Many hospitals in Germany are in financial distress. The major hospital reform of the federal government seems to have stalled. This is not only about a lot of money but also about the well-being of patients. Vital-Region.de spoke with Prof. Dr. med. Sven Lahme, specialist in urology and Medical Director of the Goldstadt Private Clinic in Pforzheim, about a hospital system in distress.

PZ: Manuela Schwesig, Prime Minister of Mecklenburg-Vorpommern, says that our hospital system is "ill" because "far too much emphasis is placed on economics, profit maximization, instead of the patient and the staff." Do you agree?

Sven Lahme: That is clearly affirmative. The goal of the German hospital system should be the best possible recovery of patients. Achieving the best possible healing outcome is the inherent task of doctors and nurses. However, in the German hospital system, patient care is limited by a legally defined cost framework. Health insurance companies and public hospitals decide on the allocation of these financial resources. Nurses and doctors, as the actual service providers, have increasingly less influence on the decision-making processes in patient care and are forced, contrary to their professional understanding, to conduct medicine based on economic considerations.

PZ: What does this mean for working with and for the patient?

Sven Lahme: The associated proliferation of bureaucracy distracts doctors and nurses from their actual work. The focus of a hospital system should always be on the patient. However, when the profitability of a hospital operation takes precedence, the needs of the patients can be overlooked.

PZ: Does this apply to all hospitals, or do private clinics or private hospital operators represent an exception?

Sven Lahme: I can only speak for Goldstadt Privatklinik. As a purely private clinic, we receive no public subsidies and finance ourselves entirely. We are somewhat outside the public hospital system. This allows us to reduce bureaucracy and internal clinic structure to the essentials. The clinic management consists of doctors and pharmacists, that is, healthcare professionals. Therefore, all patients are treated strictly according to guidelines without the clinic having to meet case numbers or revenue targets. Such a private clinic can only exist if patients are satisfied and the highest quality standards are met. The fact that we do exceptionally good work is reflected in the many positive clinic reviews.

PZ: Is the idea of the reformers to move away from case rates and form a hospital network in three levels of care sensible?

Sven Lahme: The hospital reforms of recent decades have primarily been measures to save costs. With each reform, a new layer of bureaucracy was implemented. When I now hear about three levels of care, it sounds like another push for more bureaucracy. We don't need an administrative reform, but rather a reform for better patient care.

PZ: Hospitals primarily treat inpatients. With Goldstadt Privatklinik, you're consciously taking a different approach by offering outpatient consultations. Aren't you spreading yourself too thin?

Sven Lahme: We consciously follow an integrative treatment approach. Patients are consistently cared for by a urology-trained specialist team, starting from outpatient consultations, through their inpatient stay, to follow-up care. All staff members provide care with a high level of personal attention. This ensures that all stakeholders are fully informed about a patient's health status and know what needs to be done.

PZ: What does your patient-centered treatment concept look like in practice?

Sven Lahme: To give you a better idea of the patient's journey through the clinic, let me briefly outline the path of a bladder cancer patient: It begins with the outpatient initial examination. Diagnostics are conducted in-house. If a bladder tumor is detected, treatment is provided as part of an individualized therapy plan. In the early stages, local treatment is possible, allowing the bladder to be fully functional. In advanced stages, it may be necessary to surgically remove the bladder and either form a replacement bladder from other tissue or surgically create an alternative urinary diversion. This occurs during an inpatient stay. The anesthesia team is an integral part of the clinic's team and specializes in urological surgeries. They care for patients from preoperative assessment through anesthesia to postoperative anesthesia rounds. Depending on the course of treatment chosen, regular outpatient follow-up for bladder cancer patients may be necessary as bladder cancer can recur.

PZ: What is the central advantage of this approach?

Sven Lahme: The concept of urology under one roof avoids loss of interfaces, gives patients security, and alleviates their fear of examinations.

Urological Forum on May 10th at Goldstadt Private Clinic

Doctors from Goldstadt Private Clinic, a specialized urological clinic in Pforzheim, will explain important aspects of diagnosis and treatment for bladder cancer in a Zoom conference on May 10th from 7:00 to 8:30 PM. The urology forum on "Bladder Tumors" is an online event offering insights into the operating room and showcasing treatment options. Experts will answer audience questions. Visit goldstadt-privatklinik.de/forum/ to find everything you need for free participation in the Zoom conference.

The online access details for the Zoom conference of the Urological Forum on Bladder Cancer on May 10 from 7:00 PM to 8:30 PM can be found at https://goldstadt-privatklinik.de/forum/

Author: Thomas Kurtz