Demand planning should take pain medicine into account
29.03.2022 15:37
In the future, demand planning for statutory health care should take into account the need for pain medicine. At the end of March, the representatives of the traffic light coalition promised Prof. Dr. Armin Grau (Member of the Bundestag, Alliance 90/The Greens) and Prof. Dr. Andrew Ullmann (MdB, FDP). The German Society for Pain Medicine eV (DGS) and its President Dr. Johannes Horlemann continues to call for the introduction of specialists in pain medicine in order to ensure the replacement of pain medicine practices. This year's German Pain and Palliative Care Day, which took place online with almost 3,500 participants, ended with this health policy discussion.
In Germany, around 1,321 outpatient pain doctors are currently caring for the increasing number of patients. At least 10,000 trained pain doctors would be needed to provide comprehensive care for the approximately 3.9 million people suffering from severe pain. Pain patients are currently massively underserved and, despite their severe symptoms, have to wait a long time for an appointment with a specialist. Creating incentives for young pain physicians The participants in the panel discussion, health policy representatives from the Bundestag and representatives of the DGS, agreed that more pain physicians need to be trained. Dr. However, Silvia Maurer, Vice President of the DGS, complained about problems with young talent. Doctors who want to qualify in pain medicine would first have to complete a course of study lasting around 6 ½ years and then around 7 years of specialist training before they could undertake further training in “special pain therapy”. In order to take on this, there would also have to be monetary incentives for young doctors. Grau confirmed that a time-consuming anamnesis is the basis for the diagnosis and therefore has to be reimbursed.
GBA report confirms the need for a specialist
The “Expert report on the further development of requirements planning” from the Federal Joint Committee speaks in favor of the “specialist in pain medicine”.1said Horlemann. This confirms that a specialist is necessary to provide good care for pain patients. Horlemann also called for the issue not to be left to medical self-administration. Politicians must create the legal framework. For the bio-psycho-social support of pain patients, an integrative view is necessary that is not reflected in any individual discipline. This leads to doctors working in pain medicine, like Horlemann himself, working beyond retirement age because they cannot find suitable successors to care for their pain patients. Grau promised to ensure that needs planning takes pain medicine into account in the future in order to pave the way for better care: “Wherever patients need pain therapists, they should find them.” Ullmann also wants to pursue the goal of needs planning to be aligned with the additional designation in the future in order to ensure succession to the practice.
Contract reduces bureaucracy for the regulation of cannabinoids
Another topic of health policy discussion was the supply of cannabinoids to pain patients. The German Society for Pain Medicine eV recently concluded a contract with the AOK Rheinland/Hamburg to improve the quality of care for patients with cannabinoids for medical needs. The basis for the simplified prescription of corresponding preparations is the qualification of the participating contracted doctors via a 20-hour curriculum. The project is supported scientifically. The hurdles for the use of cannabinoids are currently still high. Doctors must have the prescription approved by the patient's health insurance company and the approval process takes time. Around a third of applications are currently rejected. Horlemann praised the structural agreement with AOK as a flagship project. Matthias Mohrmann, board member of AOK Rheinland/Hamburg, is sure that other health insurance companies will also join this contract.
1 Resolution of the Federal Joint Committee to approve the final report “Expert opinion on
Further development of requirements planning within the meaning of Sections 99 ff. SGB V to secure statutory health care” from September 20, 2018. https://www.g-ba.de/downloads/39-261-3493/2018-09-20_Endbericht-Gutachten -Further development requirements planning.pdf