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Contracts for Primary Physicians - Good Feedback, but Far from Perfect

Representative survey: Many German physicians have accepted the contracts for primary physicians, but tangible improvements are missing.

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Subtitle: Representative survey: Many German physicians have accepted the contracts for primary physicians, but tangible improvements are missing.

Koblenz (euro adhoc) - The primary physician´s position remains a popular topic in German healthcare policy. The contracts for primary physicians, which are expected to improve healthcare and reduce the bureaucratic barriers, are a particularly hot topic. That´s apparently what many primary physicians are hoping, because over half of all surveyed physicians (58%) have already enrolled in an HZV contract (primary physician-centered contract). Fifty-five % of the participating primary physicians are happy about positive changes - that´s a success. However, 59 % of the primary physicians surveyed are of the opinion that the primary physician-centered healthcare needs to be strengthened and they are opposed to the Federal Government´s planned fee limitations in the new contracts. More than one third of the surveyed physicians (36.6%) are even actively participating in protests against these austerity measures. That was the result of the monthly CGM health monitor, a representative survey of 440 randomly selected primary physicians, conducted by CompuGroup Medical, the Rhein-Zeitung and the Medical Tribune.

Dream job with disadvantages - primary physicians demand support

Most private practice primary physicians have a special work ethic - they are there for their patients past "normal" working hours and are even available at night and on weekends. This personal effort is surely appreciated at the human level, but the monetary reward offered by the state is insufficient. The Hausärzteverband (Association of Primary Physicians) criticizes that general practitioners in particular are still languishing at the lower third of medical pay and are at a disadvantage in light of the high workload. This situation is supposed to be mitigated through contracts that the physicians will execute directly with the health insurance companies. As the surveys demonstrated, the majority of primary physicians consider the contracts to be promising. Almost 6 out of every 10 physicians (58%) have enrolled and 42 % of physicians are adopting a restrained reaction so far.

The improvements can still be upgraded

The question whether physicians enrolled in an HZV contract are satisfied is probably best answered with yes and no. After all, improved healthcare was reported by 15.4% of those surveyed, 14.8% would like more contracts with more health insurance companies, and 17.7% even report that they are satisfied with the fees. However, 45% of participants did state that overall, not enough positive changes were made. There are probably many different reasons for this dissatisfaction and it is most likely also influenced by the various types of contracts that are currently offered. For example, physicians enrolled in rectification contracts pursuant to section 73b SGB V (German Social Code Book 5) are currently unhappy with the efforts required for the conversion. And with regard to the add-on contracts, the German Association of Primary Physicians has doubts that they will actually improve healthcare.    It is also possible that tedious bureaucracy plays a role in this: only 7.1% report that the HZV contracts have reduced this burden.

Skeptics want to be convinced

The relatively high percentage of dissatisfied colleagues bolsters critics of the contracts in their opinion that they made the right decision by not enrolling. Two thirds of the 185 people surveyed (67.5%) that are not enrolled in any primary physician contract decline it with the justification that they just aren´t convinced by the contract offered. The physicians that are not enrolled (13.5%) feel that they are better off in the health insurance system and they don´t want to give up that security. And 5.4% state that the HZV contracts available so far don´t apply to enough of their patients and they were not participating for that reason. An additional 8.1% might participate but they stress that no contracts are offered in their region.

Primary physicians are criticizing the Federal Government´s austerity measures

Despite partial skepticism, the surveyed primary physicians want to see the HZV contracts strengthened. Well over half (58.6%) feel that it is inappropriate for the Federal Government to limit pay rates in the new contracts. Of the 440 physicians surveyed, 28.8% "don´t care",  but that may be due to the fact that the planned limits at the basic care level do not affect the current contracts. Only 8% of the primary physicians surveyed show some insight into the austerity measures and feel that they are unavoidable in the current situation.

Many physicians are even taking to the streets

Many primary physicians are so outraged about the austerity policy planned by the Federal Health Minister, Dr. Philipp Rösler, that they are actively supporting protests against it. More than one third of the surveyed physicians (36.6%) personally participates and may even take to the streets with a placard. At least as many colleagues (36.8%) find the protests justified, even if their own medical practice is not directly affected. Only 20.5% do not want to be involved in the discussion and do not endorse the protests. If you add up all those numbers, it is obvious that with their protest against the Federal Government´s HZV plans, the German Association of Primary Physicians is acting in agreement with the mindset of right around three quarters of all primary physicians. The association perceives the entire German healthcare provided by primary physicians to be so endangered by the austerity measures that they have cancelled the opening ceremony for the Association´s 50th anniversary. The reason: there is no cause for celebration with the current HZV situation.

About CompuGroup Medical AG CompuGroup Medical is one of the leading e-health companies worldwide. Its software products, designed to support all medical and organizational activities in doctors´ offices and hospitals, its information services for all parties involved in the healthcare system and its web-based personal health records contribute towards safer and more efficient healthcare. The services of CompuGroup Medical are based on its unique customer base of around 370,000 doctors, dentists, hospitals and networks as well as other service providers. CompuGroup Medical is the e-Health company with one of the biggest coverage among e-health service providers worldwide. The company operates in 14 European countries as well as in Malaysia, Saudi Arabia, South Africa and in the USA and currently employs around 3,000 people.

The CGM GesundheitsMONITOR: The CGM GesundheitsMONITOR is a joint initiative of CompuGroup Medical, the Medical Tribune and the Rhein-Zeitung. They perform representative monthly surveys of 440 general practitioners with regard to current issues in the healthcare system. You can download free printable graphs and find publications as well as information about the representative survey at www.cgm-

About Medical Tribune: For over 40 years, the Medical Tribune has been one of the most widely read publications for private practice physicians. The popular weekly newspaper offers an attractive mix of medicine, health and professional policies relevant to private practice, and economic issues that apply to the medical profession. In a unique style, the Medical Tribune provides multi-faceted continued education, personal advice, and interesting reading material within a newspaper. The Medical Tribune´s success story has been documented by the independent readership review (LA-MED) for decades.

About Rhein-Zeitung: The Rhein-Zeitung area of circulation connects the metropolitan areas Köln-Bonn and the Rhein-Main region. The economically strong region around Koblenz is located in the center. With a circulation of right of 224,000 copies and 17 local issues, the Rhein-Zeitung has approximately 640,000 readers.

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