I'm a simple emigrant, but why is everything with praxis so complicated?

Recently wrote about medical practices. And now I'll share several reasons why, in my opinion, the system has come to what we have. Let's start with the general background. As I have written many times, the average age in the country keeps rising. And that means there are fewer sponsors for the healthcare system, while the number of active users is growing. In 2023, on average residents of Germany visited a doctor 10 times a year – one of the highest rates in Europe. At the same time, personally I haven't noticed any particular fondness among locals for visiting doctors just for the heck of it. Next. There is a critical shortage of doctors here. Although there are quite a few of them, almost 40% are near retirement age, so in the next three years up to 8,000 practices could close. And the younger generation isn't eager to fill these gaps; they prefer the prospect of working in pharma, biotech, and consulting. Those who do become doctors gladly take only part of the load: now in Germany only 85% of doctors work full-time. That is, nominally there are more than enough doctors, but in reality working hours are much less. At the same time, you can't simply open another 300 gynecology clinics: the number of clinics in each specialty is limited by law. Feel that? The number of clinics is capped at a maximum, but there aren't enough doctors inside. Well, people just come to chat in the waiting room, what else is there to do. Originally this was done so that there would be equal access to medicine across the country, and people wouldn't have to travel five days by dog sled and riding on a donkey to the nearest hospital. But, as in many places in Germany, the system lacks flexibility. The practices that still work and try to do this conscientiously are squeezed between bureaucracy and funding. In 2022, on average three hours a day were spent on administrative tasks, time that could have been spent with patients. But even if there were time, doctors wouldn't take everyone in, because insurers dictate how many patients there is budget for. In other words, an effective doctor who quickly and enthusiastically accepts patients beyond the limit shoots themselves in the foot and makes their work financially unprofitable. Recently, though, this system began to change, at least for therapists. Although I still wouldn't relax. For psychotherapists too, they've reformed the training. In short: officials changed the lengthy training of specialists, during which earning money was impossible. The new education system said: "Enough suffering! All postgraduate training should be well paid!". But you know what they forgot? To figure out where to get money for this feast. Seven years have passed, and poor specialists and poor patients still can't find each other. #Ordnung #useful