Family doctor’s practices groan under strain: “We won’t be able to do everything anymore”

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The co-existence of snow puddles and at least one person coughing, sniffling or sneezing on public transport is currently as guaranteed as Christmas Eve in 19 days – that’s how much winter weather and cold season have Germany under control. According to current information from the Robert Koch Institute (RKI), 7.4 million people suffer from respiratory diseases. But how do general practitioners’ practices cope with the disease?

Compared to the years before the corona pandemic, activity in respiratory infections is “very high”

“As every year, as the temperature drops, the number of infections in our practices increases significantly,” says Nicola Buhlinger-Göpfarth, federal chairwoman of the Association of General Practitioners, when asked by FOCUS online. “Our impression is that there is currently very high activity in respiratory diseases, especially compared to the pre-pandemic years,” says the professor. In addition to an increase in typical colds, such as rhinoviruses, family doctors are also observing a relatively high number of Covid-19 cases.

However, Buhlinger-Göpfarth refuses to talk about a silent pandemic. “In my opinion, a comparison with pandemic times is inappropriate, even if the current figures should of course be a warning signal for all of us to behave carefully towards ourselves and others,” she says. In the course of the pandemic, many people have built up a certain level of immune protection, be it through vaccination, infection or both. This would mean that the majority of corona illnesses would be much milder than they were a few years ago.

The number of infections is no longer so important. “They are also not very meaningful, as testing and reporting are no longer carried out to the same extent as during the pandemic,” says the general practitioner.

More and more patients, less and less time

If respiratory diseases were the only everyday challenge, practices would be challenged. “But there is no reason to worry,” says Buhlinger-Göpfarth. However, a number of factors would place an enormous burden on general practitioners.

“More and more patient concerns have to be distributed over less and less time as a general practitioner. Incorrect digitalization and the everyday bureaucratic madness are making the situation even more difficult, while at the same time costs are continuing to rise,” reports the general practitioner. “All of this is causing us increasing concern because in the long run we simply won’t be able to do everything.”

In view of the past cold season, which was also characterized by numerous respiratory diseases as well as two strong waves of RSV and flu and put an enormous strain on the practices, the family doctors sincerely hoped that the number of respiratory infections would not increase any further. “However, we are not very confident given the quite severe flu wave in Australia this year, which is mostly a harbinger for Europe,” says the chairwoman.

General practitioners call on high-risk patients to be vaccinated

On the one hand, the General Practitioners Association therefore appeals to high-risk patients to get vaccinated against influenza. Ideally, these people should contact their family doctors at the beginning of the cold season and check which vaccinations are still missing or should be refreshed.

In view of the very high activity of respiratory diseases, Buhlinger-Göpfarth advises older people and people with previous illnesses to “protect themselves as best as possible from the risk of infection, for example by

regular ventilation
washing your hands thoroughly
or even that Wearing a medical maske in crowded spaces.”

General practitioners’ association takes politicians to task

On the other hand, the association also holds politicians responsible for relieving the burden on general practitioners. “One measure that could quickly relieve the strain on our waiting rooms and the patients we know is the rapid reintroduction of the telephone AU [Arbeitsunfähigkeitsbescheinigung, Anm. d. Red.] “This has already been decided, but it can’t take weeks to come,” says Buhlinger-Göpfarth.

In fact, according to research by ARD, this step could be taken as early as this week. Accordingly, the topic should be on the agenda for the plenary session on December 7th. As Monika Lelgemann, chairwoman of the responsible committee of the Federal Joint Committee, told the broadcaster that the regulation could come into force immediately if approved by the Federal Committee. “That means it will be possible from December 7th,” she said.

General practitioners are calling for fee and medical study reforms

In addition to sick notes by telephone, long-term measures are also needed to support family doctors and stop the shortage of general practitioners.

This includes the “long-necessary fee reform,” says Buhlinger-Göpfarth. In view of the increased costs, general practitioners are demanding a double-digit increase in fees from the umbrella association of statutory health insurance in order to guarantee patient care. This is hardly possible given the current remuneration and working conditions. “We are heading towards a huge supply problem if the outpatient sector is cut short and becomes increasingly unattractive for young doctors,” said the chairman of the board of the National Association of Statutory Health Insurance Physicians (KBV), Andreas Gassen, to the “FAZ”.

A reform of medical studies is also necessary, emphasizes Buhlinger-Göpfarth. The federal government has been working on this for years. Among other things, it aims to address the shortage of family doctors, particularly in rural regions. As part of this, medical students will in future be expected to complete at least one quarter of their practical year in a family doctor’s practice. This is what the current reform draft provides for. The federal and state governments had already drawn up a basic framework six years ago. The reform has so far failed due to disputes over funding between the federal and state governments.