Alternatives to the medical monopoly on diagnosis and treatment

There is a huge shortage of specialists in the healthcare sector.
A general practitioner was recently quoted in the news portal Mediniside as saying that we don’t have too few GPs, but that too many of them are doing the wrong thing.
Advanced Nurse Practitioners (ANP) are mentioned as a possible solution to the shortage of specialists.
In its response to an interpellation by Councillor of States Hans Stöckli(22.4369), the Federal Council wrote that the KVG is based on a “monopoly on diagnosis and prescribing by doctors”.
This may be true, but healthcare policy must answer the question of how the shortage of specialists can be countered.
There is probably a need for triage and initial consultation centers that do not have to be staffed by doctors, as proposed by the Federal Council in the consultation draft for the cost containment 2 package of measures.
The focus is on strengthening interprofessional cooperation in the outpatient sector.
Certain services could probably already be billed today under the delegation model.
The main responsibility remains with the delegating doctor.
There are also services for which the detour via a doctor would be considered a violation of the WZW principle in the KVG.
Examples include direct access to physiotherapist services for back and knee problems.
The evidence for direct access exists, but it is largely ignored.
In the case of midwives, too, it makes no sense if the necessary medicines for home births are only reimbursed with a doctor’s prescription via basic insurance.
The FDHA and the FOPH are reluctant to propagate solutions that would already be possible under the current KVG.
Instead, for example, the fundamentally good idea of the initial consultation center was deleted from the bill without replacement.
If we persist in box-ticking, we will not be able to solve the shortage of specialists.
The burden will be borne by patients and hospitals, which will be overwhelmed if we do not strengthen and expand outpatient structures.

Köhler, Stüdeli & Partner GmbH
Amthausgasse 18
3011 Bern
+41 31 560 00 24
info@koest.ch

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The agency is located in the old town of Bern at Amthausgasse 18. The entrance is in Amthausgässchen (4th floor), to the side of the Diagonal restaurant.

Köhler, Stüdeli & Partner GmbH can be reached in a few minutes on foot from Bern main station (Schauplatzgasse-Bundesplatz-Amthausgasse).

The Casino parking lot at the Hotel Bellevue is in the immediate vicinity.
The Federal Department of Home Affairs (FDHA) is located directly opposite (Inselgasse).

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