A Frankfurt resident wants to turn the hospital system upside down
-
fromSarah Bernhard
shut down
Neurologist Dr. Christian Schwark from the Frankfurt Northwest Hospital is the new chairman of the Marburg Federation of Hesse. He has big plans.
Frankfurt – recently Dr. In the next four years he will make the profession more attractive and focus on the patient. But actually he would like to rebuild the whole system.
Mr. Schwark, you are now the chairman of the largest professional association for doctors in Hesse. How did you come to be a doctor in the first place?
That was more of a coincidence. I was interested in biology, but then discovered that a doctor is a very diverse profession. I’ve been doing it for 26 years and it’s still exciting.
Why?
You organize a lot, you work with people, you can worry and contribute, but you also have to think economically without it becoming too operational. I also always had the opportunity to help shape things and to do projects outside of the routine spectrum.
Do you want to take up topics in your Which term of office?
A very important topic is sensible staffing across all professional groups. It has not yet been possible to cut the load peaks in such a way that there is really job satisfaction. Since the beginning of the pandemic situation, long working hours under difficult conditions have led to an increasing number of overloads.
Because there isn’t enough personal?
And because in many corporations even medical jobs are being cut.
During the corona pandemic?
This has less to do with the pandemic and more to do with healthcare funding. A case value is calculated for each disease, let’s say 3000 euros for an appendix removal. If a clinic has costs of 3100 euros, it makes a loss and has to save elsewhere. With the introduction of the nursing budget, cuts in the nursing staff are no longer worthwhile. As a rule, there is no longer any potential in purchasing, just as little as in the service companies, which are often outsourced to external limited liability companies or pay minimum wages. Only the doctors remain.
How could you change that?
One could also outsource the personnel costs for doctors so that they are no longer a marshalling yard. The best thing would be to get rid of the whole system and develop a new one. It cannot be that I will be punished if, like here, I have a lot of elderly patients, I cannot send them home after the flat rate per case because there is nobody to look after them.
And what does the new system look like?
As the Marburger Bund, we advocate, among other things, a “peer review” system in which the houses check each other and discuss what is going well and what is bad. But one would also have to agree on what constitutes sensible personnel planning. We do not want lower staff limits, but a traffic light system that defines an optimal staffing and is gradually given limits, which are then sanctioned separately. Savings in personnel would not be economically viable.
Quasi the opposite of the status quo.
We finally have to seriously ask ourselves what we want. At some point, for example, society decided that the auto industry was of great value. IT IS CLOSED WITH HIGH SUMMER. But shouldn’t we set other priorities in the 21st century? There is finally a reason why people go to non-medical health professions: Because there is time for a conversation. Doctors can do the same thing – and at the same time they recognize the patient’s organic complaints.
That sounds reasonable, but not new. Why does nothing change?
The politicians are reporting that they are not being approached by the constituency residents on the subject of the hospital. And you can’t just turn the entire healthcare system upside down. What we definitely need, however, is a change from the sector-centered to the patient-centered view. This means that different doctors, nurses, general practitioners and other health professions have to cooperate instead of competing with one another. The exponential increase in knowledge in individual specialist areas leads to the fact that diagnosis and treatment are becoming more and more complex and it is becoming more difficult to keep track of things. This makes collaboration all the more important.
How far has the “Cooperation” project come?
It is still very specialized in individual areas. In oncology, for example, there are tumor conferences where the surgeon, oncologist and radiation doctor discuss the most sensible therapy together. Here at the Northwest Hospital, we try, like others, through outpatient special medical care. Then there are the medical care centers. In the emergency room, for example, there is a common counter so that resident and hospital doctors Höchst can exchange ideas. And there are medical centers where the patient’s paths are short. In addition: Virtually all patients, we ask, say that it is very uncomfortable that they constantly adjust to changing contact persons. When. You go to the family doctor with something, when and for x-rays to the radiologist and then on to the next specialist. It would actually take someone to hold the strings in hand and structures that shorten distances and simplify treatment.
How about the electronic patient file, for example?
In an ideal world, EVERY doctor would have access to shared information. It also gives doctors time to spend longer with the patient. At the moment you are sometimes busy for hours looking for preliminary findings or waiting for them.
Are there any other topics on your agenda?
For some years now, more and more doctors have stayed in the hospital instead of settling down. This to the life job means that we must see to it that people can make it throughout their lives transformation. And that’s better if you’re not burned out at 55. This also includes the compatibility of family and work, not only in the medical field, but in all professions. Young colleagues in particular who die again after their baby break are an incredible asset.
How come?
You are well organized above average, motivated above average and bring a different perspective on your work. This is great resource. We must therefore ensure that women do not continue to be punished for having children.
Do you feel that you are being heard with your positions?
Everyone is interested, in principle, in doing the best they can. And I have the feeling that, overall, things are easy to talk about. But we live in a parliamentary democracy in which the processes are tough but balanced. I therefore do not consider scolding politicians to be sensible in principle. Sometimes you just have to be patient or lend a hand yourself. In our system this is open to everyone.
This knowledge seems to be disappearing more and more. See the corona protests.
At the moment everyone thinks they are an expert and that their point of view is the right one. For example, that vaccination is the devil’s stuff. The mRNA active ingredients were also developed using methods that have been in use for many years. The Paul Ehrlich and Robert Koch Institutes have vaccination monitoring systems that show that there is no noticeable accumulation of side effects. Nevertheless, people are now waiting for conventional vaccines, as they often contain parts of a virus. It is not safer, but just as certain. And the same people then get into cars whose Tüv has expired or ride bicycles, although an accident is much more likely than a vaccination complication.
Do you also have a solution page for this?
We have to find a culture again in which public discourse is possible without polemics, because it is the most important instrument of a democratic society. It is now so far that many colleagues no longer want to express themselves publicly. We lose a lot there. It’s scary. (Sarah Bernhard)