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Healthcare in Austria: Why are there fewer 'public' doctors?

Julia Hjelm Jakobsson
Julia Hjelm Jakobsson - [email protected]
Healthcare in Austria: Why are there fewer 'public' doctors?
A doctor during a consultation with a patient. (Photo by PASCAL LACHENAUD / AFP)

The number of elective doctors, known as "Wahlarzt" in German, is increasing in Austria - as the number of 'panel' doctors, those connected to the public health insurance system, drops.


The proportion of elective doctors in Austria, those known as a "Wahlarzt", is increasing, according to a new report

Over the past six years, the increase has been particularly notable for doctors specialising in dermatology (rising from 58 percent to 71 percent) and urology (increasing from 55 percent to 62 percent). This means that more than a third of dermatologists in Austria are now "elective" doctors, seeing people in their own private practises and charging for their consultation.

Elective doctors are those without contracts with health insurance funds. If you receive treatment from one of these doctors, you have to pay the bills yourself and will only receive partial reimbursement from your insurance funds.

This is quite different from visiting a doctor who has a contract with the health insurance funds, known as "panel doctors" in Austria, where the bill is directly paid by your insurance fund - and consultation and treatment are, therefore, free for the person. 

A higher proportion of elective doctors means there are fewer panel - or 'free' - doctors available, a situation particularly made worse by the fact that Austria faces a staff shortage and there are fewer doctors overall. Opposition parties have said that the country's "two-tier" healthcare system - with some people receiving faster and better care if they can afford it and some left to wait for weeks for a panel doctor's appointment, is at a "tipping point".   

But why are there more and more elective doctors?

According to IHS health economist Thomas Czypionka, two main reasons contribute to the increase in elective doctors, reported Kurier.

Firstly, the legal reduction of doctors' working hours in hospitals allows them to offer their services in private practice alongside their hospital jobs.

Secondly, the working conditions in insurance-funded practices are no longer as attractive to many doctors as they once were, the report said.

Despite the increase in patients as the population grows, the Medical Association does not want to increase the number of insurance-funded practices. By limiting the number of doctors, they can allow them to earn a higher income even though insurance companies pay low fees.


However, earning a high income as a doctor in an insurance-funded practice requires treating a large number of patients daily. This means that the doctors do not have the possibility to spend enough time understanding and addressing the patients' health concerns, according to Czypionka.

READ MORE: What kind of insurance do I need to have in Austria?

Improving competencies for non-physicians

To maintain a functional healthcare system despite this situation, Czypionka suggests that other healthcare professionals, besides doctors, should take on more responsibilities so that the doctors can focus on their main tasks.

In practice, this means that patients may not always be cared for directly by the doctor, as they currently often are.


Czypionka disagrees with recent ideas from various parties about mandating doctors to provide services in the public system. "This would conflict with freedom of employment. Additionally, it would suggest that the medical profession is second-class if obligations were imposed," he says.

READ NEXT: EXPLAINED: What is a Wahlartzt in Austria?


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