What a pity, thinks the young resident. Too bad there was no strike. That might have been more effective. He and his colleagues at the kitzinger land clinic had been entitled to strike on thursday – had the marburger bund not reached an agreement with the employers after all. The doctor wished to remain anonymous. On the one hand, because he speaks for many, not only for himself. On the other hand, to be able to express his opinion openly. He thinks that things are going very badly for hospital doctors.
Theory and practice
"It is no wonder that no one wants to do the job anymore. The burden is too high and is not paid adequately." By this, the young doctor means above all the on-call services at night. "2.9 percent more on the base salary is also too little, but you can live with that. In contrast, the ratio is not right at all in the case of the services." They pay only partially as working time, because the doctors can lie down in between, and are accordingly remunerated only with a percentage of the basic salary. According to hospital director klaus rihm, the average workload of doctors on standby duty must not exceed 49 percent. If this average is exceeded, the work is full time.
So much for the theory. The practice looks different according to the doctor. "There are nights when you only have to go out twice. But the ones in which you don't get any sleep outweigh the others." Two doctors – an internist and a surgeon – are responsible for the whole house at night. That is: for outpatient departments, emergencies and the wards. "People can't imagine how it works sometimes." The doctors are called when a drunk comes in with a knocked-out tooth, someone has broken a leg in an accident or the infusion needle slips out of an inpatient's mouth. "With six to seven patients in one night, sleep is out of the question – but it's not enough to be fully compensated either." The fact that no improvement has been made here worries the young man mablos.
The marburger bund had originally demanded that the on-call services be limited in number. More than half of the physicians in municipal hospitals were required to perform an average of five to nine such services per month, and three percent were required to perform ten to 14. These include employees of the kitzingen clinic, who work around 200 hours a month – including all duty hours, during the day, at night and on weekends – but are paid differently.
The result of the negotiations was a higher remuneration for stand-by duty – but only from 97 onwards. Hour a month. "Here we had to swallow a rough crust", says vanessa schmidt, press officer of the marburg association of bavaria. But because the services in the hospitals are regulated differently, it was difficult to find a solution that could be applied to all of them. "Doctors can at least claim this extra payment."
The resident finds it "hypocritical". The hours one to 96 are not less burdensome than the following ones. "But any accommodation is good", he admits. That's where you can start again in the next negotiations.
However, according to rihm, the restriction would not have been feasible, at least for smaller hospitals and departments, without jeopardizing on-site services. "The people involved don't really want to." This demand was more about money. "On-call duties are self-evidently stressful and should be paid properly." The result is therefore satisfactory from his point of view.
Clinics in the zwickmuhle
Rihm is also relieved that the marburger bund has reduced the salary increase from the demanded six percent to just under three percent. "The doctors are to be conceded. The problem, however, is that hospital budgets are only increasing by 1.48 percent for the same level of service." This rate, which is regulated by law, puts municipal hospitals in the predicament of having to save money elsewhere. "In our case, it will be the costs for tree removals that will be reduced." And yet the kitzingen clinic is still doing very well, because it has been able to increase its acceptance and thus the number of patients by 24 percent since 2006.
Many physicians, however, are more likely to fear underuse if employers don't provide better conditions. "I have a nice job that I would like to continue doing", says the resident. "But it is already made difficult."