Landarzt

In rural areas, the distances between doctor and patient, as well as between general practitioners and specialists or hospitals, are greater, and the average age of patients is higher. Rural doctors often perform tasks that are handled by specialists in urban areas. They are also the first point of contact in emergencies. Regular home visits are more important than in urban general practices.

The term "country doctor" first appeared in Bavaria at the beginning of the 19th century, after the University of Bamberg was dissolved in 1805 and its medical faculty ceased teaching in October 1809. The Munich government subsequently established a "country medical school" (after having already considered training second-class doctors for the rural population in 1808).

Situation in Germany

Germany is experiencing a growing shortage of general practitioners in rural areas, initially in eastern Germany, but now also in other regions. Reasons often cited include the less attractive working and living conditions in rural areas compared to large metropolitan areas, coupled with the aging of the current rural medical profession. The entrepreneurial risk of self-employment deters many young doctors from establishing a practice, as does the difficulty of reconciling self-employment with family planning and the threat of financial penalties for prescribing above-average amounts of medication. This uncertainty is exacerbated by healthcare policy reforms and the resulting lack of predictability in self-employment. By 2021, 42 percent of general practitioners will retire. The district of Osterheide on the southern edge of the Lüneburg Heath recorded the largest population decline nationwide (minus 12.8%). Only a few holiday resorts, primarily on the coast, have managed to buck this trend. Neustrelitz (Mecklenburg-Western Pomerania) and Görlitz (Saxony) also held their own well in rural environments. According to the study, the population group aged 18 to under 30 is particularly mobile. They move primarily from small towns and rural communities to large centers and university cities for education and career opportunities. In contrast to earlier times, they are significantly less likely to return to their hometowns after completing their education.

Attempts are being made to counteract the shortage of rural doctors through measures such as scholarships or financial incentives. In 2014, the German Council of Experts on the Development of the Healthcare System proposed increasing the remuneration for rural doctors by 50 percent and doubling the number of doctors training to become specialists in general medicine and internal medicine. Other approaches include the Rothenburg Model or the networking of practices. The delegation of tasks to medical assistants is also being discussed. Various approaches exist for this, such as the MoNI model in Lower Saxony r Verah (Practice Assistant in General Practice). In Lower Saxony, there was also a pilot project called the "mobile medical practice" to ensure a minimum level of medical care. Hesse also has a pilot project called the Medibus, which provides medical care to villagers as a "mobile medical practice.

At the end of 2012, the Federal Joint Committee increased the planned number of general practitioner positions in rural areas by 3,000. n return, 1,800 positions in oversupplied cities will be eliminated. Furthermore, measures are intended to make it more attractive to settle in rural areas, such as the elimination of residency requirements or the abolition of claims for reimbursement in cases of excessive prescriptions. The target is one practicing physician per 1,671 residents.

In some regions, particularly in the former East Germany, rural medical care was typically provided through so-called rural outpatient clinics. These were polyclinics with employed physicians, similar to medical care centres , which are gaining in importance.