Doctors refuse to guarantee appointments within four weeks

The board of the Association of Statutory Health Insurance Physicians of Lower Saxony (KVN) has criticized the grand coalition's plans for a Deadline guarantee of four weeks rejected after a referral to a specialist. With the plan, the government wants to reorganize the referral process and reduce waiting times. Meanwhile, the KVN considers the endeavor "inappropriate and bureaucratic".

"Two-thirds of patients in Germany receive an appointment with an appropriate specialist within three days," Mark Barjenbruch, chairman of the board, said in a KVN statement. The association warned against useless bureaucratization, saying a Higher logistical effort is to be expected. An improvement in waiting times can only be achieved by moving away from budgeting.

Doctors in Germany are left sitting on their overtime. According to the KVN, 26.7 percent of all services in the specialist area were not reimbursed in 2013. In monetary terms, this amounted to more than 206 million euros. "In total, doctors and psychotherapists in Lower Saxony worked around 4.3 million hours without pay last year. That would correspond to a demand of about 2.400 additional panel doctor seats," says Barjenbruch.

"The demand for shorter waiting times against the background of these figures is unjustified. With limited remuneration, there can only be limited services. And this inevitably leads to longer waiting times," said KVN board chairman.

Health Minister Hermann Grohe already sees measurable success in the debate about shorter waiting times: "It is positive that the discussion about the appointment guarantee alone is moving a lot. In some regions, doctors have already set out to reduce the problem, by better practice management, cooperation in physician networks or own appointment service points, Grohe told the Rheinische Post in an interview.

The bill on the appointment guarantee would be presented before the end of the current year. The regulation would then come into force in 2015. The measures are to be implemented by the associations of SHI-accredited physicians. They should set up appointment service centers and work with health insurance companies.

The Service points patients with a referral to a specialist should get an appointment within a week – but no later than four weeks. If the doctors' service center is unable to arrange an appointment within the time limit, it would have to Offer appointment in a clinic.

Left-wing health expert Harald Weinberg sees the causes of the scheduling problems in the Imbalance between statutory and private insurance. "PKV needs at least twice the resources for medical treatment of its insureds compared to GKV," Weinberg said. It's no wonder "doctors are so happy to see privately insured patients that those with statutory insurance have to wait".

Accordingly, public health insurers would have to become more efficient. This is also the declared goal of the German government. According to the health minister, there is no disadvantage for privately insured patients: "I do not ame that improvements for patients with health insurance will be at the expense of privately insured patients."

Whether the waiting times of the patients can be reached alone by an optimized practice management of the physicians, may be doubted. The Costs and bureaucracy, The bill to establish service points puts prere on physicians and health insurers. With the emergency solution of a clinic appointment, the problem is also shifted from the waiting rooms of the specialist practices to the hospitals.

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