The doctor Michael Lob gives up his practice in Wolfratshausen.
In an interview with our newspaper, he talks about the reasons.
Wolfratshausen
- Whether the inpatient medical care of the population is a compulsory state task or whether you can put it in private hands with a clear conscience: This is currently - keyword the future of the district clinic - a hotly debated topic in the district. The sometimes difficult situation of the resident doctors shows that there is a lot going on in this country in terms of health policy. One, Michael Lob, has now pulled the rip cord. The 58-year-old is giving up his Nantwein practice without a direct successor after 16 years. In an advertisement in our newspaper, the general practitioner got to the bottom of the matter with one sentence: "The given framework conditions for a freelance medical activity in an individual practice are no longer in line with my ideas and possibilities." We followed up on praise.
Mr. Praise, you will close your practice on June 11th. What made you take this step with major consequences?
Politicians do not like to hear the topic of practical death.
But it's a fact.
I think more doctors will follow me.
As part of my job, I often have to deal with pharmaceutical consultants.
Over time, a relationship of trust has developed, and I've heard many times that other doctors stop for almost the same reasons as I do.
That would be?
Let me put it this way: The KVB (Association of Statutory Health Insurance Physicians in Bavaria, d. Red.) Acts like a franchise company. It dictates what is going on, and we have to follow it - underpriced, of course. Only now, in the corona pandemic, is there suddenly money. While I get 23.58 euros plus a distance-graded travel allowance of 4.07 to 12.80 euros for a home visit, I get 15 euros per smear in the corona test station at Schwankl-Eck. And I can cut 80 swabs in two hours. What a discrepancy! For me, there is a large amount of underfunding in the healthcare system, many items, such as electrocardiograms, are billed in the quarterly flat rate and are therefore not reflected financially. Especially for doctors like me in basic care - the rank and file, as I would like to call it.And in the end, not enough will come out.
Can you be more specific?
I have no planning security, no room for investments or for a possible move that would be imminent for me.
I looked at my account with my tax advisor for five years.
Nothing happens, I'm always in the red - and I don't get rich because there's nothing there either.
With my possibilities, I slowly come up against not only financial limits, but also psychological ones in the long run.
And I want to put a stop to that.
A problem with many general practitioners is that the health insurance fund hardly gives them any time for the patient. How do you hold it?
I always took the time.
My patients appreciate that.
I'm basically on a farewell tour.
Many patients, especially the older ones who trust me, worry about how things will continue.
58 is not an age to quit.
I know.
A lot of people ask me if I'm going to retire.
I always answer: It would be nice, but I can't.
As a freelancer, I have taken care of my retirement provision and health insurance entirely on my own for the past 16 years.
In the first three years of my freelance work, I took a break from paying into my old-age pension and used the money from the practice fee fund to make a living, just by the way.
However, I cannot continue as before and have therefore decided to withdraw from self-employment.
I could tell you things there.
Go ahead!
What I was very annoyed about: I had a prospect who wanted to take over with my medical certificate and open a group practice. But this doctor alienated the KVB by demanding that she fill the position immediately from July 1st if she wants to take over the approval. Of course, the prospect could not pull a doctor out of her hat, so she withdrew from her plans. On the subject: We make sure that the medical care is continued. I even asked the KVB whether they could grant six months of grace: Answer: No, it doesn't work. You have to know that the handover of a health insurance license is subject to a rigid replacement procedure under the direction of the admissions committee for doctors at the KVB. For a doctorwho registered for the first refill procedure one week after the application deadline had expired, I therefore initiated a second refill procedure and tender for the cash register admission on May 5, 2021. The deadline expires this week of June. A final outcome is therefore pending.
And now?
Now it can happen that my approval goes to the KV Munich - or I still manage to hand over my health insurance approval to medical colleagues.
In the district we are currently having a heated debate about the continued existence of the district clinic.
It's all going in the same direction.
When I hear the political talk about the urgent promotion of family doctors, I can only say: the chickens are laughing.
Do you want to talk about your financial situation?
Why not?
My very old landlords, with whom I have a very good relationship, have been tacitly extending my lease every year since 2016, as we had agreed by mutual agreement.
Since the start of the lease in 2005, my rent has never been increased, it is affordable.
But if I had to move the practice, it would cost around 20,000 euros.
Taking out a loan for a move would no longer be an option for me, and I'm not ready to do so either.
It would simply not be economically viable.
Do you have a family? What is left for you to live with?
I am divorced, have a 31 year old daughter, also a doctor, currently in specialist training.
She lives married in Italy.
Last year I became a grandpa.
I co-financed your medical studies until five years ago.
My salary, which I transfer to myself from my business account, is 4,300 euros gross - so not as high as people always think.
Of this, 1,300 euros go to medical care for old age and 500 to private health insurance.
In addition, I invest 600 euros a month for my retirement provision.
I get along well with the rest of the money.
A family could certainly not be supported in our area.
How many hours do you work a week?
Between 50 and 60.
And how big is your patient base?
Usually between 700 and 800 people per quarter.
With Corona we had a slump of around 20 percent.
I caught this by participating in the infection clinic in the current Wolfratshauser vaccination center.
I also exposed myself to a certain risk from November to February without a vaccination.
There were corona patients there.
Now, as mentioned, I am working in the test station at Schwankl-Eck.
I am assigned three times a week there, for which I settle once.
You have to do something to make ends meet.
What will happen to your employees?
I have two permanent medical assistants in the practice.
A third force based on 450 euros had to stop because of Corona.
As an employee of a hospital, she was no longer allowed to work on the side.
Both of my employees have already found new jobs, and I'm very happy about that.
I also have a fairy godmother who cleans the practice and my friend who helps me with the bureaucracy, the preparatory work for the tax advisor and with the practice laundry.
These two are still trying to find follow-up jobs.
Can you say how things are going with you professionally?
First of all: I don't regret my decision. Life is a river that will take me somewhere. But I haven't got anything fixed yet. First of all, I want to finish my practice cleanly. Everyone in my family clasped their hands over their heads, but they've done that a lot (laughs). I was at the forefront of patient care for 29 years, 16 years here in the practice, 13 years in clinics. Perhaps there will be an opportunity to find a job in the health department or in the surrounding rehabilitation clinics. I would also like to explore the possibility of working in Italy, because in the medium term I will probably move to Italy, close to my daughter, to the city where I studied medicine, in order to complete the circle.
Also read: Wolfratshausen District Clinic - District Administrator demands new strategy and long-term investment plan.