Dream job as pediatrician up for grabs: kronach district not attractive enough for young doctors

The joy in kups is coarse: the 8000 inhabitants coarse market community gets again a pediatrician. Beatrix wenzel moves from lichtenfels to kronach county and opens a practice in the center of town. No other message on the community’s own facebook homepage has received as much response as this one. "An insane profit for kups" and "i’m glad. Right now we’re going all the way to rodental" are only two of the enthusiastic comments.

The importance of a pediatrician’s practice in the local area is emphasized by kups mayor bernd rebhan: "we all know that specialists do not grow on trees – and doctors are an important factor for a location. This is a great enrichment for us."

It is the exception rather than the rule that a physician from outside the country is drawn to the tranquil district of kronach. But it happens. One of the two pediatricians in kronach is a living example of this: hans-dieter eisner got to know and love kronach almost 20 years ago. At that time, the upper palatinate native was offered the opportunity to take over the practice from a colleague, took it up – and has not regretted the step to this day. He proudly reports that he is a pediatrician: "this year, my practice will be in full operation. Kronach was a very good decision."

Two doctors for 10,000 patients

Together with his colleague, eisner is responsible for nearly 9500 children and adolescents in the district. According to the guidelines of the bavarian association of statutory health insurance physicians (KVB), a pediatrician in a so-called self-care area such as kronach should treat a maximum of 2,862 young patients – in mathematical terms, the 54-year-old has so far doubled this number. "In the meantime, we have a limited admission freeze here." this means that eisner accepts newborns and new patients, but not those whose parents just want to change doctors. "Whoever has a pediatrician should be satisfied."

Eisner does not have too little to do: he performs about 1,500 treatments per quarter in his practice. His pure practice time amounts to 35 hours a week. In addition, there are individual cases of home visits, training and emergency services – about 90 hours a year. "In the past, there were sometimes 24-hour shifts", eisner recalls. In the meantime, the shifts – sitting duties in the on-call practice and driving duties – are only ten hours long. "We also have drivers now, which makes things more relaxed." further he can hand over shifts to colleagues, who would like to earn something in addition.

In the event of a house call, eisner now also offers virtual consultation hours. Parents and their children can video chat with eisner via an app on their tablet or smartphone. "A handful of patients already use this option for minor complaints, such as a rash." especially at corona times, when some people avoid visiting the practice, the video consultation is a useful addition.

His job is never boring. Working with the children keeps them young, and the parents are all friendly. "Nevertheless, I always plan to close the practice at 6 p.M. And go home – and that usually works," he says, eisner tells with a smile. "I can only recommend the district of kronach to others."

Too little stuediaplatze

The experienced physician views the growing shortage of physicians in rural areas with concern. "I estimate that the situation will continue to worsen in the coming years."Only if more prospective doctors are admitted to medical school, eisner believes, will more doctors be drawn to the countryside. A rethink is already taking place at many universities. At the university in gottingen, it is now possible to study medicine without a high school diploma, provided that certain requirements are met, such as related training and several years of professional experience. Eisner himself – who began his medical career with an apprenticeship as a chemical laboratory technician – came to medical school via a second-chance education.

The KVB’s outdated needs figures have also come in for criticism in the past, which is why the guidelines for calculating them were changed last year (see below). Especially in the northern part of the county, the shoe is still on the block. The community of steinbach am wald has been trying for years to find a pediatrician – so far in vain. "There are simply too few doctors on the market." mayor thomas loffler leaves no stone unturned and recently even negotiated with a joint practice that already has two practices in hof and naila.

The idea was that a doctor could treat the children from steinbach and the surrounding area at least two days a week. "Steinbach and the surrounding communities have a combined population of 17,000", loffler recounts. "The equivalent of one doctor’s office. We are definitely not lacking in new blood."

But this hope has been dashed in the meantime. "The practice has cancelled us because they themselves do not have the capacity to send someone to steinbach." the prerequisites are there. "There are two properties available and we have created all the necessary conditions for a new pediatrician to feel at home in steinbach", promises loffler. "We also have a pharmacy that is doing well."

Even if the rejection letters are a bitch, steinbach’s mayor is not willing to give up and is now considering hiring a "headhunter – a kind of intermediary for physicians – to be called in. Eisner and his colleague from lichtenfels prove: miracles keep happening.

Rural doctor quota to ease situation – in twelve to 15 years…

The fact that there will soon be a third pediatrician in the district of kronach was an important step in the right direction. With only two pediatricians – both based in the county seat – the county was the worst in the state, with a coverage rate of less than 60 percent, according to statistics from the bavarian association of statutory health insurance physicians (KVB). The threat of undersupply. Now the care rate is close to 90 percent.

The reform makes the need in rural regions even more apparent. "But it’s not about what it looks like on paper already", makes adam hofstatter from the KVB clear. "According to the old guidelines, the district of kronach would have been finished with a third pediatrician. Now, however, there is the possibility of a fourth pediatrician settling in the area."

Bavaria has just introduced a quota for rural physicians. The new law will allow 114 high school graduates to study medicine even if they don’t have an A average – if they commit to practicing medicine in the region for at least ten years afterwards – a sign for hofstatter that the government has recognized the need for action. "However, the quota will not take effect for another twelve to fifteen years. Without wanting to get political, I believe that too much time has been allowed to pass." it is all the more important to make rural regions such as kronach better known to young doctors, for example through the health region plus program.

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