Data, facts and instruments on the German health system
What it’s about
In the meantime, there is a multitude of proposals on how the problem of the shortage of medical specialists can be countered. They range from more appreciation and better pay to a general upgrading of the profession and the offer of a 4-day week. In contrast, there is hardly any talk about eliminating practice management insufficiency and about digitalisation. But practice owners have two acutely useful alternatives to solve their problem.
The other perspective
To manage a staff shortage, it is always worth asking the additional question of whether there are ways to reduce staffing requirements in such a way that patient care does not suffer.
For example, practice management comparisons show that one third of the work in medical practices is completely unnecessary. The staff are busy, but their activity is neither effective nor efficient or productive. This is problematic not only because of the waste of working time, but also because this effort is used to calculate staffing levels. Or to put it another way: in many practices the staffing level is too high.
This situation is a direct consequence of practice management insufficiency. i.e. the fact that in GP and specialist practices only half of the instruments, regulations and behaviour necessary for smoothly functioning work are used. Instead, work is often carried out with misadjustments in the workflow, which, as routines, have mostly characterised day-to-day business for many years without being checked.
Personnel replacement through synergy expansion
The practice management insufficiency in the area of personnel management means that there are hardly any “real” teams with synergistic-positive effects working in practice operations, but only groups. This means that people work together, but only within the limited personal framework that is given. Personal initiative or helping out with problems are rather rare. Moreover, cooperation is often characterised by unresolved conflicts. Although every medical assistant strives to do her job well, there is no sustained commitment to continuous improvement.
Professional leadership management and excellent working conditions help to retain good staff and to be attractive to new staff. However, related aspects such as training, appreciation, feedback and delegation in the sense of transferring responsibility instead of simply handing over work, are a major deficit in medical practices today.
Optimisation through benchmarking
The easiest way for practice owners to determine the status of their practice management and to optimise it on their own is to carry out a benchmarking exercise. All information on this is summarised in the publication “Benchmarking practice management for general practitioners and specialists – method, application and benefits”.
Technology helps too
The second strategy for dealing with the skills shortage is digitalisation. Consistently implemented, it leads to the fact that many time-consuming administrative tasks, for example at the reception, for anamnesis, on the phone or document management can be automated and done electronically, so that less staff is necessary as a result. This option affects the companies of the individual specialities quite differently. However, it must also be taken into account that in the future, the existing specialties may no longer exist in their current divisions, but that mixed forms will emerge.
As individual examples already show, consistent digitisation can reduce the need for skilled workers by about a third without any loss of quality.
R2049 