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Shortage of doctors: if nothing changes, clinics will also die

05/12/2022

Shortage of doctors in hospitals: If nothing changes, clinics will also die.
shortage of doctors in hospitals

Risks and side effects of a shortage of doctors?

"He was an impressive man in every way: tall and powerfully built, with a wild brown mane and a distinctive face. At over fifty years of age he was still an apparition with patients all over the world falling at his feet.” Medical novels in the genre of dime books describe senior male physicians in hospitals in this or a very similar way. Patience and care beyond any normal measure and never tired, ever, even after three appendix ruptures. No wonder that reality can hardly keep up here. Not only is there a lot being asked of doctors around the clock, the white coat in the hospital has also cracked for them. Germany's clinics are currently lacking around 15.000 doctors.

Career beyond the clinic

The hospitals are forced to save, inflexible working hours, increasing bureaucracy and time pressure in patient care are just some of the reasons why doctors are increasingly leaving the hospitals or not even applying there at all. The migration to the non-stationary sector or to countries where higher salaries are attractive, such as Switzerland, is striking. A brilliant career in the hospital at any price - that was once. The work-life balance, i.e. the compatibility of private life, family and work, has also become more important to doctors. Digital health providers (online advice) as well as pharmaceutical and industrial companies are increasingly valued as a more flexible and independent alternative to hospital operations. Others prefer the regulated service in a private clinic or an MVZ. After the end of their training, some go directly to a management consultancy and from there support private and statutory health insurance companies, associations and medical practices.

Not only numerus clausus bricks

And the shortage starts at the universities. Between 3.000 and 6.000 additional medical study places per year would have to be created in Germany just to maintain the current level of care (source: Central Institute for Statutory Health Insurance Physician Care, 2019). The numerus clausus is still a hurdle that leaves many young people who would be perfectly suited for the responsible medical profession behind in front of a wall. A reform of study admissions, as demanded by the German Medical Association, is long overdue.

All of this already has far-reaching consequences for the clinics. Just one example: If a specialist department can no longer produce a fixed job key to maintain a department, it is threatened with closure and the hospital loses a specialist area that is important for patient care in the region. It should be noted that the emigration does not only affect the medical profession. This can also be observed significantly in commercial positions. Here, too, the reasons lie in the high workload in the "agile hospital" and in more and more legal regulations and specifications that must be observed.

The HAGER Business Unit Life Sciences & Healthcare sees another phenomenon. In the clinics, fewer male and female senior physicians are striving for the position of chief physician or clinic manager, once the culmination of their career path. The civil law, personal liability of a chief physician has emerged as the main reason; a responsibility from which subordinate physicians are exempted in the event of damage.

“Many doctors are being lost to the clinics because the structures are too rigid. And they can earn twice as much in the pharmaceutical industry or in consulting.”

Obstacles for foreign doctors

The doctor shortage continues to worsen. Also outside of the hospitals: If nothing changes in the near future, according to a study, around 2035 general practitioner positions in Germany will be vacant by 11.000 and almost 40 percent of the districts will be underserved or threatened by underservicing (source: Robert Bosch Stiftung, 2021). There are a few solutions. However, their root must be to promote the next generation of doctors and to make the profession more attractive again.

This includes new roster regulations and fairer pay that does not favor individual departments. A key point would also be to remove the bureaucratic hurdles that foreign doctors (especially if they come from a non-EU country) encounter when they want to work in German clinics - and practices. The foreign doctors have to prove their German language skills with the specialist language test and have their qualifications recognized for the specialist admission. A sometimes years-long and time-consuming process that could be streamlined. Experience has shown that general German as well as medical terminology is learned quickly and the level of commitment is above average.

Without immigrant doctors - and medical professionals in general - and the corona pandemic has shown this as if under a magnifying glass, the health care system may be on the verge of collapse in the near future, and not just in the clinics. As of today: Already 56.000 doctors in Germany do not have German citizenship, that is 13,7 percent of the total number (source: Expert Council for Integration and Migration, Berlin, 2022). If you look at the demographic development, the German healthcare system would hardly be able to act without these specialists (also in the nursing professions).

Offer more options

So it is not only more efficient structures in the hospitals that can be used to counteract the shortage of doctors and thus a gap in supply. Many hospital doctors no longer want to work full-time, and they too should be given more options. And finally, medical novels have to reformulate: Patients do not want to “lie at the feet of the modern clinic doctor”, but rather find a competent and motivated contact person in him or her. The white coat is protective clothing and no longer a status symbol.

Do you need help recruiting doctors? Then contact the authors of the article Mr dr medical Markus Neumann, Business Unit Manager Life Sciences & Healthcare and Michaela Bender, Healthcare Manager.

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