Future of the healthcare system
GDR cult figure suddenly becomes a role model
Aug 29, 2026 – 3:32 p.mReading time: 3 minutes
The federal government is planning to introduce a primary care system. Given the shortage of family doctors, a system from the former GDR could make a return.
In the German healthcare system, after the reform always means before the reform. After the Contribution Rate Stabilization Act recently passed by the Bundestag is intended to improve the financial situation of health insurance companies, especially in the short term, more fundamental reforms are now on the political agenda.
The Health Finance Commission – a committee of experts that has already laid the foundations for the Contribution Rate Stabilization Act – is currently working on its second report. This will also be about the introduction of a planned primary care system, as commission members Ferdinand Gerlach and Jonas Schreyögg explained in an interview with the “Ärztezeitung”.
Family doctor becomes the first point of contact
The introduction of a primary doctor or primary care system is one of the most important projects Federal Government in healthcare. It stipulates that the family doctor should be the first point of contact for all patients. This person looks at the respective problem and – if he cannot solve the problem himself – refers the patient to suitable specialists if necessary.
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5,000 family doctor seats are already unfilled
At the same time, the number of general practitioners in Germany is low. Around 5,000 family doctor positions are currently vacant. This number could increase significantly in the near future. According to a study commissioned by the Bosch Health Campus, around 12,000 family doctor seats could remain vacant by 2040 – that corresponds to a fifth of all seats. Many regions, especially rural areas, are at risk of undersupply. In which regions there is a risk of undersupply, you can read about it here.
What is a family doctor’s office?
A family doctor’s office is the official license for doctors to be able to bill for the treatment of legally insured patients. Without such a seat, a doctor can treat private patients or self-payers, but not statutory health insurance patients. A family doctor’s office is not necessarily tied to one person – it can also be shared between several doctors or purchased by a medical care center with several doctors.
But how can a primary care system function without enough family doctors? In addition to higher fees for general practitioners in underserved regions, Gerlach and Schreyögg advocate investments in primary care centers.
The commission members note that such a center does not necessarily have to be run by a doctor. It would be conceivable that patient care could largely be provided by other professional groups. The skills of nurses and medical assistants would need to be expanded accordingly. However, in terms of regulation, we are still in a gray area here, noted Gerlach.
