At present, practice structures are subject to multiform change. Various social parameters are recreating the environment in which medical practices must position themselves. Hansulrich Blunier, MD, Schüpfen, and Christoph Cina, MD, Messen, addressed feminization, changing professional roles, and societal changes in particular at this year’s KHM Congress.
First, Hansulrich Blunier, MD, of the MediZentrum in Schüpfen, referred to a social factor: “Feminization is sometimes reflected in the fact that almost 70% of graduates are women,” Dr. Blunier said. “Because starting a practice often coincides with starting a family, small part-time workloads increasingly need to be created and baby breaks made possible.” This cannot result in financial responsibility for the company. Further, the mechanization of medicine is contributing to the change in professional roles: Imaging is an important part of diagnostic success. Ways of dealing with the flood of data are in demand. There is a shift in competence in favor of the specialist. Finally, polymorbidity, along with the changing age pyramid and cost explosion, forms the third factor affecting practice structures.
How to respond to change?
Using the MediZentrum in Schüpfen as an example, the speakers presented possible solutions for the paradigm shift outlined. “We’ve had 20 years of experience with motherhood and family medicine,” Dr. Blunier said. Specifically, this includes the following:
- Good management of childcare at the center
- Workload is based on school schedules.
- Short distances to work, school, shopping
- No financially burdensome entry-level models. The center is organized as a joint-stock company: 90% of the share capital belongs to the employed physicians, who work at least a 40% part-time.
The center is responding to the changing professional role with training in ultrasound. “Ultrasound is the stethoscope of the 21st century. A very good instrument that has benefited a lot from technical developments in recent years,” Dr. Blunier emphasized. “In addition, we have a consultant service in-house. Specialists come by at certain intervals for meetings. This results in a uniform therapy strategy in which the perspective of the general practitioner plays a central role. In addition, the offer is used for advanced training or continuing education. So specialists don’t just come to us, we create synergies and networks that benefit the patient.
Societal changes are sometimes reflected in the fact that the shortage of primary care physicians is further exacerbated by early retirements, necessitating new models of care. “For example, assistant professions can be integrated into medical care, or specialists can supplement the team,” Dr. Blunier concludes. “Interprofessional collaboration is the model of the future.”
Source: “New Forms of Practice,” workshop at the 15th Continuing Education Conference of the College of Family Medicine (KHM), June 20-21, 2013, Lucerne.
