The shortage of staff in Munich's hospitals is getting worse and worse. This will also have noticeable consequences for cancer patients, warns the Director of Radiation Therapy at the LMU Hospital.
Munich – Due to a lack of important employees, the high-tech equipment in radiotherapy at the LMU Hospital can no longer be fully utilized. "As a result, there is a risk of delays and waiting times, especially for cancer patients," reports the director of the Clinic for Radiation Therapy, Professor Claus Belka. In an interview with Münchner Merkur and tz, the internationally renowned cancer physician sounds the alarm: "We have a very serious problem. We urgently need to improve the framework conditions for our employees in the non-medical sector (MT-R). Otherwise, we are threatened with a staff collapse with serious consequences for our patients."
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Cancer specialist Claus Belka: "Devices are too important for our patients to stand still"
The call for help comes, so to speak, from a heart chamber of cancer medicine: Radiation oncology at the LMU Hospital in Munich is one of the largest and leading centers for radiotherapy in the world. It has six high-tech devices, each worth between two and million euros – and "not only too important for our patients, but also simply too expensive to stand still," Belka criticizes. Every year, about 2400 patients are irradiated in Großhadern, the vast majority of them suffering from cancer.
The background of the staffing crisis in hospitals
Now a personnel crisis is putting a strain on the very good and encouraging treatment options (see info box). The background: Even before Corona, Munich's hospitals were struggling against a full-blown personnel crisis. The pandemic acted as an accelerant. More and more employees are quitting their jobs – especially in the care sector. They feel burned out, lack tangible social appreciation and are frustrated. One sticking point: the comparatively poor pay. It is not enough for many employees to shoulder the high rents and cost of living in the sinfully expensive Munich conurbation. And the increased inflation since the outbreak of the Ukraine war has made the situation of hospital staff even more difficult. In addition, there are overtime burdens, which are exacerbated by the lack of personnel.
Important advances in radiotherapy
Advances in radiotherapy benefit patients with a variety of cancers. An example is the treatment of prostate cancer. "In the case of low- or medium-risk carcinomas, the cure rate after radiation is now just as high as after surgery, as an evaluation of patient data 15 years after treatment shows," explains Professor Claus Belka. With the MR-Linac irradiation device, it is possible to irradiate prostate carcinomas in short treatment series of five sessions. "There are significantly fewer side effects than with X-ray control procedures." The treatment series for the irradiation of breast cancer have also been significantly shortened.
Munich-based technology enables rapid treatment of brain metastases
In the fight against brain metastases, the LMU Hospital uses a new technology developed by the Munich-based company Brainlab. It enables the simultaneous radiosurgical treatment of several brain metastases in an extremely fast session. The accuracy is almost perfect with a maximum deviation of 0.5 millimeters.
New technology saves patients with claustrophobia from having to wear a closed mask during head irradiation
There are also better treatment options for people with claustrophobia. Thanks to a special positioning system, doctors and their staff can save patients from having to wear a closed mask. "With almost comparable precision, a more comfortable storage is possible," reports Professor Belka.
Clinic staff are migrating from all areas of work
+Responsible task: "Medical Technologists for Radiology" (MTR) such as Judith Schmutzler look after patients during irradiation. A doctor is not always present (as in this photo Professor Claus Belka).
© Andreas Steeger/LMU Klinikum
This leads to a chain reaction that hits state hospitals particularly hard – far beyond the care sector: they lose many employees to private clinics or practices in all areas of work. There they can earn more than in university hospitals or municipal hospitals, which are bound by the collective agreement of the public sector.
Mass exodus from the medical professions in Munich
In addition, physicians in private practice can often offer regular working hours, and it is not uncommon for night and weekend shifts to be eliminated. "The overall package is tempting for many employees from the university hospitals – and vice versa, they are particularly sought after because of their excellent training and expertise," says Prof. Belka. However, it is also true that the exodus from the medical professions in Munich affects not only the university hospitals, but everyone. More and more hospital employees are moving away from Munich or changing professions.
The only school for medical-technical professions (radiology) in Munich has only 25 places
At the same time, there is a lack of offspring. The seriousness of the situation can be seen in the field of radiotherapy. More precisely, in the only school for health professions in Munich that trains employees for radiotherapy and also the other radiological departments. It is located at the LMU Klinikum and has just 25 places. "These are far too few in view of the great demand. We need at least a third more places," says Judith Schmutzler, Head of MTR at LMU Hospital. Accordingly, the graduates are in great demand. Many of them are subsidized by private practices during their training, but in return they have to commit to working for their supporters for a few years after their training.
Starting salary in radiotherapy is 3400 to 3600 euros
Against the background of Munich's rents and the responsible activities, their salaries are nevertheless not lavish. A "Medical Technologist for Radiology" (MTR) - the official job title since January 1, 2023 - earns 1065 euros in the first year of training, 1125 euros in the second and 1222 euros in the third and last. The starting salary after training and the end of the six-month probationary period in the public sector is around 3400 to 3600 euros gross. For comparison: A doctor starts at the university hospital with about 4900 euros, a specialist receives about 6500 euros plus service allowances in the first salary level, a senior physician in the first earnings level about 8100 euros.
Clinic Director Belka: "Employee pay does not do justice to demanding work"
"The remuneration of our employees (MT-R) does not do justice to their demanding work. They deserve more," argues clinic director Belka. "After all, they alone bear a considerable responsibility." In concrete terms, this means that you are allowed to set the irradiation devices in motion even without the presence of a doctor – strictly according to the treatment plans, of course. Therefore, in order to ensure the quality of treatment, the legislator prescribes two medical technologists per shift and device. In doing so, they are obliged to meticulously comply with the specifications of doctors and physicists. For example, they are allowed to irradiate the patient's brain. "It continues to be a fascinating profession that perfectly combines medicine and technology," says MTR Director Schmutzler. "But if the financial conditions do not improve, we will lose more and more colleagues and will be able to attract fewer and fewer young people to the professional field of MT-R and in particular to radiotherapy."
