/ChiccoDodiFC, stock.adobe.com
Berlin – The bill to reform emergency care (Emergency Law) is receiving a lot of criticism from doctors. The project goes against efforts to make the health system more efficient by creating unnecessary dual structures in clinics and agencies and ignores the fact that the current shortage of doctors leaves less and less room for maneuver, warned the president of the Hartmann AssociationKlaus Reinhardt.
“The Minister of Health has just praised the Law on Strengthening Health Care (GVSG) as an instrument that will greatly increase the attractiveness – especially of family doctor work – in outpatient care. Including both telemedicine and emergency outpatient care in the specifications of 24/7 KVs, or suggesting that residents should engage in so-called cooperative practices, is definitely not an invitation to settle down,” Reinhardt emphasized. .
The need of the hour is to sensibly coordinate existing and increasingly scarce capabilities. This requires intelligent patient management that ensures people receive the best possible medical care in the appropriate location in the event of an emergency, even with limited resources, says Reinhardt. This is due not only to patients, but also to doctors who have been working “for a long time at their limit” in offices and clinics.
The president of the Hartmannbund is now waiting for members of the German Bundestag. It is now important to convince them that it is still necessary to make appropriate corrections to the law.
The board of the Lower Saxony Association of Statutory Health Insurance Physicians (KVN) also harshly criticized the bill. KVN board chairman Mark Barjenbruch called the bill “an inadequate reform proposal to the detriment of practicing doctors and statutory health insurance associations.” In principle, KVN supports a reorganization of emergency and acute care – but not in this way.
Thorsten Schmidt, vice-chairman of the KVN board, clearly rejected plans for an on-call outpatient service and telemedicine services seven days a week and 24 hours a day. “This will reduce the regular basic outpatient care provided by doctors and will not be affordable in terms of staffing.” system. There simply weren’t enough human resources to do this.
No regulation to the detriment of contracted doctors
KVN is also critical of the planned creation of an intensive care center, which will partially replace the well-known KVen consultation point at 116117 and will be in network with rescue control centers. “Close cooperation between the statutory health insurance on-call service and the country’s emergency services makes sense. “But it should not only aim to alleviate the burden on emergency services and inpatient structures in hospitals and therefore be done at the expense of statutory health insurance doctors,” warned Schmidt.
Exclusive control of citizens through integrated control centers is not realistic. “Patients go directly to the hospital emergency room and don’t first call control centers to be directed to a level of care,” says Schmidt.
The bill basically tries to regulate emergency care down to the smallest detail, down to the content of cooperation agreements. “It smells like state medicine that has to be administered by the KVs”, concludes Barjenbruch.
The proposed law stipulates higher requirements for the accessibility of 116117, according to the president of the board of the Central Institute of Statutory Health Care (Living room) Dominik von Stillfried, legal health insurers should only cover 50% of the indirect costs of the improved offer.
The legislator would thus “generate additional services for the insured community, but would only have half paid for” – because the remaining expenses would have to be covered by contributions from doctors contracted to KVen. Boss Zi criticized that something like this does not apply to emergency services or clinics. “This unequal treatment is met with a lack of understanding.”
Von Stillfried also highlighted that the 24/7 transport service and the expansion of home visits in the on-call service will quickly reach their limits in operating hours practice in times of staff shortages. Even if 116117 were used cautiously, a significant amount of additional staff would be required – in competition with practices, emergency services and hospitals. © aha/aerzteblatt.de