Doctors' practices and health clinics across Germany remained closed on Monday.

With most such facilities closed on weekends and Tuesday October 3 being a bank holiday in Germany, the strike was timed to create a four-day gap without local non-emergency services for many people. 

A patients' organization accused striking doctors of choosing a tactic that would "primarily affect the sick and the weak," and said it showed that patients were not treated like the customers they ultimately are in a system predominantly paid for by health care consumers and their employers.

What is the strike about? 

Thousands of health professionals walked off the job in protest to government health polices that they say are failing to help them cover rising costs, while at the same time overloading them with bureaucracy.

"Doctors' offices are so strangled by various regulations — especially when it comes to billing restrictions — that they now have to limit their services because they can't afford to offer them all anymore," Dirk Heinrich, chairman of the Virchowbund, the doctors' union which called the strike, told Tagesschau.

Heinrich claims practices spend around 60 days per year dealing with paperwork rather than caring for patients. He also bemoans a government cap on the costs health insurance companies can cover, saying it prevents doctors from taking on more patients.

"This is a clear signal to health politicians in the coalition government and to Chancellor Olaf Scholz that they need to put the brakes on [health minister Karl] Lauterbach," said a Virchowbund statement, adding: "We're bleeding out. Politicians and insurers have been forcing practices to cut costs for 30 years. We can't do it anymore."

The Virchowbund says patients are having a harder time getting appointments and have to wait longer when they get them. Meanwhile, doctors face rising energy, material and salary costs. It is estimated that over 10,000 practices striked Monday.

Criticism from patient's organization, and health minister

The chair of the German Foundation for Patient Rights, Eugen Brysch, criticized the methods chosen by unions on Monday. 

"Any group of professionals can fight for improved pay. But closing doctors' offices will primarily affect sick and weak people," Brysch told the dpa news agency, adding that the day's disruption would not greatly impact health insurers or Health Minister Lauterbach. 

"For other freelance workers, it would be unthinkable to target your customers in this way. This makes it clear that patients in our health system do not even have a status akin to that of a customer," Brysch said.

According to the health insurance union GKV, wages have been adjusted accordingly, with spokesperson Helge Dickau referring to an "ample increase" that takes into account inflation.

Government Health Minister Lauterbach of the Social Democrat Party (SDP) even took to the platform X, formerly Twitter, to claim that doctors with practices earn a median of "around €230,000 [$242,000] per year," and ask: "Should [patients'] basic contributions increase so that salaries can increase?"

Wages are scheduled to increase by 3.85% in 2024, but the Virchowbund said inflation was hovering between 5-6% and contradicted Lauterbach, citing a much lower average salary of €85,555 after tax and insurance contributions.

The longer practices do not receive adequate support, according to Heinrich, the more they will be tempted to turn to private investment more focused on profit, which he says brings its own risks.

"[Private practices] also look after their patients, of course, but with a different focus, often on the sale of individual services," he said. "Appointments are then only given provided the patient brings enough money with them."

mf/msh (dpa, AFP)