Bavaria's doctors want family doctor contracts again

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Bavaria's doctors want family doctor contracts again. The Bavarian Association of General Practitioners calls back the contracts already concluded in a statement.

A bitter dispute flared up between doctors and statutory health insurance companies at the end of last year. The General Practitioners Association threatened to exit the till system. As a result, a large number of health insurance companies terminated the contracts themselves. Now the general practitioners are asking for admission to the system again. It is still unclear whether most health insurance companies will get involved in a "deal" again. The small statutory health insurance for farmers and foresters (LKK) has already successfully completed the first negotiations. The cash register is given a pioneering role.

In the first negotiations about the return to the till system, Bavaria's general practitioners had a first success. The LKK (traditional cash register for farmers and foresters) intends to continue the family doctor contract retrospectively at the beginning of 2011. Another major health insurance association also wants to resume the contracts. Here, however, the contract should only apply for a limited period until the middle of the year, so that both sides are given the opportunity to negotiate again. Which cash register is involved is currently still unclear.

Family doctor contracts were terminated without notice At the end of last year, a large number of health insurance companies had terminated the doctor contracts without notice. This was preceded by a bitter dispute over the fee system, although the new contracts promised clear advantages for medical professionals. The Bavarian Family Association called in the course of the conflict to exit the till system. In a member survey, it was decided whether the doctors would jointly return the approval from the statutory health insurance. If 60 percent of the general practitioners surveyed had agreed to this, the system would have been phased out. Ultimately, in a member survey, there was no majority for the protest action proposed by the association. However, the health insurance companies had voluntarily terminated the general practitioner contracts without adhering to the deadline. The health insurance companies justified this step because the doctors had violated applicable law by announcing the return of the health insurance certificate. Here, the funds argued, the basis of the contracts had been blatantly violated. Although the family doctor association was ultimately unable to assert itself among its own members, the health insurers stuck to their resolute position. The consequences were sometimes very bitter for the doctors. The more than 7,000 Bavarian GP practices affected have to accept a loss in sales of around 10,000 euros per quarter.

Negotiations with the AOK started
The Bavarian General Local Health Insurance Fund (AOK) was responsible for the dispute on the part of the health insurers. The health insurance fund is the largest member of statutory health insurance in Bavaria and therefore has the greatest influence. According to the AOK, initially only negotiations with the general practitioners association had started. So far, concrete results have not been achieved.

According to the knowledge gained so far, the negotiations are likely to drag on even further. The Bavarian Medical Association urges that the contracts be concluded again on the legal basis as they were before the termination without notice. At least some of these corresponded to the ideas of the medical representatives. According to some doctors, the AOK does not want to get involved in this. According to internal circles, the atmosphere of the meetings was cool but friendly.

One might think that after the unsuccessful protest, the medical representatives take a humble attitude towards the health insurance companies. This is apparently not the case, because the designated Chairman of the General Practitioners' Association, Dr. Dietrich Mittler said in a statement: "There are no alternatives to family doctor contracts under the old law". And you want to fight with "uncompromising hardness". It is questionable whether the AOK is willing to accept such “harshness”. Finally, the cash register managers have proven that they are using the longer lever. And the members of the association should not be happy that the contracts were canceled, although the majority voted against the exit of the cash register system. The long-running dispute has so far only reduced GPs instead of improved fee systems. (sb)

Read about General Practitioners Association & Contracts:
AOK Bayern terminates family doctor contracts without notice
Family doctors association insists on system change
Bavaria calls on doctors to reason
Substitute health insurers also terminate their family doctor contract
Bavaria: General practitioners fight against health insurance companies

Image: Gerd Altmann /

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