Federal Health Minister Nina Warken (CDU) expects a planned primary care physician system to deliver better and faster medical care. At present, patients decide for themselves which doctor they visit, Warken said on Tuesday in Berlin. This leads to “an inefficient use of our limited resources” and in some cases long waiting times at practices. “We want to change that, and we will,” the minister announced.
The CDU/CSU and SPD had agreed in their coalition deal to introduce a so-called primary care physician system. Under this model, a general practitioner would generally become the first point of contact for health concerns. A specialist could only be consulted afterwards. The aim is to reduce the number of doctor visits and thereby lower costs.
On Tuesday, Warken spoke with representatives of medical associations and health insurers about the plans. As the health minister explained afterwards, patients will in future have three options for obtaining a specialist appointment. They may either visit their general practitioner, or receive an initial assessment by telephone or via digital means. Exceptions would apply to visits to ophthalmologists, gynaecologists, dentists and paediatricians, as well as for people with chronic illnesses.
The deputy chair of the National Association of Statutory Health Insurance Funds (GKV), Stefanie Stoff-Ahnis, emphasised the importance of digital elements in the planned reform. In addition to electronic initial assessment, there must also be electronic referrals and electronic appointment scheduling, she said. The goal is a “digital care pathway” for patients.
According to Warken, she intends to present draft legislation for the primary care system by summer. A cabinet decision should follow by the end of the year. The health minister expects the new system to show “its first effects” in 2028.
The German Association of General Practitioners welcomed “the starting signal for implementing a binding primary care physician system.” However, association president Markus Beier criticised in the Rheinische Post the idea of making digital initial assessment the first point of contact for patients. “Initial contact through the familiar GP practice must remain the gold standard in outpatient care,” he said.
The executive board of the Patient Protection Foundation, Eugen Brysch, also criticised the federal government’s focus on a “digitalisation offensive.” Warken, he said, provided no answer “to the question of how digitally inexperienced people are supposed to be included.” The minister must “not continue to ignore the practical perspective of elderly and care-dependent patients,” he added.
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