Primary Care System | General Practitioners to Manage Patient Referrals

In a significant healthcare reform proposal, the leadership of the Techniker Krankenkasse (TK) has expressed support for the upcoming plans of the coalition government consisting of the Union and SPD to establish a primary care system in Germany. The TK's chief highlighted the value of directing patients through their general practitioners (GPs) for specialist referrals, aiming to enhance the coordination within the healthcare system.

Currently, the process for accessing medical care can be disorganized, often leaving patients uncertain about which specialist to consult for their ailments. For instance, a patient experiencing headaches might consider seeing a neurologist, an ear, nose, and throat specialist, an eye doctor, an orthopedist, a psychiatrist, or their GP. This lack of clear guidance can lead to random and inefficient healthcare decisions.

The proposed reform emphasizes the need for GPs to play a pivotal role in evaluating patient needs and recommending appropriate specialists, which could lead to improved access and faster appointment scheduling for patients. However, concerns have been raised regarding potential delays in care as patients may first need to visit their GPs before getting referrals.

Eugen Brysch, from the German Foundation for Patient Protection, has voiced criticisms of this approach, suggesting that it could result in two waiting periods for patients: one for the GP appointment and another for the specialist visit. Additionally, there are challenges as many GP practices are unable to accept new patients, and numerous individuals lack an established general practitioner.

To address these issues, the TK has proposed implementing a mandatory digital initial assessment of medical concerns. This assessment could occur through various channels, including mobile applications, calls to the medical hotline 116 117, or directly at medical facilities. This initial evaluation would also help determine the urgency of the patient's condition.

The coalition's agreement outlines a commitment to introducing a binding primary care system, wherein primary care physicians would be tasked with determining the necessity for specialist referrals. The goal is to streamline the process, ultimately leading to enhanced patient care and a more efficient healthcare system.