Lack of physician the condition of a health system is called, in which the need at medical workers exceeds the offer. This lack can extend to individual regions, individual sectors of the health system or the entire system.

One calls the contrary situation, in which for trained physicians no sufficient number from places stands to the order, physician oversupply.

The situation in the world

While in the industrial nations and developing countries the medical supply of the population is mostly constantly improved, the World Health Organization (WHO) before a substantial lack of physician warns in particular in Southeast Asia and Africa. The trend of a drift of physicians and medical personnel will itself intensified, in order to supply the aging population in the industrial nations.

The situation in Europe

Great Britain trains traditionally fewer physicians, than for the own health system are needed. The need gap is covered on the one hand with physicians from the European foreign country (in particular also from Germany), on the other hand with physicians from the Commonwealth OF nation. Critics criticize at home and abroad that development and developing countries along-finance the British health service over the costs of education for their physicians. Enticing the good clinical training in Great Britain and the relatively good payment for the young foreign physicians, which however high cost of living faces, are recognized.

Norway has difficulties for many years to find specialists for the sparsely populated regions in the north of the country. Therefore aimed physicians are enlisted also in Germany. The earning facilities in Norway are well, the work times very employee friendly.

Also from Sweden, Finland, Belgium and Australia on lack of physician one reports.

The situation in Germany

Hardly a politics policy is as disputed as the Gesundheitspolitk. Also the job market for physicians projection field of opposite interpretations of of the political parties as well as the actions is accordingly in the health service (minister of health, health insurance companies, physician chambers, cash-medical Federal union, hospital company, different representatives of the family doctors, specialists and hospital physicians (Marburger federation)).

While physician representatives postulate gladly a lack of physician, in order to be able to implement their demands better, the constantly rising expenditures in the health service increase the pressure to the physicians.

History

The occupation situation for physicians follows a pig cycle in Germany. An offer in excess at workers gave it last since the end of the 1970er to over the 1990er years outside. Highest unemployment of the physicians, with free worked guest physicians, 1997 was reached. Counter measures like the introduction physician in the practical course in the year 1988, took the pressure of the missing eligible for financingness of places for graduates of study. Simple clinical activities could be paid now, under the level for not-academic occupations. Alternative vocational fields outside of German hospitals were promoted. In addition a substantial dismantling of study places in the Humanmedizin led to the present situation. Fewer becoming study places increasingly by women were occupied. After the study and the birth of children step out some of it of the occupation of the physician in the hospital.

Job market: Full employment for physicians

The medical job market exhibits at present (2005) full employment. The unemployment ratio lies for physicians with approximately 2%. At present approx. 6,140 lady doctors and physicians are work-looking for as announced. Of it 80% (thus about 4,800 persons) are briefly unemployed (maximally three months). It remains medical base unemployment of approx. 1,200 lady doctors and physicians. As 3.000 to 6,000 one indicates to the number of free places alone in the hospitals and hospitals. It is disputed whether this need with the resting reserve is to be covered. However official unemployment was never very high also at times of the physician oversupply by the flexibility of many medical profession.

Indicators of a lack of physician

The following indicators are stated, which are to speak for a lack of physician:

• constantly increasing average age of the established house and specialists
• increasing portion of the established physicians over 60 years
• constant acceptance of the absolute and relative number of the lady doctors and physicians under 35 Lebensjahren (new generation indicator)
• sinking number of practicing family doctors in predominantly rural regions
• smaller entrance of young physicians with the physician chambers after conclusion of the study
• higher Abbrecherquoten in the medicine study
• rising number of medical immigrants from the Eastern European foreign country

Indicators against a lack of physician

The following indicators are stated, which are to speak against a lack of physician:

• The number of physicians rose continuously.
• Many places are not due to applicants lacking, but does not occupy by the administration.
• Most places for physicians are further limited, with the lasting from partial under one month.
• Dismantling of bedding and hospital capacities.
• Rising number of medical emigrants abroad European and non-European.
• Rising number of physicians, who move away into not-clinical fields.
• There are few countries with a as high physician density per inhabitant as Germany.
• Saving potential by EDP and not-medical personnel was so far used insufficiently.
• The potential of the reintegration of women with family was so far not exhausted.
• Each fifth physician registered again with the physician chambers is foreigner.

Causes of a lack of physician

Over the factors lying to reason and the necessary counter measures socially disagreement exists. The following explanations are to be found frequently:

The worsening economic perspective of the occupation of physician

Funds, with which medical Leistungserbringer (physicians, hospitals, pharmacist, Pharmaindustrie and further) was recompensed so far, are increasingly budgetiert. The administration becomes accordingly more so that funds in the health insurance company and administrative machinery are not steered and no more for the remuneration of medical activity and for the patient supply to be available. Running out contracts were not any longer again occupied. Andrea Fischer said as a health minister at that time that the rise of the expenditures in the health service with the rising number of the physicians correlates. Therefore a reduction is to be aimed at.

Many alternative occupation possibilities, moved in the time of the physician oversupply in consciousness, and and further for example by the Marburger federation were only promoted.

Also the long-term perspective changes. If one had the position of an upper physician or a Chefarztes in former times after the medical further training to the specialist with a career in the hospital before eyes, and/or the liberty of the established physician, then these positions increasingly more unattractively, in order to bear bad initial conditions.

For the established physician the increasing budgeting means that it carries the risk of a self-employed person, whom does not have economic success of its practice however any longer in the hand.

The increasing pressure of limited resources

The constantly rising expenditures in the health service lead to an increasing pressure on the Leistungserbringer. A postulated lack of physician can strengthen the negotiating position and the strike readiness of the physicians. With a lack of physician the possible loss of the current job is rather risked.

The switching of physicians abroad and into not-clinical ranges, promoted by the Marburger federation, leads just like the support of the European work time regulations to a shortage of the offer.

The increase of protests of the physicians stands in connection with an increasing publicising of a lack of physician.

Changes of the medical career profile

From changes of the account nature and introduction of new documentation obligations in the framework of Diagnosis Related Groups, Disease management programs and to quality control in practice and running of hospitals additional tasks resulted. From the helping occupation, which many first-year university students aim at, a less attractive administrative activity becomes increasing. The change to not-clinical fields becomes more attractive thereby.

The changing picture of the physician in the population

Parallel to it the social role of the physician changes. If he was traditionally aid, hope carrier, confidence and respect person, he is regarded in the meantime predominantly as "an offerer of services in the health service "and taken by "the customer "in recourse, if desired success (health, in addition, regulation of certain medicaments or rehablitation achievements) does not adjust itself. Beyond that it is taken by the health system in recourse, if it uses too many resources for its patients. Reports over malpractices or account fraud in individual cases are transferred pretty often to the profession as such.

Articles in category "Lack of physician"

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