Should you go to your family doctor first after falling off your bike? – A dangerous detour!

30.04.2025 16:35

Especially in the event of an accident, prompt and competent medical care is crucial. Especially for acute injuries, such as those frequently encountered in sports or everyday life, the current discussion about a mandatory primary care physician system for those with statutory health insurance, which the CDU/CSU and SPD are proposing in the coalition agreement, reveals serious weaknesses from the perspective of the relevant professional association DGOU and the professional associations BDC, BVOU, and BNC. They urgently warn of the consequences of such a system and demand that direct access to trauma physicians be maintained within the healthcare system.

„We see no advantage in requiring every accident to be handled by a general practitioner first,“ explains Professor Dr. Dietmar Pennig, Secretary General of the German Society for Orthopedics and Trauma Surgery (DGOU). „A mandatory primary care system would mean that people with acute musculoskeletal injuries, such as a broken arm while cycling or a knee injury from a fall down stairs, would first have to visit a general practitioner – this creates more bureaucracy and, above all, is a dangerous waste of time. Furthermore, reality shows that general practitioners' offices are neither staffed nor structurally equipped to diagnose and treat acute injuries promptly and appropriately.“

Risk of mismanagement in the healthcare system

The trauma surgeons are calling for the preservation of the proven system of immediate accident care provided by appropriately qualified specialists for those with statutory health insurance. They argue that, particularly in cases of musculoskeletal injuries, rapid and competent care is crucial to prevent long-term damage and lengthy treatments.

In their view, a mandatory primary care system controlled solely by general practitioners carries the risk of placing an additional burden on the healthcare system and promoting mismanagement:

Overburdened general practitioners' offices: General practitioners would be confronted with a flood of patients whom they could neither treat efficiently nor appropriately.
Treatment delay: Acute injuries must first be assessed and referred before specialist medical treatment can take place – with serious consequences for recovery.
Rising costs: More bureaucracy and unnecessary transfers would make the system more expensive without improving care.

The planned system isn't working – emergency rooms would be overwhelmed.

Jan Henniger, chairman of the Professional Association of Practicing Surgeons (BNC), explains: „The reality is that private surgical practices are currently relieving the burden on both general practitioners and hospitals. In the future, however, patients will go directly to the emergency room if they can no longer be treated immediately by specialist staff. In the context of the emergency care reform, the idea of a mandatory primary care physician system is therefore nonsensical.”.

“A proven system: Accident care by D-doctors“

Associations and professional societies also point to the existing system of designated physicians (D-doctors), which has proven its worth in the treatment of workplace accidents for decades. This network of specialized physicians ensures fast and high-quality care for accident victims – without unnecessary detours.

„The employers“ liability insurance associations insist on mandatory primary care by qualified D-doctors for good reason, because ultimately costs are saved by minimizing expensive long-term damage,„ explains Dr. Jörg-A. Rüggeberg, Vice President of the Professional Association of German Surgeons (BDC). “Why shouldn’t such a system also apply to patients with statutory health insurance who haven’t had a work-related accident?” Conclusion: No time for detours – accidents belong in the hands of specialists.

„"A mandatory primary care physician system may seem sensible in theory, but in practice it must be designed intelligently and flexibly; otherwise, it will only lead to higher costs, more bureaucracy, and potentially greater risks for patients, especially in the care of accident victims. Therefore, direct access to specialized accident and emergency physicians must be maintained for all those with statutory health insurance.".

“Fast and professional help not only saves lives, but also the quality of life of patients,” explains Dr. Burkhard Lembeck, President of the Professional Association for Orthopedics and Trauma Surgery (BVOU).

About the BDC

The German Association of Surgeons (BDC) is the largest surgical association in Europe, with approximately 17,000 members. It represents surgeons of all specialties in hospitals and private practices throughout Germany. The BDC Academy organizes nearly 200 events annually for physicians at all career levels, thereby promoting continuous and professional development in surgery.

Via the BNC

The BNC is the professional association of independent surgeons in Germany, whose interests it represents through a national executive board and regional associations (ANC). It is committed to the education and training of its members and advocates for the promotion of outpatient surgical treatment and interdisciplinary exchange. To this end, the association engages in dialogue at the national level with policymakers, health insurance companies, businesses, and other professional associations.

About the BVOU

The German Professional Association for Orthopedics and Trauma Surgery (BVOU) is the professional association representing more than 7,000 colleagues working in private practice and hospitals. The BVOU advocates for the professional interests of its members by developing standards for orthopedic and trauma care in collaboration with scientific societies, shaping the political and economic framework, and thereby shaping the public perception of its members as experts in orthopedic and trauma care – all for the benefit of patients and the public good.

About the DGOU

The German Society for Orthopedics and Trauma Surgery (DGOU) is a medical-scientific professional society with approximately 10,400 members. The DGOU represents the overarching and shared interests of the field of orthopedics and trauma surgery in the areas of research and teaching, continuing education and training, in clinical practice and private practice, as well as in health policy, in order to shape the framework for the field of orthopedics and trauma surgery accordingly.