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Rapid Responses: Rapid Responses published:
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![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Relief Not For The Needy But For The Greedy
- Dr. Herbert H. Nehrlich (4 September 2008)
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Insurers also play a role in expensive German medicine
- Peter Mahaffey (5 September 2008)
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Dr. Herbert H. Nehrlich, Private Practice Bribie Island, Australia
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A number of my relatives, former classmates and acquaintances in the Fatherland are practicing physicians. None show any outward signs of being financially challenged, on the contrary, they all own beautiful homes and are enthusiastic supporters of the automakers located in Stuttgart, Ingolstadt and Munich. Several have visited us down under and most are conversant with African wildlife, having been on at least one safari in the past three years. It's a comfortable life and well it should be, after all, the years of school were exhausting and the hours in training were long. Still, with the current situation in the practice of medicine being what it is, namely a huge amount of waste, service duplication and overtreatment, it ought to be obvious to most in the business that a 10 % increase in remuneration for doctors is an unnecessary and even shameful act of greed. Yes, they all seem to be doing it and it may even reduce the number of gratuities from the Pharmaceutical Industry (though there is no guarantee)to individual practitioners but please! We have witnessed the death of humane medicine some years ago, we see and hear calls for more screening and for dispensing of drugs, we change the rules in order to make more money, we strive to achieve drug dependency in our patients, calling it compliance and we deny the existence of the phenomenon of a healthy person. Many of us have become little dictators, we no longer advise, we order. And we demand, from our patients and from the system. We keep throwing ever more money into the Sickness Industry and we act as if we were making great progress. Little wonder that the men and women in their white starched coats want a bigger slice of the pie. I guess it beats stress leave (though it has been shown numerous times that fewer people die when doctors strike). Competing interests: None declared |
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Peter Mahaffey, surgeon bedford mk42 9dj
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Dr Nehrlich, in his rapid response above, is being a trifle unfair in pillorying his fellow professionals in Germany. I wonder what salary he makes in sunny Australia? From first-hand experience of the German medical system, one of the major factors in high expenditure there is the almost complete absence of the kind of 'gatekeeping' system of good basic family practitioners which the UK enjoyed for 60 years and is now being smashed up by our Labour Government. In Britain, family doctors would decide whether a patient needed specialist investigations or consultation and then refer to the most respected or appropriate local consultant. Now of course that system, so immensely cost-effective, is breaking down, indeed has gone into reverse. GPs are being given financial incentives, under the 'practice- based commissioning' system, NOT to refer patients to hospital. That is leading to significant numbers of delayed diagnoses and poorer treatments in some cases. They are also being discouraged from referring to named consultants, producing yet poorer end-results. Conversely in Germany, the family based medical practice places few constraints on insured patients who wish to seek their own specialists (often the wrong ones)or to request their own expensive investigations. Inappropriate MRI scanning is rife. And the insurers seem perfectly happy to fund this profligacy. Its hardly fair to blame the German medical profession when German health insurers cant be bothered to encourage the kind of tight referral structure which served the UK well for so long and I believe still pertains in Australia. Competing interests: None declared |
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