And above all, Lauterbach referred to the planned major hospital reform: locations would be reduced and care would be concentrated.