Are german general practitioners and specialists masochists?

What it’s all about

Work overload, insufficient remuneration, non-functioning digitalisation, nonsensical health policy regulations and bureaucratisation dominate the complaints of doctors in private practice about their work. They convey the image of a profession that is suffering under its burden. However, a look at the reality of practice operations shows that this need not be the case, as numerous unused optimisation opportunities in practice management often remain unconsidered. This article examines the causes and consequences of this neglect and poses the provocative question of whether doctors in private practice may have masochistic tendencies.

Untapped potential: half of the best practice standard remains unutilised

The validated best practice guideline describes all regulations, instruments and behaviours that are essential in the areas of practice management, from planning, market research, organisation, management, patient care and marketing to controlling, to ensure that the work functions smoothly even under changing requirements. Benchmarking analyses of practice management in GPs and specialists show that on average 50% of these are not used. The negative consequences are felt by doctors, staff and patients on a daily basis

The analyses also show that many starting points for improvements are recognised by the staff and are also mentioned to the practice owners, but they do not react to them. Simple changes to processes or organisation could significantly increase efficiency and satisfaction.

Lack of organisational analysis: an unused key to improvement

Only a quarter of all doctors in private practice have so far carried out a fundamental organisational analysis of their practice. This figure is alarming, as productivity and working conditions could be sustainably improved in almost every practice by identifying deficits. Carrying out such analyses would not only improve work results, but also reduce the workload of doctors and their staff. However, despite these obvious benefits, change often does not occur even when problems are recognised.

Innovation barriers: Ideas are ignored

New ideas, especially those developed by medical assistants, have little chance of being implemented in medical practices. Professional idea meetings or systematic improvement suggestion systems are not in place in most practices. This leads to an inhibition of innovation and stagnation in practice development. The disregard for employees’ ideas and the lack of integration of these into everyday working life prevent potential improvements from being realised.

The vague answer to the “why?”

When asked why no changes are made despite recognised problems and existing solutions, doctors often give noncommittal, diffuse answers: there is no time, the ideas are not fully developed, a plan still needs to be drawn up, the consequences are not clear, etc. These excuses reflect a deep-rooted, neophobia-fuelled resistance to change.

Masochism or simply unwillingness?

The provocative question of whether there is a hint of masochism among doctors in private practice may seem exaggerated, but the ongoing refusal to implement necessary and known improvements points to paradoxical behaviour. This “refusal to change” not only has negative consequences for the doctors themselves, but also for their staff and patients.

Sadistic aspects of the refusal to change

For staff and patients, the rigid attitude of doctors often results in agonising situations. Staff who know how certain processes could be optimised experience frustration and demotivation when their suggestions are ignored. Patients suffer from longer waiting times and inefficient processes that could be improved by simple organisational changes.

Conclusion: The need for change

The inability or unwillingness of doctors to address known and actionable improvements in practice management has far-reaching negative consequences for all involved. There is an urgent need for doctors to rethink their attitude to change and actively utilise the potential that exists in their practices. Only through such change can workload be reduced, efficiency increased and staff and patient satisfaction enhanced. The provocative question about masochistic and sadistic tendencies should be seen as a wake-up call that emphasises the need for far-reaching changes in practice management.