Status: 08/11/2022 11:02 a.m
Lack of staff, overtime, time pressure: A survey by the Marburger Bund doctors’ association shows the conditions under which doctors work in German hospitals. Many physicians have long since reached their breaking point.
By Isabelle Engler, rbb
Pediatrician, that has always been a dream job for Johannes Knierer. Helping the little patients, making them healthy, taking time for them. But the beautiful imagination of young medical students meets the harsh reality of the hospital in everyday life. And unfortunately it often looks very different.
Knierer works at the Wilhelmsstift Catholic Children’s Hospital in Hamburg. Even on a relatively quiet night shift in the emergency room, he doesn’t manage to take a break: “Of course we have a reduced staff at night. If two seizures come at once or a child is sick on the ward and a child is acute down in the emergency room If you need help, then of course sometimes it gets tight.”
Survey shows heavy workload
Many doctors feel the same way, according to a recent survey by the Marburger Bund medical association. Every two years, members are also asked about their workload. The results from 2022 make it clear the pressure doctors are under: 28 percent of the doctors surveyed rate their working conditions as bad or very bad.
57 percent, i.e. significantly more than half, stated that they work at least 49 hours a week. 66 percent assess the staffing in the medical service of their institution as rather bad to bad.
A pediatrician from a clinic in Dortmund describes the Team UPWARD editorial team of the ARD lunchtime magazine: “When we are so few, things sometimes go wrong. We have sometimes ordered the wrong chemo or ordered medication from the person next to us. If you ask doctors, everyone would say that something like this has happened before, because you constantly working under enormous pressure.”
As a result, every fourth respondent is considering a career change. Also because the doctors cannot take care of their patients as they would like. 57 percent stated that they had to calculate more than three hours a day for purely administrative activities, i.e. data collection and documentation.
Profit-oriented healthcare system
Behind this is a healthcare system that is profit-oriented: the DRG system (Diagnosis Related Groups system). According to this, hospitals receive money per diagnosis or treatment, regardless of the length of stay in the hospital – a so-called flat rate per case. For the hospitals to be profitable, this means that they have to treat as many patients as possible in a short time.
The DRG system was gradually introduced as mandatory for all clinics from 2004 under Federal Minister of Health Ulla Schmidt of the SPD. Her closest adviser at the time was Karl Lauterbach, who is now Minister of Health. The new system should make the hospitals work more efficiently.
But this has also led to overworked doctors protesting or even quitting their jobs. Frieder Hummes from the “Bunten Kitteln”, an association of doctors who opposes the DRG system, is therefore also calling for the abolition of the flat-rates per case: “In our opinion, flat-rates per case cannot be reformed. Since they were introduced, there have been constant reforms and discussions about what gets better, but everything gets worse.”
Does the government want to change anything?
Karl Lauterbach (SPD), who is responsible for the system, could take countermeasures as Federal Minister of Health. But when asked, his ministry said: “There is no financing system that is independent of case flat rates and that meets the requirements for performance-related, transparent remuneration for inpatient hospital services, so it is not possible to simply abolish the DRG system without having a suitable alternative is.”
Doctor Frieder Hummes from the “Bunten Kitteln” says that the health minister does not know what the situation in German hospitals actually is: “I would like to ask him whether he would still like to work in such a system or whether he is a patient would be treated in the hospital.”