Navigating private practices is progressively complex for general practitioners

In the picturesque district of Bodensee, a severe doctor shortage is looming, with only twelve general practitioners serving a population of approximately 260,000. One practice that is feeling the strain is the family practice in Kluftern, a district of Friedrichshafen, which has been run by Drs. Florian Sattler and Marcus Schwandt since January 2020.

The practice, currently full and unable to take on new patients unless they live in the area, employs a total of six doctors, mostly working part-time. Dr. Ulrike Krauss, a doctor in training, is expected to stay on as a GP in Kluftern once she obtains her specialist degree in general medicine in the summer.

The district's shortage of pediatricians may further complicate matters. LeuMed, a managing director position for which has been advertised since January, includes two pediatricians who share the third health insurance seat, but there is only a special permit for this that has to be extended again and again. The Bodenseekreis is oversupplied with pediatricians, which may prevent the permit for the third pediatrician, Elisabeth Pfluger, from being granted by the Association of Statutory Health Insurance Physicians (KV).

A potential solution to this dilemma could be a cooperative that operates a medical care center (MVZ). The district health department has been trying to place this proposal with municipalities and doctors for months. The main advantage of this legal form is the low liability risk and the possibility of aligning the cooperative with the common good.

The practice owners, Sattler and Schwandt, are against expanding due to the need for more medical assistants, the overwhelming administrative burden, and the additional workload as bosses to 14 employees. The practice is already facing space constraints, making it difficult to accommodate more doctors and patients. If only two or three of them retire without a successor, around 3,000 to 4,500 patients will be without a family doctor.

The growing complexity and frustration of dealing with bureaucratic issues is a common complaint among doctors. They did not study medicine to fight bureaucratic monsters, as Sattler and Schwandt put it. The Lake Constance district is not alone in facing these challenges. Last year, 16 general practitioners were already in retirement age, and around a third of the general practitioners in the district are 60 years and older.

In neighboring Leutkirch, a town in the district of Ravensburg, a house doctor cooperative called LeuMed has already been established. The success of this model, already implemented at the Klinikum Friedrichshafen and by the amedes group in Wasserburg am Bodensee, offers interdisciplinary medical services. Other specific municipalities with MVZs similar to Leutkirch are not explicitly listed in the available sources, but the district health department is actively seeking solutions to the doctor shortage.

Navigating private practices is progressively complex for general practitioners