German government considers ending funding of marketing courses for doctors

BMJ 2012; 345 doi: (Published 07 August 2012) Cite this as: BMJ 2012;345:e5331
  1. Annette Tuffs
  1. 1Heidelberg

Germany’s Department of Trade and Industry has announced that it is considering withdrawing funding for courses that train doctors to sell so called individual health services, after wide criticism.

The individual health services most often promoted by doctors include various diagnostic and therapeutic procedures as well as counselling. Because they are not evidence based, they are not covered by statutory health insurance, and patients have to pay for them out of their own pockets. The most common services are screening tests for glaucoma and vaginal ultrasound check-ups for ovarian and uterine cancer. In 2010 patients in Germany spent an estimated €1.5bn (£1.2bn; $1.9bn) on these types of extra services.

The services have been widely criticised by doctors’ representatives, health insurance companies, and MPs from the opposition Social Democrat and Green Parties.

Health insurance companies have set up a web page listing all the services offered and providing extensive information for doctors and patients (

The Department of Trade and Industry had previously said that like other business people doctors should be able to apply for grants to go on business courses to learn how to market their services. Since 2011 the government has been funding doctors to enrol in about 50 courses, paying about €3000 for each.

Biggi Bender, health spokesman for the Green Party, said that the courses teach entrepreneurs “how to optimise sales strategies.”

Frank Ulrich Montgomery, president of the German Medical Association, said that doctors are not business people and that therefore these sales courses are unnecessary.

The German Association of Statutory Health Insurance Companies has asked the government to stop subsidising the courses. Johann Magnus von Stackelberg, the association’s president, said, “If doctors learn how to sell their services, the relationship to their patients suffers, and patients lose their trust in them.”

A spokesperson of the Department of Trade and Industry said, “Doctors are obliged to offer only medically indicated procedures to their patients” and that the department was therefore considering, in consultation with the health ministry, revising its decision to fund the courses.


Cite this as: BMJ 2012;345:e5331

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