Mindshifting: why GPs and specialists need to focus more on the quality of practice organisation

Data, facts and instruments on the German health system

What it’s all about

Patients judge poor organisation as incompetence of the practice team, because well-functioning processes are expected to the same extent as good medicine. But in reality, the expectation is disappointed.

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Digitisation of the medical practice: there will be no reduction in workload

What it’s all about

One positive aspect that is always expected in the context of digitalisation is the reduction of workload for doctors and medical assistants. But in the overall work balance, the activities that are eliminated by automation are offset by new work that is added.

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Medical assistants and initiative: the motivation exists

Facts and figures on the German health care system.

What it is about

If one compares the statements of practice owners and medical assistants in company comparison studies, one notices a high discrepancy with regard to the self-initiative and independent completion of tasks. Among the weaknesses of the work, the doctors cite that the assistants constantly need detailed instructions on what to do. The assistants, on the other hand, complain that they are constantly being told what to do and that there is no room for initiative and self-direction.

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Helpful and dangerous at the same time: Routines in everyday practice

Facts and figures on the German health care system.

What it is about

Routines are working methods within the practice management that help doctors and medical assistants to manage their tasks in a targeted and adequate way with the least possible effort in view of scarce resources. But in most practices they are more of a danger.

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Teamwork in the medical practice: The stumbling blocks

Facts and Figures from the German Health Care System

What it’s all about

Teamwork offers practice owners, staff and patients a multitude of advantages. However, only very few GP and specialist practices have „real“ teams. This article describes which problems of everyday practice lead to this from the perspective of medical assistants and which implications can be derived for practice management.

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General practitioners and specialists: restructuring case of practice management

Facts and figures on the German health care system.

What it’s all about

The Best Practice Standard defines all instruments, regulations and behavioural patterns that guarantee smoothly functioning practice work in every work situation and even under changing stresses. On the basis of comparisons of practice management operations and depending on the degree of implementation of this standard, a typology can be derived for doctors and their implementation of practice management.

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Scarcely noticed, but highly efficient: The walkway analysis

Facts and figures on the German health care system.

What it’s all about

Conducting walkway analysis is standard practice in many industries to increase work efficiency and productivity. In medical practices, it is not widely used. So far, for example, barely ten per cent of ophthalmologists have conducted such an analysis.

Tasks dominate routes

Walking distances are hardly taken into account in GP and specialist practices because the daily walking workload is not even actively perceived in view of the tasks and work involved. However, the spatial arrangement of the contact points and the coordination of work and the resulting walking distances have a significant influence on the time available and the workload that can be handled.

A case study

The distance between the material room of a practice and the reception is 36 metres. Each of the five medical assistants covers this distance 30 times a day and needs 45 seconds to do so. Calculated over all employees, the practice team spends 1.8 hours per day travelling between the two points of the practice. If, for example, the materials room is moved directly next to the reception area – if a corresponding option exists – this time is available for other work every day.

Simple to optimal paths

The implementation is uncomplicated and can be carried out quickly:


Each team member first creates a table with the following information:

  • Between which work locations does one move (e.g. reception – waiting room, waiting room – doctor’s office, etc.)?
  • How often is each route covered during the day (the frequency per hour is determined and this value is extrapolated to the working day).
  • How long are the individual routes?
  • How long does it take to cover each distance?

In addition, it can be helpful to draw the routes as lines on a floor plan of the practice („spaghetti diagram“).


The aim of the walking route table is to become aware of the established walking routes and to look for possibilities to shorten routes and times. First, each staff member can conduct a personal analysis:

  • Could ways be saved by changing the way work is organised?
  • Are there areas of the practice that people prefer to go to less? Why?


Afterwards, the walking route tables of all team members are placed next to each other and together they check which routes could be eliminated or shortened by reorganisation.

UP: Unlocking Potentials – Facts, figures and working aids from practice management company comparisons

The facts described in this series of articles come from cross-sectional and longitudinal analyses with the results from practice management company comparisons.

This is a validated analysis system that GPs and specialists can use to examine their entire operations – from planning, patient care, leadership, marketing and organisation to time and financial management – in terms of strengths, weaknesses, threats and opportunities.

The survey, which can be implemented without an on-site consultant, compares the individual working framework of a practice operation with the best practice standard. It includes all the instruments, regulations and behaviours necessary for a practice to function smoothly even under changing demands.

The use of this survey over the years shows that practice owners can identify and implement an average of forty previously unused performance reserves with its help and using only thirty minutes of working time. The system is available via the IFABS shop:

or via employees in the medical or pharmaceutical field service who offer the system in cooperation with us.