Part 3: The Core Potentials For Changing the SystemSummary: The future of family medicine in Germany will be determined by two vital issues: the debate about gender equality of medical care and the willingness to begin a serious dispute about controversies regarding primary care. Debating gender aspects has met little response so far. Eliminating barriers for equal recruitment and career promotion of men and women in medical care has just begun. This debate deals with lapping the full potential of modern family medicine and further about integrating the primary care concept into the German medical care system. Success will depend upon understanding the relevance of this concept and the development of sufficiently equipped support programs including financing of model projects. With a more self-confident generation of family physicians in the last decade chances for changing the system have improved.
Background: In times of demographic change and increasing inequalities in the availability of primary care providers among urban and rural areas, it becomes more difficult to ensure primary care provision in Germany. The current needs-based planning only encompasses a small number of different criteria which influence the healthcare situation. The aim of this study is to identify further criteria to identify hard to serve regions.Methods: A literature search was applied to identify further criteria which influence the healthcare situation and which are internationally used in needs-based planning. Based on these criteria, hard to serve regions can be identified. Lower Saxony is used as an example for this identification.Results: The identified criteria can be classified into four different categories: Physician-to-population ratio, demography, geography and socioeconomics. First, among all rural areas of Lower Saxony, those are selected for which the predicted primary healthcare provision appears worst. Exemplarily, a joint community is identified as hard to serve region based on a regional analysis of the criteria identified above.Conclusions: The criteria, which are used to identify hard to serve regions can supplement the current needs-based planning. Thus, hard to serve regions can be identified at an early stage and new models of care can be implemented.
Abstract: The topics „reputation of family medicine“ and „physician shortage“ correlate strongly. Early contacts of medical students with their future field of practice might have an enormous impact on their attitude on family medicine. Increasing the reputation of family medicine, however, constitutes a far more complex task for the next decade.
