The patients’ perspective on comprehensive patient care

Expectations of patients to the doctors and the German health system are simple:

They want to be cured and stay healthy; they want the best hospital and the best doctors. Patients want the latest medical findings treated and expect latest information on complementary treatments as well… and last but not least: They want to be perceived as a human being. One could believe that the performance of deliverables on these wishes is easily to achieve in a health-care system consuming some 250 billion € annually. But far from it. Why is that?

The author ‘joined’ the system years ago; she was and still is a patient and experiences personally the obscurities of this highly differentiated German health-care system. But she is also a journalist and author, interviewing hospital doctors, jobbing at practitioners and also addressing health insurance institutions and companies.

This multi-dimensional approach delivers a pretty good overall picture and shows why patients very often feel patronized, quickly dispatched and, in many cases, uninformed.

Medical staff working under ongoing time pressure, increasingly following standard procedures, transform patients into a part of a—in many cases—poorly designed production process, faraway from TQM. The everlasting and increasing financial and budgetary pressure pushes physicians to become part time MBAs, but also triggers behavior to beat the system at any aspect. Economics seem to be key to everything.

Red tape and over-regulation determines the medical life. Humanity seems to be deleted. Cost–benefit ratios and evidence-based medicine are taking over, instead of an individually targeted and cross-functionally concerted, human medical treatment. Not to talk about more investment of time and money into alternative medical treatment. Alternative medicine has always been a stepchild within the system.

Although she (the author) ruthlessly points out the shortcomings of the system, there is no knee-jerk solidarity within the patient community. Instead, sustainable change happens to the medical establishment, which obviously generates the anxiety of losing ‘given’ turfs, as well as in patients, who are used to getting everything, at any time, for free. Not only sick people, but also medical personnel, feel powerless, helpless, hopeless within these system structures. Consequently, doctors and patients often talk about each other, but they are not communicating. A valid dialogue should be encouraged and allies generated to jointly propose constructive solutions. It is a must to involve and include patients in the debate about limited resources, budgets, increasing and necessary standardization, with a desirable reconciliation between clinical (orthodox) and complementary medicine.

All these conditions are needed for optimal medical care in the future.

We will need a sustainable behavioral change in all sectors of our health-care system in order to cope with future challenges, necessary to be addressed NOW!

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