[The professional profile of the oromaxillofacial surgeon in the clinic].
The German Society of Oral and Maxillofacial Surgery (Die Deutsche Gesellschaft für Mund-, Kiefer- und Gesichtschirurgie) is celebrating its 50th birthday--an occasion to highlight the current professional and political situation and future perspectives in the clinics devoted to this specialty. To this end, structural data from 71 major clinics (or divisions) are analyzed. The clinics have 2,300 beds, 32 on average, with a variance width of 10:64. This corresponds to one clinic bed for approximately 35,000 inhabitants. The neighborhood of the clinics and thus the working conditions and personnel situation have changed markedly in the past few years. Working conditions are evident from the doctor-bed proportion with its resulting burden on the medical team. There are 244 assistants currently studying for their specialty; 107 others are striving for the additional title of "Plastic operations". Plans for positions are based less on the planned number of beds than on the number of cases, productivity, and treatment spectrum of the clinic, sometimes with a bonus for research and teaching. The outpatient sector, which plays a major role, is not considered. Health-care politics continue to stress budgeting and rationalization, i.e., further cuts for positions and beds, including for maxillofacial clinics. While the professional and political concerns of the clinic doctors increase, health insurances are increasingly exerting influence on medical services and the financing of hospitals. This can prove life threatening for the clinics. The administrative structure of the clinics is also being questioned and is to be replaced by a collegial system. But the survival of the clinics and their personnel structure depend specifically on qualified management, clearly set goals, the ability to integrate, and openness to innovation. The advanced education of young oral and maxillary facial surgeons should be reconsidered, and more unlimited positions for medical specialists should be created. If the high standard of our specialty and the quality of education can be strengthened and extended, the perspectives for the future of clinical oral and maxillofacial surgery can be considered to be propitious, in spite of aggravated conditions.
Koch
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Klinik für Mund-Kiefer-Gesichtschirurgie-Plastische Operationen, Ev. Krankenhaus Bethesda, Mönchengladbach, Deutschland. Kochabethesda-mg.de
D003740:Dental Clinics / Q000639:trends*; D005544:Forecasting; D005858:Germany; D006801:Humans; D009313:National Health Programs / Q000639:trends*; D019239:Practice Patterns, Dentists' / Q000639:trends*; D013038:Specialization / Q000639:trends; D013515:Surgery, Oral / Q000639:trends*