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BMJ 2009; 338:b97 doi: 10.1136/bmj.b97 (Published 12 January 2009)
Cite this as: BMJ 2009; 338:b97
News
Germany abolishes its compulsory retirement age for doctors
Annette Tuffs

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Author Affiliations
1Heidelberg

A new law abolishing the compulsory retirement age of 68 for GPs and specialists in primary care in Germany came into effect at the beginning of this month. The new law has been introduced because of a shortage of doctors in rural areas and small towns, especially in east Germany.

The German Medical Association (Bundesärztekammer), which has long advocated an end to the age limit, which was brought in in 1993, welcomed the law. “The age restriction was out of date. It does not make sense to stop doctors treating their patients if their patients want them to continue to do so,” a spokesperson said.

The age limit was introduced to try to prevent a predicted surplus of doctors and to give younger doctors a chance. It applied only to the treatment of non-private patients, which make up about 90% of the population. Doctors aged 68 years or older have always been allowed to treat private patients. Several court cases against age discrimination have been unsuccessful.

The law was eventually changed because the expected oversupply of doctors failed to materialise, except in some popular towns and regions. Instead in the past decade a third of qualified doctors decided to abandon clinical medicine and go into other professions.

Many doctors also emigrated. Recent statistics show that by 2007 about 16 000 German doctors had left the country, many of them (4200) to practise in Britain.

Furthermore, doctors became less inclined to set up their own practices or to take over a practice from a retiring colleague because of the high financial risks and long working hours.

At a press conference in October 2007 the German Medical Association and the National Association of Statutory Health Insurance Physicians warned that several rural areas did not have enough GPs, gynaecologists, ophthalmologists, neurologists, and dermatologists and that patients were having to wait several months for an appointment or were having to travel to neighbouring towns. “In 2012 we expect a deficit of about 41 000 doctors,” Andreas Köhler, head of the national association, told the press conference.

However, a few critics, such as Marco Dethlefsen, spokesman of the Association of Statutory Health Insurance Physicians in the north German, largely rural state of Schleswig-Holstein, said that lifting the age limit would not fix the problem but only postpone it until many older practitioners retired.

His colleague Jochen Hansen, chief hospital anaesthetist in Schleswig-Holstein, warned that doctors should not carry on just for financial reasons if they were not physically fit. Regular obligatory check-ups, similar to those that pilots and train drivers have to undergo, should be instituted, he said.

But the German Medical Association said that it had confidence in the self assessment system for doctors and pointed out that standards of health care were not under threat, because older doctors were obliged to attend vocational training.
Notes

Cite this as: BMJ 2009;338:b97