For some time now, pharmacies in particular have been calling for closer cooperation in medicine. This was published by the Federal Association of German Pharmacists' Associations in the perspective paper “Pharmacy 2030”.
Closer cooperation between doctors, hospitals and pharmacists is required
In particular, the changing patient structure, the increasing number of people in need of care, but also the enormous shortage of skilled workers are reasons that speak for closer cooperation.
Doctors and hospitals are rather critical of this demand, because the reform could change the entire health system. Furthermore, experts fear that the competencies of pharmacists could be exceeded. The news magazine Die Welt addresses the doctors' point of view:
- "[...] But it is also clear that the boundaries to the core competencies of the other should not be weakened." (Andreas Gassen, CEO of the National Association of Statutory Health Insurance Physicians)
Gassen adds that the treating physicians are most likely to know about useful preventive measures, since only they know the patient's state of health in detail. In addition, the cooperation between doctors and pharmacists is already good and does not need to be changed.
The pharmacies, however, hope that the reform will have more influence on the healing process for patients. Another reason in favor of closer cooperation is to counteract the shortage of skilled workers. A closer cooperation could relieve both sides elsewhere.
Health industry particularly affected by the shortage of skilled workers
According to a study by Roland Berger Strategy Consultants Holding, the entire industry is affected by this situation. At this point, the hospitals should be mentioned, because according to the study, most of the staff is missing here.
Around 80 percent of hospitals are already victims of the shortage of skilled workers. The pharmaceutical industry is not exempt from this trend either. Although the job offer is plentiful, there is still a nationwide shortage of trained people.
This already confirms a critical look at the advertised positions. According to the job advertisements on stepstone.de, in addition to pharmacists and pharmaceutical employees, highly qualified quality and product managers are currently being sought.
In the pharmaceutical sector, there are particularly regional bottlenecks in Baden-Württemberg, where vacancies for positions are 44 percent above the national average. Berlin and Hamburg are also affected by this trend. The lack of qualified personnel is also noticeable in research, as the large pharmaceutical companies are constantly looking for skilled workers. Michael Burkhart, Head of Health Care and Pharmaceuticals at the management consultancy PricewaterhouseCoopers AG Wirtschaftsprüfungsgesellschaft, warns of this development.
- "The shortage of staff will increase dramatically from 2020, both for doctors and non-medical specialists".
Studies by the Federal Employment Agency confirm the search for qualified personnel.
This problem could be counteracted by closer cooperation between the various sectors, because better cooperative preventive work on the part of doctors, hospitals and pharmacies would reduce the number of urgent illnesses. The result would be a relief for the specialist staff.
Patient coordinators for relief within the hospitals
A constructive suggestion from those responsible are so-called patient coordinators who take on the tasks of both doctors and nurses within the hospitals. These coordinators regulate the entire process from admission to discharge. This would ensure adequate patient care, and the redistribution of the bureaucratic effort to the coordinators would reduce the workload of the specialist staff.
Pharmacies require involvement in the treatment
In principle, pharmacies are calling for closer cooperation between the different medical areas. One example is the commission for the involvement of pharmacists in diabetic care.
A cooperation between the German Diabetes Society and the Federal Chamber of Pharmacists has called for greater involvement of pharmacists in the treatment of patients with diabetes. This initiative went particularly to Prof. Dr. med. Hermann Ammon back. The aim was to increase the level of knowledge of pharmacists through certified training programs and evaluations and thus to guarantee high-quality advice in the case of diabetes.
A similar involvement is already established in the treatment of asthmatics. This is defined in the program for National Care Guidelines. These have been compiled by those responsible in all medical areas and are intended to support those affected as well as doctors and pharmacists in the correct treatment.
Another initiative - the "future drug supply concept"
A model project has been set up in Saxony and Thuringia to ensure continued cooperation between doctors and pharmacies. Different health insurance companies are also involved in the project. The aim is to jointly supply medicines for chronically ill people or patients who are supposed to take more than five active ingredients.
Because the more medication is taken, the greater the risk that medication will fail. The project aims to provide patients with the correct active ingredients and quantities. In this way, any communication problems between pharmacists and doctors can be resolved constructively, because software offers those involved an up-to-date overview of current medication. The concept is based on three pillars:
- Active ingredient regulation
- Medication catalog
- Medication management
The advantages of this initiative are in particular the avoidance of double medications and time savings for doctors. They then have more leeway to explain the intake and the side effects to the patient. A total of around 1,000 pharmacists and doctors have taken part in the project so far.
The recommendations refer to eight diseases, including hypertension, osteoporosis, heart failure, depression and Alzheimer's dementia. However, the start of the project was rather slow.
In Thuringia, for example, 150 doctors take part in the initiative, which is only five percent of all doctors in the state. Nevertheless, the numbers have risen continuously over the past year. Experts therefore assume an increasing trend.
The Federal Court of Justice accommodates the cooperation
There are usually strict rules governing the allocation of drugs. Nevertheless, the Federal Court of Justice has increased the scope for cooperation between doctors and pharmacists. Specifically, the judgment concerned a Freiburg pharmacist who is now a partner in a discharge management company due to the judgment.
He receives medication prescriptions from the university clinic shortly before the patient is discharged. This approach increases the success of further treatment after the hospital stay. However, the prerequisite for this collaboration is that the patient's situation improves and that the patient agrees. In practice, this judgment could have an impact on the closer cooperation between the individual areas that was requested at the beginning.
