Lack of time: A toxic mindset in outpatient medicine

Data, facts and instruments on the German health system

What it’s all about

One of the central problems of outpatient medicine is the persistence of toxic mindsets. One of these „toxic dogmas“ refers to the feeling of practice owners and medical assistants that they suffer from a chronic lack of time.

The scissors in the head

The impression of a mismatch between tasks and available time characterises the stress perception of many GPs and specialists and their staff. The feeling is cited as an aggravating circumstance in connection with all aspects of practice work, in recent years also specifically as an obstacle in the implementation of digitalisation. External influences such as bureaucracy, excessive patient demands or additional services such as transformation in the form of the TI projects are identified as reasons.

The big mistake

But the fact is that in GP and specialist practices it is not a lack of time but a time use problem that exists. The results of practice management benchmarking analyses show that even in businesses whose owners describe their work as problem-free and do not suffer from a lack of time, there are on average forty starting points for unused performance reserves in practice management, some of which lead to noticeable time freed up when activated. Basically, about one third of the working time in medical practices is used for unnecessary activities, which could be freed up by simple corrections.

Missing best practice alignment

A sense of stress and lack of focus depends crucially on the quality of practice management. It is defined by the best practice standard. It comprises all regulations, instruments and behavioural patterns that are indispensable for a practice that functions smoothly even under changing stresses. According to their own statements, doctors and medical assistants in practices characterised by a best practice implementation level of 80% or more hardly feel any stress. From a best practice realisation of 60% onwards, the stress level increases disproportionately. On average, however, practice teams do not implement just under half of the standard.

Time deficit due to lack of analysis

This best practice deficit is not recognised, however, because hardly any analyses of work efficiency or productivity take place in medical practices. This is all the more tragic as the amount of work required for a complete professional study of practice management on one’s own requires only thirty minutes of doctors‘ working time plus 20 minutes per MFA, supplemented by a patient survey. How this convenience approach works and what it achieves is described in detail in the publication: „Benchmarking practice management for general practitioners and specialists – method, application and benefits“. It is free of charge for GPs and specialists; the code needed for the free download can be requested by e-mail to, stating the practice address.