Experts Warn Eastern Germany in Dire Need of Doctors

In the tiny village of Beerfelde in the eastern German region of Brandenburg, 40 kilometers from Berlin, Dr Gerd Hohnstädter attends to eight-year-old Christine, suffering from a sore foot caused by a too-tight shoe. For almost four decades, Hohnstädter has been treating patients and dispensing medical advice in Beerfelde, home to 600 residents. Another year to go and then Hohnstädter who turns 65 next year can look forward to retiring and devoting time to his hobbies.

But, enjoying his hard-earned pension is the last thing on the doctor’s mind. He first needs to find a successor to fill in his shoes. That, as the doctor is discovering, is proving to be a huge problem. "For over a year, we’ve been looking through magazines, the Internet, insurance companies and all else that one usually does, but until now I’ve received no information that somebody is interested in the job," Hohnstädter told Deutsche Welle.

Dramatic lack of young doctors

It’s a problem that’s becoming all too familiar in Germany and was confirmed again this week when studies conducted by two leading medical associations revealed a serious shortage of young budding doctors in the medical field.

The surveys discovered that several jobs in hospitals could no longer be filled and that rural doctors, in particular, were wringing their hands in despair for successors. "The longer this downward trend lasts, the more difficult it will be, to plug the gaps that older doctors leave behind," Professor Dr Jörg-Dietrich Hoppe, President of the German Medical Association (BÄK) said this week.

The studies showed that between 1995 and 2002, the number of working doctors above the age of 59 rose by 58 percent, while at the same time the number of younger medical practitioners fell by 31 percent. In the year 2002, there were just about 17 percent of working doctors younger than 35.

Hoppe described the phenomenon as "alarming." "An increasing number of medical graduates decide against becoming a doctor and seek a more attractive professional alternative outside the realm of curative medicine, that promises a higher income and better working conditions," he added.

Eastern Germany running out of GPs

Dr Manfred Richter-Reichhelm, chairman of the Federal Association of Compulsory Health Insurance (KBV), said the situation was especially dramatic when it came to general practitioners (GPs), who made house calls.

According to the studies, by 2011, about 23,000 GPs are expected to retire in the country, in the former communist East Germany, almost a third of all GPs will vacate their posts in the coming years. "This development has to combated, otherwise home medical care in eastern Germany will be seriously threatened in the near future," Richter-Reichhelm stressed.

Dr Hohnstädter knows the situation all too well. Owing to high unemployment in the region, many young people in and around Beerfelde have been moving to the West, leaving behind older people, who are frequently ill. That in turn exacerbates the problem for German doctors like Hohnstädter, who are part of the public health insurance system. The health insurance funds allocate doctors a fixed sum, which they are supposed to phase out over a year. But if a doctor treats too many patients with frequent health problems and crosses the fixed budget, he may be forced to shell out money from his own pocket for some of the costs.

Medical experts in turn fear that a burgeoning number of elderly patients in rural regions, in the face of a shortage of family doctors in the area, might be forced in future to turn to expensive treatments in hospitals even for minor ailments.

Rural doctor an unattractive profession

In addition, rural medical practitioners are also expected to make home calls. Hohnstädter clocks up close to a 1000 kilometers in his car a month to attend to patients in emergency cases. He is also expected to regularly visit the surrounding villages and set up his practice for a fixed time as well as be available round the clock for his patients eight times a month. "It can be quite quiet when I’m on emergency mode. But at times, it can be hectic, you can consider yourself lucky if you can get to sleep the night through," Hohnstädter said.

Given the grueling routine that rural doctors in Germany keep, young people can hardly be blamed for turning their backs on the field. Add to it the ticking demographic time bomb, in the form of a rapidly graying population and one of the lowest birth rates in western Europe, and it’s not hard to understand that Germany has a serious problem on its hands.

Richter-Reichhelms said there was only one solution: "Doctors have to receive more practical training and their working conditions have to be made more attractive. That’s the only way young people will develop a renewed interest in the profession."