There is a shortage of family physicians in Switzerland, especially in rural areas. A novel business model has developed solutions to this problem. The concept, which is based on cooperation and outsourcing, has proven its worth so far.
The company MeinArzt Schweiz [1] wants to save the classic family practice in the countryside into the future by bringing together old and young doctors. The model for succession plans is intended to take a big burden off family physicians before they retire.
Alternative to large medical centers
The company buys medical practices, renovates them and looks for a suitable successor. In addition, the entire administration is taken over: Accounting, IT and purchasing. In a first step, MeinArzt Schweiz will take over 100 percent of the practices. In the long term, however, the majority of the practices are to be returned to the ownership of the respective primary care physicians. Veteran physicians can continue to work part-time in their practices in exchange for profit sharing. The new physicians are given regular working hours and can participate in the practice from the second year. In the long term, MeinArzt Schweiz usually holds a minority stake of 20 percent.
This concept meets a current need. More than ten GP practices in Switzerland have already joined the label. The model of MeinArzt Schweiz is intended to be a counter design to the large medical centers. On the one hand, because many family physicians have reservations about selling their practices to large groups and, on the other, because working in a smaller family practice is still attractive, he said.
The future of family practice?
The outsourcing of accounting and administrative activities while remaining independent is perceived as a relief by many young family physicians. Cost-effectiveness of primary care practices is a hot topic. Although the single practice is often described as a discontinued model, ten percent of young family physicians still choose this model. This is the conclusion of a study conducted by the Young Family Physicians Switzerland Association and the Bern Institute for Family Medicine [1,3]. Many physicians want to follow their patients personally over a longer period of time. According to the study authors, the most important factor for a successful start is personal experience: more than 40 percent of the young physicians surveyed took over a practice in which they had been employed during their time as residents. However, financially viable practice models, a stronger presence of family medicine in medical school and more flexible working models are also important.
Still an important function
Family physicians can independently and conclusively treat a large proportion of all health problems [4]. Family physicians are also important players in the health care system in connection with chronic diseases and multimorbidity. They can treat patients, provide guidance and/or identify treatment options. This may include counseling regarding the complexities of the health care system [4]. According to the Bern Institute of Family Medicine, this medical subfield is also increasingly developing into an academic discipline with family medicine teaching and patient-centered clinical research [3]. Making the profession of family doctor more attractive again is one of the goals of the Young Family Doctors Switzerland (JHaS) association, founded in 2009, which today has over 1100 members and is committed to networking and supporting prospective family doctors [2]. “Nothing is more convincing and motivating than our own enthusiasm. We have made the most exciting and challenging profession our dream job out of conviction. As a family doctor, I can accompany my patients in the long term, do important preventive work, and I have a broader spectrum than any other specialist – this is professionally and personally enriching,” explains Gabriela Rohrer, MD, President of the JHaS and family doctor in Flüeli, her personal motivation for this profession [5]. According to a survey conducted in 2019, young family physicians not only want to work in the city, but rural positions are also of interest [5]. However, further efforts are needed to counter the shortage of primary care physicians, he concluded.
Literature:
- MeinArzt Switzerland: www.meinarzt-schweiz.ch
- Young Family Doctors Switzerland (JHaS), www.jhas.ch
- Bern Institute of Family Medicine (BIHAM). www.biham.unibe.ch
- Institute of Family Medicine, University of Zurich, www.hausarztmedizin.uzh.ch/de/forschung.html
- Media release: 10 years of Young Family Doctors Switzerland (JHaS). Young family physicians – well on their way, but not yet there. Young Family Physicians Switzerland (JHaS), April 25, 2019, www.jhas.ch.
GP PRACTICE 2020; 15(2): 39
