Opinion: German Doctors Feel the Pinch | Germany| News and in-depth reporting from Berlin and beyond | DW | 19.01.2006
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Opinion: German Doctors Feel the Pinch

A week of protest by German doctors frustrated by their working conditions culminated in a demonstration that saw thousands take to the streets on Wednesday. They were right to do so, says DW's Karl Zawadzky.


There's no relief in sight for Germany's frustrated doctors

The anger of doctors, whether they are employed by a hospital or have their own practice, is understandable. Assistant doctors and an increasing number of senior physicians in hospitals feel they're being exploited.

Workdays that routinely involve massive amounts of poorly paid or even unpaid overtime are simply unreasonable -- not to mention the danger it poses to patient's lives.

Hospital directors also feel victimized. The fact is, clinics are being confronted with enormous cost saving measures. If they can't make it with what little money they have, they face closure. Due to the pressure to save, the hospitals that remain have to make do with fewer beds. In some cases entire wards are being closed, and each year, the average length of time patients spend in hospital gets shorter.

Grim future

Ärzte Protestwoche in Deutschland

"The system is sick" reads this protestor's sign

Doctors who have their own practices are also suffering from the funding shortage. The days when opening a practice automatically ensured prosperity for doctors are long over. Today, the threat of bankruptcy hangs over many a private practice. Doctors still enjoy a certain standing in society, but the reality of daily life in hospitals and clinics is humbling, and future prospects are grim.

For this reason, more and more newly qualified doctors are leaving Germany to work in other European countries, or the United States, where working conditions are much better.

Doctors feel as if they're in the grip of a vise -- caught between the expectations of their patients and the cost-saving measures dictated to them by the government. It's a development that can only lead to the rationing of medical services. At the same time, the ministry of health makes promises to politicians and the public that doctors are frequently unable to fulfill. That's what's driving our doctors onto the streets.

Huge challenge

However it may seem to outsiders, the reality is that healthcare in Germany is not subject to political whim. Rather, the framework for the provision of care has changed dramatically for the worse. For many years now, employee contributions to health insurance funds have been dropping. Meanwhile, medical advances mean that people are living longer than ever -- something that is coupled with enormous costs. Add to this Germany's demographic shift: soon, the number of Germans of employment age will decline, relative to the number of senior citizens, which is going up. Health insurance funds with shrinking means will face increasing demand for services.

When it comes to healthcare, Germany -- in addition to many other industrialized nations -- faces a huge challenge. Dramatically rising expenditure levels are unavoidable if patients are to receive optimal care. And that means the cost of health insurance will also rise. The result is predictable -- patients will have to bear increasing costs for healthcare in the form of insurance contributions or co-payments for services. Or else, medical treatment will be rationed. It is the job of politicians to make the situation clear to the public. Doctors are right to protest when government makes promises that can't be borne out financially, or else come to bear on those people who work in the healthcare sector.

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