Germany has enough doctors – the reason for the shortage is quite different

Germany seems to have too little of many things – too few apartments, too few skilled workers, and too few doctors. At least that’s what people always say. And yet the number of doctors is growing steadily, reports the “Welt”. Since 1990, the number of doctors has increased by 65 percent.

And even if you put the numbers in relation to the population as a whole, there is no shortage. I am the opposite. A survey in 2020 found 4.5 doctors per 1,000 inhabitants – purely mathematically, more than one more doctor per 1,000 inhabitants than, for example, Canada or the United Kingdom.

Complaints are being made about seemingly endless waiting times, appointments that are available for months, and medical care that is generally unavailable. This may also be due in part to the fact that Germany is aging, and this alone is putting a strain on the system and the practices.

One in three doctors now only works part-time

However, there is another, simple explanation, according to the “Welt”. In 2009, only 3.8 percent of doctors worked part-time. Currently, the figure is 35.2 percent – ​​slightly more than one in three doctors.

Antonius Schneider, a general medicine and healthcare researcher from Munich, has calculated that the number of hours worked by ENT specialists, ophthalmologists and dermatologists has remained constant in the Free State, despite an increase in the number of doctors. For general practitioners, on the other hand, it has fallen. Only in individual cases, for psychotherapists and internists, has the increase in doctors ultimately led to an increase in full-time equivalents.

In other words: Because more doctors are working part-time, there are mathematically fewer full-time doctors in many areas, even though the sheer number of physicians continues to rise.

“Young doctors no longer see the point in working 60 to 80 hours a week like their bosses,” Schneider told “Welt”. In the 1990s, doctors had created jobs due to a glut of medical professionals. Today, young doctors know that they can simply change employers if their employers are not flexible enough.

Young doctors want a secure income instead of the risk of their own practice

When it comes to income, young doctors also prefer security, says Schneider. “If young family doctors have the choice between 180,000 euros gross for 50 hours of work with the risk of self-employment or 90,000 euros for 40 hours of employment, many will choose the latter.”

In general, many doctors would prefer not to open their own practice. “Freelance work is no longer as attractive,” explained health economist Stefan Greß from Fulda University to the “Welt” newspaper. “Young doctors want more planning security, less overtime and, ideally, no economic risk.”

Having your own practice is not such a big risk, Greß added: “Doctors may have to take out a large loan, but they have a guaranteed turnover because of the statutory insurance.” He has never seen a practice go bankrupt.

Elsewhere, fewer doctors work part-time – because childcare is better

Instead of forcing the sector to train more doctors, the sector had to respond to the changing demands of doctors. The trend towards part-time employment is irreversible, Hamburg professor of health care Jonas Schreyögg told the newspaper.

“We have enough doctors in Germany, even if you take into account those who work part-time,” said Schreyögg. Larger practice units in the outpatient sector could help, as could better childcare. “In France and Scandinavian countries, doctors also work part-time less often because there is comprehensive childcare for their children,” added Schreyögg.

Simply offering more places to study medicine, as Health Minister Karl Lauterbach (SPD) planned to do in the spring, would not have the desired effect, explained health services researcher Schneider. This is because young people are allowed to choose their specialization, with a foreseeable result: “As a result, we have many orthopedists and cardiologists, but there is still a shortage of general practitioners.”