90 % of the Germans have a public health insurance, 10 % a private insurance. The system is extremely liberal: all patients can decide freely whether they want to consult a GP (primary healthcare) or to see directly a specialist (secondary healthcare). With your public health insurance card you can for example go directly from Berlin to see a neurosurgeon in Munich without any referral. This makes our health care system very expensive and it also creates a lot of competition between GPs and other specialists.

Nevertheless the GPs, exspecially in rural areas, enjoy a high reputation. The quality of our GP training has improved significantly in the last decade. In Western Germany before 1990 existed no obligatory training after university to become a GP. Now we have a minimum 5 years training period with 2 years in internal medicine, 18 month in a GP practice and 18 month in an elective subject. Also the number of Family Medicine departments at our medical schools constanty increase.

Most GPs are small entrepreneurs with their own office. But in the last years the number of group practices rises as well as the possibilities to work as an employed GP.

In 2008 we founded JADE (www.jungeallgemeinmedizin.de) as a working group for young GPs and GP trainees within the German College of General Practitioners and Family Physicians DEGAM (www.degam.de). Our aim is to improve our working, training and research - conditions in collaboration with our European friends from the Vasco da Gama Movement.
 

National Exchange Coordinator for Germany

Dr Konrad Schmidt (konrad.schmidt@med.uni-jena.de)