Lack of doctors

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Lack of doctors describes a situation in the health system in which the demand for medical services exceeds a scarce supply . The opposite situation, in which more medical workers are offered on the labor market than in demand, is known as the medical glut . The situation can vary according to region and subject . For example, the ratio of resident doctors to residents in rural areas can be viewed as too low in terms of health policy . Bottlenecks in medical care can be a consequence of this relationship.

In January 2007 the Federal Employment Agency reported a shortage of doctors in Germany , Sweden , Norway , Denmark , Great Britain , France , the Netherlands , Ireland and the Slovak Republic . In 2002 there was talk of a shortage of doctors for the first time in Germany. In the Netherlands, however, the situation has now turned. Since 2014 there have been reports of increased unemployment (even among specialists).

Measurement problems

In most health systems, medical care is not organized through a market, but through insurance companies . This typically leads to moral hazard and thus to an increased demand for medical services, so that a demand that exceeds the supply cannot necessarily be interpreted as a "shortage".

Another problem is the international comparability of job profiles. In other health systems, part of the care provided by doctors in Germany is provided by academically trained nurses who are not counted as "doctors". That makes a comparison of the doctor densities difficult.

Situation in Germany

Development of the number of doctors in Germany

The relative number of doctors is not a sufficient criterion to define a lack of doctors. In an international comparison, the density of doctors in Germany is high with 4.1 resident doctors per 1000 inhabitants ( OECD average: 3.0). While in other countries a full-time equivalent is used for the calculation, these figures are missing for Germany. The number of doctors in Germany has been increasing continuously for several decades. According to the German Medical Association, there were 348,695 working doctors at the end of 2012, 1.9 percent more than in 2011. Since 2002, the number has increased by 15.8 percent. While 9,396 doctors were registered as unemployed in 1997, the number of unemployed doctors fell to 3,686 in 2007.

According to the judgment of the European Court of Justice (ECJ) brought about by the Kiel surgeon Norbert Jaeger, which confirmed the on-call duty of clinicians as working time, an additional demand of up to 27,000 doctors at the German Hospital Society and up to 15,000 doctors at the German Hospital Association was expected in 2003 Marburger Bund and the German Medical Association .

A study by the German Medical Association and the National Association of Statutory Health Insurance Physicians from 2010 shows the following aspects:

  • The average age of both contract and hospital doctors is rising steadily, while the total number of medical students and graduates is falling. After graduation, 12 percent of the graduates do not work curatively.
  • The growing proportion of women (33.6 percent in 1991 to 42.2 percent in 2009, 60 percent of medical students are now women) leads u. a. to fewer full-time positions, as women often deal more intensively with family tasks.
  • In Germany, many general practitioners can no longer find a successor; Many medical positions in rural areas, but also in large cities, can no longer be filled, with the new federal states being particularly affected. As a result, the German healthcare system is increasingly dependent on the recruitment of foreign doctors, especially from Eastern Europe and Austria. One attempt to solve this problem is the Rothenburg model .
  • Due to the demographic development of the population and the associated change in the morbidity spectrum and the expansion of multimorbidity, an increased number of doctors will be necessary in the future. Medical progress also leads to higher treatment costs and an increasing need for doctors.

The study comes to the conclusion that medical training needs to be more practical and the working conditions of doctors need to be made more attractive (in particular, appropriate remuneration, fewer regulations and less bureaucracy). The medical profession must be made more family-friendly, especially for women doctors, and more junior doctors have to be won over to the profession of family doctor. The Institut der Deutschen Wirtschaft , however, sees no shortage until 2025. The immigration of foreign doctors with at least 31,000 doctors trained abroad has an additional positive effect, so that more doctors continue to be trained than leave the profession.

In order to counteract a shortage of country doctors , the federal government wanted to increase the income of country doctors in a new 'supply law' in 2011 .

The law to strengthen health insurance coverage in June 2015 also addresses the shortage of doctors in rural areas, among other things. Doctors who set up a practice in the country can count on a subsidy from the Association of Statutory Health Insurance Physicians (KV).

Emigration of German doctors

Some of the young doctors are moving abroad from Germany; in 2010 a total of 17,000 doctors were working abroad. The emigration of doctors working in Germany was around 2,560 per year at the end of the 2000s. According to the German Medical Association , around 16,000 doctors emigrated between 2001 and 2008. More than 3000 doctors left Germany in 2008 while around 10,000 completed their medical studies in the same year. The balance of immigration and emigration remains strongly negative.

The working conditions and stress are often cited as the motivation for emigrating, as is the concentration of services resulting from cost pressure and bureaucracy and activities away from the patient.

Opposing positions

Health insurance companies such as the AOK assume that there is no shortage of doctors, only a spatial unequal distribution of doctors. This inequality is also confirmed by recruitment agencies specializing in doctors.

See also

Individual evidence

  1. ↑ Jürgen Malzahn, Christoph Stosch: Diagnosis lack of doctors: vacancies and increasing numbers of doctors. In: Deutsches Ärzteblatt . Volume 104, Issue 31–32, August 6, 2007 (online)
  2. ↑ German Medical Association : Statistics ( Memento of the original from December 5, 2011 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. , 2002. @1@ 2Template: Webachiv / IABot / www.bundesaerztekammer.de
  3. ^ Peter Ilg: Diagnosis of full employment. In: Monster.de , October 10, 2003.
  4. ↑ Eindelijk arts, heb je geen work. In: nrc.nl. Retrieved June 7, 2016 .
  5. ↑ OECD Health Data 2006 - Country Notes and press releases (online)
  6. ↑ Michael Bertschi: Investigation of medical care - final report. ( Memento of November 5, 2010 in the Internet Archive ) (PDF; 351 kB). Solothurn, October 27, 2005.
  7. ↑ There are more doctors in Germany than ever before. on: welt.de , July 8, 2013.
  8. ↑ ECJ, judgment of September 9, 2003, Az. C-151/02 Jaeger
  9. ↑ According to the judgment of the European Court of Justice, up to 27,000 additional doctors are needed / Judge: On-call duty is working time. There is a shortage of thousands of doctors in clinics. In: Berliner Zeitung . September 10, 2003 (online at: berliner-zeitung.de )
  10. ↑ Thomas Kopetsch: The German health system is running out of doctors! Study on the age structure and development of the number of doctors. 5th act. Edition. Berlin 2010, ISBN 978-3-00-030957-1 .
  11. ↑ Number of doctors study by BÄK and KBV: The gaps are getting bigger. In: Deutsches Ärzteblatt. 2010.
  12. ↑ The emergency is out for years. ( Memento from January 8, 2014 in the Internet Archive ) Institute of the German Economy Cologne.
  13. ↑ Country doctors should earn more. In: Rheinische Post. May 9, 2011.
  14. ↑ Supply Strengthening Act helps against the shortage of doctors. on: sueddeutsche.de , accessed on January 14, 2016.
  15. ^ P. Ilg: Escape abroad. In: time online. May 22, 2010.
  16. ^ Peter Ilg: Escape abroad. In: Zeit Online. May 22, 2010, accessed January 20, 2019 .
  17. ↑ Thomas Vitzthum: Why so many doctors are leaving Germany. In: world. October 25, 2007. Retrieved January 20, 2019 .
  18. ↑ AOK sees a glut of doctors instead of a shortage of doctors. (No longer available online.) Archived from the original on May 10, 2014 ; Retrieved April 21, 2014 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.aerzteblatt.de
  19. ↑ a doctor's agency talks about the current situation. Retrieved December 10, 2015 .

Web links

Wiktionary: medical shortage  - explanations of meanings, word origins, synonyms, translations