Z Orthop Unfall 2019; 157(04): 434-439
DOI: 10.1055/a-0762-1139
Original Article/Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

An Opinion Survey of Orthopaedic and Traumatology Surgeons Working in Outpatient Care (Society, Laws and Patients)

Article in several languages: English | deutsch
Ehsan Omari
Institut für Arbeitsmedizin, Sozialmedizin und Umweltmedizin, Zentrum für Gesundheitswissenschaften, Klinikum der Goethe-Universität, Frankfurt am Main
,
Wolfgang Thoma
Institut für Arbeitsmedizin, Sozialmedizin und Umweltmedizin, Zentrum für Gesundheitswissenschaften, Klinikum der Goethe-Universität, Frankfurt am Main
,
Johannes Schulze
Institut für Arbeitsmedizin, Sozialmedizin und Umweltmedizin, Zentrum für Gesundheitswissenschaften, Klinikum der Goethe-Universität, Frankfurt am Main
› Author Affiliations
Further Information

Publication History

Publication Date:
27 November 2018 (eFirst)

Abstract

Background The German health care system is well accepted, but efficiency, costs and patient satisfaction are sometimes criticised. Opinions and models prevail, and empirical data are rarely presented, although quantitative data are a precondition to assess the acceptance of the health care system.

Method To determine the appraisal of the patient-doctor relationship, economic situation and cooperation with clinical institutions, a 37 item was developed where participants indicated their agreement with a statement on a four point Likert scale. This questionnaire was answered by 525 German orthopaedic and/or traumatology surgeons, representing 7.7% of all German specialists working in outpatient care.

Results 75% of all respondents felt challenged by demanding patients and a need for justification; what was less pronounced was the feeling of being exploited as physicians. Restrictions in medical treatment from budgeting expenses were seen by 74%. More than 90% considered that it was impossible to finance their medical practice expenses by conservative medical treatment only. The respondents felt similarly critical about the current cooperation with hospitals – only 19% were not interested in closer cooperation and 96% advocated higher fees for this cooperation. 74% confirmed that hospitals are taking over outpatient tasks, whereas only 35% agreed that more clinical patient care can be provided by outpatient providers, especially due to legal restrictions.

Discussion Practitioning orthopaedic and traumatology surgeons feel exploited by uninformed patients, misallocation of reimbursement funds and legal restrictions, as well as unilateral substitution of outpatient care by hospitals. They do not consider that the current structures are sustainable for long term patient care.