Results of the German GfK Doctors’ Sentiment Index for H2/2008
The experience of general practitioners (GPs) in Germany with the innovations introduced into the healthcare system over the past two years or so is still doing nothing to improve the reputation of the healthcare reforms.
In particular, GPs are highly critical of the financial position of their own practices, which leaves them with very little scope for investment or savings.
These are the findings of the GfK Doctors’ Sentiment Index for the second half of 2008. The indicator value remains unchanged at -7 points.
The future expectations of GPs are, at present, even worse than their assessment of the current situation. The indicator stands at -16 points, which also signals no change from the first half of 2008. This shows that doctors do not perceive any positive trends for the further development of the German healthcare system.
It is particularly striking that all of the future indicators of the GfK Doctors’ Sentiment Index forecast negative development, despite the fact that the key provisions of the new healthcare reforms came into force on April 1, 2007. This suggests that GPs do not trust the reforms to get to grips with the problems of the German health system on a lasting basis.
Prevailing mood is negative in almost all areas
Overall, the opinion of GPs on the situation of German healthcare remains negative.
They assess the quality of medical care in Germany as good for the current period, but rate the treatment opportunities for patients insured under the health service, doctors’ working conditions and the general conditions in the healthcare system as poor to very poor. GPs even assume that the situation will deteriorate further in the future.
Problematic financial position
The financial position of GPs’ own practices is perceived as particularly problematic. Although 15% of doctors assessed the situation as good to very good, approximately one third of the GPs surveyed viewed the financial position of their practice as poor to very poor.
This overall picture reveals no change from the first half of 2008. However, the values are down on those for the previous year and this is also reflected in the propensity to invest. 57% of the doctors aged under 45 admitted that they had not invested in the practice during the survey period. This figure is 58% for the doctors aged between 45 and 55, and as high as 77% for those older than 55.
The poor financial position is also evident in the area of staffing. 80% of the doctors answered "no” when asked whether they had employed additional staff in the past six months, and 7% had even had to make job cuts.
With a total of 90% of doctors stating they were not intending to create new positions, and 13% saying it was likely or very likely that they would have to make people redundant, this is set to remain the case in the future.
The same applies to trainees: a total of 84% of surveyed doctors had not employed any trainees in the past six months, and 7% were unable to take on a trainee at the end of his or her training period.
In the coming six months, 89% of the doctors surveyed said they would not take on a trainee and 6% already knew that they would not be able to employ their trainee at the end of the training period.
In view of this situation, it is unsurprising that doctors are also taking a very pessimistic view of the future development of the overall indicator for the economic situation. At -17 points, this value has declined compared with the last survey and also with the previous year.
Patients dissatisfied with healthcare policy
GPs continue to perceive a high level of dissatisfaction among their patients. Patient displeasure has even increased somewhat compared with the previous year, and the doctors are assuming that this will not change in the near future.
Concerning the question of how satisfied their patients are with the benefits of statutory health insurance, GPs believe that around 80% are reasonably satisfied.
However, the issue of how satisfied patients are with the current healthcare policy is a different matter. According to GPs’ impressions, just under 40% of patients are not very satisfied or completely dissatisfied. In this respect too, nothing is likely to change in the foreseeable future. On the contrary: all the indicators of patient satisfaction are pointing downwards.
This trend is further exacerbated by the fact that more than 40% of patients feel that in principle, their doctors devote too little time to them. This also corresponds with the doctors’ complaint that the healthcare reforms have resulted in even more red tape, consequently leaving them with less time to treat their patients.
Being a doctor is no longer necessarily a dream job
One of the main elements of the doctors’ criticism of the healthcare reforms is the additional workload, which is viewed negatively given the already long weekly working hours. Almost half of doctors admit to working more than 55 hours per week.
It is therefore also no surprise that a career as a doctor is apparently losing its appeal. More than a third of the doctors answered "no” when asked whether they would currently recommend a career as a doctor to a young person.
These findings are extracts from the "GfK Doctors’ Sentiment Index” and are based on half-yearly online surveys of a current total of 467 general practitioners and physicians in Germany. The sentiment indicator developed by GfK HealthCare evaluates the German healthcare system from the doctors’ viewpoint.
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Nuremberg - May 2009