The president of the German Medical Association said that medical care in some parts of Germany is under acute pressure. Especially in parts of eastern Germany, there is a dramatic shortage of general practitioners, Jörg-Dietrich Hoppe told the Associated Press. Part of the problem is at the training level, he said. One in four people with degrees in medicine take jobs outside the field. About 5,000 hospital jobs for doctors are presently unfilled. "I fear that we are at the beginning of a downward spiral and that were heading toward waiting-list medicine," he said. He pointed to the Netherlands as an example of a country where the shortage of doctors is so serious that some residents travel to Germany to see a specialist instead of waiting for an appointment at home.