UEMS – Dietrich Bornemann Presentation GERMANY 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Presentation GERMANY 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Presentation GERMANY Landscapes 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Presentation GERMANY 81,8 million inhabitants 229 inhab. / km² (357 Tsd. km²) type of government: federal republic, 16 states capital Berlin 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Presentation GERMANY Government federal president federal chancellor parliament 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Health Care Market 328 Bill. €uro (2014) equates 4.050 € / inhab. = 11,2% Gross Domestic Product 70 % = 194 Bill. € social insurance 29 Bill. € private insurance 76 Bill. € „second“ health care market (2014) greatest health care market in Europe leads to greatest interests for the players on this market (development of hightech products, innovative drugs, new treatments, new ways of patient centered care) 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Health Care Market outpatient costs: 163.0 Bill. € Doctors offices 50.2 Bill. Dentists 24.9 Bill. Physioth. et al. 11.5 Bill. Pharamacies 44.7 Bill. Nursing service 13.3 Bill. 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Health Care Market inpatient costs: 123.4 Bill. € Hospitals 85.9 Bill. Prevention/Rehab. 9.0 Bill. Nursing service 28.5 Bill. total costs MSD: 24 Bill. € 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Health Care Market 230.000 companies 1.996 hospitals (2013) 104.018 medical offices (2013) 20.662 pharmacies (2013) 124 social insurances (2015) 43 private insurances (2013) 24.700 nursing services (2011), hospital treatment 12.400, outpatient 12.300 medical engineering, biotechnology, pharmaceutical industrie 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Health Care Market 5,2 mill. jobholders, each 8th earner 371.300 physicians (2015) ; 70 % specialists 150.000 statutory health insurance physicians (SHI physicians) 189.000 clinicians 13.11.2018 UEMS – Dietrich Bornemann

number of physicians in thousand 13.11.2018 UEMS – Dietrich Bornemann

distribution of physicians in counties number of inhabitants per physician 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann medical disciplines 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann O & T Specialists 2015 Total 17.455 14.829 male 2.626 female working 14.677 Office 7.137 independent 6.063 employed 1.074 Hospital 6.813 Administration 125 Others 625 13.11.2018 UEMS – Dietrich Bornemann

average age of physicians 13.11.2018 UEMS – Dietrich Bornemann

percent of physicians under 35 years 13.11.2018 UEMS – Dietrich Bornemann

employed physicians in outpatient offices 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Specialists and GP‘s 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann foreign physicians 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Health-Insurance general obligatory insurance 90% social insurance payed by employer + employee in equal shares 14,6% of income; includes family 10% private insurance possible if > 50.000 € income costs depending on personal risk profile no income : contribution payed by social assistence office 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Health-Insurance Insurance card = open access to doctors office ! free choice of physician ! (general practioner or specialist) 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Health-Insurance 71.2 mill. treatments quarterly by specialists ( in- and outpatient) 3.000 cases / year / SHI-physician 93 % of specialists treatment take place outpatient 7 % hospital treatment = 19.6 mill. cases / year 7,4 days mean stay in hospital 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Medical Chamber(s) 16 countries = 17 State Medical Chambers of Physicians German Medical Association joint association of the state chambers represents 470.000 physicians in matters relating to professional policy achieving the most uniform possible regulation of professional duties and principles for medical practise in all fields. dual function of representing interests and being a supervising body 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Medical Chamber(s) State Medical Chambers self-governed institutions registered corporations under public law compulsory membership of physicians pension funds monitoring final examination of students specialists training trainers execution of specialists examination 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Medical Chamber(s) Speciality training regulations (Weiterbildungsordnung) which define the content, duration and objectives of speciality training and specialist designations (valid for all 17 chambers) Accreditation of CME/CPD-events (e.g. DKOU in 25.-28.October in Berlin) Defining vocational training contents for medical office assistants and conducting the examinations in this field are further tasks legally assigned to the Chamber. 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Education physicians begin the training after passing the second state exam, 12-month-on-site-training and receiving their license in addition to this specialty training, all active physicians in Germany are required to continuously do extra training to maintain up-to-date medical knowledge: 250 CME-points in 5 years, recorded at state med. Chamber sanction: SHI phyicians loose income, ultimately license clinicians has to be shown in annual report ! 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Education in O&T 6 years overall 24 months surgery basic 48 months O&T, within this period 12 months in office possible Logbook 17 chambers = 17 logbooks compulsory exam: performed by the Chamber of Physicians, 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Organisations BVOU : 6.693 office 3.890 hospital 1.290 founded 1951 DGOU 10.291 founded 2008 (Foundation President Joachim Grifka) DGOOC 3.415 founded 1901 SpiFa joint association of 27 specialities founded 2012 (2005) 13.11.2018 UEMS – Dietrich Bornemann

UEMS – Dietrich Bornemann Organisations SpiFa represents 150.000 specialists SpiFa will become the representative for all German medical specialists in UEMS from 2017 on 13.11.2018 UEMS – Dietrich Bornemann

Reasons visiting Germany 13.11.2018 UEMS – Dietrich Bornemann

Thank you for your attention 13.11.2018 UEMS – Dietrich Bornemann