Germany: Cardiovascular Primary Care Overview

Prof. Martin Scherer - EPCCS Council 2017

Introduction Cardiovascular risk management by primary care in Germany

In Germany, there are 450,000 physicians, 343,000 active clinicians, 57,000 GPs, 170,000 in hospital, and 143,000 ambulatory care. The GPs are entrepreneurs and are running small companies. They are allowed to do many things, but they are not paid for everything.
There are 38 universities with a medical faculty and half of the universities have a department-like struture with a full-time GP who acts as a lecturer but often without sufficient infrastructure.
The German College of General Practitioners (DEGAM) has 6,000 members (approximately 10% of all GPs). As a part of DEGAM there is a guideline committee with 80 members which produced 40 primary care practice guidelines and participated in 30 interdisciplinary guidelines.
The „Hausärzteverband“ is another society in Germany with 30,000 members representing the political lobby of german GPs.
In Germany, cardiovascular disease is dealt with in primary care. General practice guidelines deal with heart failure, cardiovascular prevention, chest pain, and coronary heart disease. Most German cardiologists treat their patients accorsing tot he ESC guidelines.
There are organized disease management programs for CHD, Diabetes, Asthma/COPD.
The DEGAM developed a cardiovascular risk calculator software (ARRIBA), which helps the GP in the calculation and commmunication of relative and absoute risk.
Furthermore we are developing DEXIMED as a point-of-care-encyclopedia, which is an adaptation of the NEL (Norsk Elektronisk Legehåndbok).