Doctors’ President Yvonne Gilli warns of a gap in healthcare: ‘Drama is on the horizon’

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SonntagsBlick: Ms. Gilli, in one sentence: What is troubling the healthcare system?
Yvonne Gilli: Because we talk too much about costs and too little about benefits.

People listen to priests and doctors. Talk!
You forgot the teachers on your list. This shows that it is never a single professional group that decides how to solve problems.

One of the problems is distribution: The density of specialist doctors is high in cities, and there is a lack of general practitioners in mountainous regions. From where?
Specialist doctors work in large clinics. And they are in cities. The infrastructure they need is there.

One reason for the shortage of GPs is probably that specialists earn much more.
It’s a legend. Four out of ten doctors who receive further training want to enter primary care, that is, to become a family doctor or pediatrician. This value has not changed in recent years. The reason why we have few family doctors is not because wages are low. Rather, it is the old Tarmed tariff structure. It has not been replaced since 2004. For example, the family medicine department is missing. That’s why primary care providers urgently rely on the new Tardoc tariff to reflect their work in a contemporary way.

Can new tariffs prevent cost increases?
The Federal Council’s requirement is that the system change must be implemented in a cost-neutral manner. So it shouldn’t be more expensive. Premiums cover one-third of the costs. And everyone, whether millionaire or factory worker, pays exactly the same amount. This is an issue we need to discuss: Single-parent or medium-sized families who cannot get premium reductions are being overburdened.

So the new tariffs only provide for redistribution? Shouldn’t the cake be made smaller?
We live in a privileged country where expensive treatments are affordable. I want us to continue to be prepared to fund this in the future. Again: let’s finally talk about the benefits! Healthy people can continue to work and are there for their children. This is also an economic benefit. I argue this: You cannot solve the problem by restricting costs, reducing services, or eliminating them altogether.

But this is exactly what the bourgeois parties demand.
I don’t want to have to have this discussion in Switzerland. We have one of the best healthcare systems. Elsewhere, as an elderly person with a knee problem, you have to wait months for an MRI. It is painful, psychologically stressful, and limits quality of life. It is important for households that have to make excessive payments to be relieved of the premium burden.

Do I sympathize with the SP initiative, which stipulates that a maximum of ten percent of family income should be spent on premiums?
I am speaking here as the President of the FMH. For us, the quality of healthcare is our focus. We are undisputed that heavily burdened households need compensation. We supported the indirect counter-proposal to the SP initiative, but we are open to different solutions. Patients should not have to give up important services for fear of not being able to pay for them.

Do you encounter such cases in your daily practice?
I experience this when looking at pregnant women. Although this treatment is no longer within the scope of the franchise, some women arrive for their first checkup too late. They are afraid of the bill. Even older people are usually very cost conscious. A woman suffering from severe vomiting and diarrhea came into the office shortly before dying of dehydration. This gives me something to think about.

Figures show that one in four doctors is over the age of 60. What’s going on right now?
A drama ensues. Baby boomers are approaching retirement age. We face the threat of a gap in healthcare. In the past, we trained very few doctors. If we decide to provide much more training now, it will still be another ten years before these people can actually practice their profession. Therefore, our aim should be to keep the difference as small as possible.

How can this be achieved?
First: Doctors who reach retirement age can work longer. Many are highly motivated to continue working until age 71 or 72; Being a doctor is their profession. But if general conditions continue to deteriorate, they will not take this step. Secondly, we must significantly increase the number of training places. If we do not do this, the shortage of family physicians will become even more evident. Third, we need modern working conditions for young doctors. Its requirements are extremely moderate: 46 hours per week.

As for the service catalog: Alternative medicine has no place in basic insurance, right?
This is an old suggestion that insurers continue to make. One thing is clear: Insurers want to offer this service as a business model in supplementary insurance! Of course, this is a legitimate interest. However, this does not change the fact that the public thinks completely differently. The demand for complementary medicine is great.

Scientific evidence is even smaller. Homeopathic beads have not yet been proven to work.
There are also serious studies that reach the opposite conclusion. I agree with you: We want more research, more data. This is basically what FMH is committed to. This is true for all disciplines, including complementary medicine.

For example, the electronic patient record (EPD) can provide this data. Why is the medical profession so vehemently opposed to this?
We need useful digitalization. EPD is a product that is not suitable for meaningful use of data. In its current form, it’s a library of PDFs: medication plans, doctor’s reports, lab results—it’s a complete mess. To use EPD effectively, standards and structured information that everyone can understand are needed.

A functioning EPD will help reduce costs.
This is a promise that has not been fulfilled in any country. However, it can reduce the administrative burden on doctors. Doctors spend two-thirds of their time in the hospital on activities that do not directly benefit patients. There is a shortage of skilled workers; We cannot afford to spend more time on office work than in a hospital bed.

Source :Blick