title: [The growing endangerment of specialists in private practice--opening up access to hospital outpatient clinics from the medical specialists' point of view].
abstract: The legislator is increasingly disadvantaging medical specialists in private practice by promoting hospital-based ambulatory treatment. It should not be ignored, though, that the office-based specialist covers a range of services which has so far not been provided by hospitals, which means that hospitals will have to cope with an additional demand. In the past, hospitals have not exhausted their options either. For instance, only 5% of all ambulatory surgical interventions are performed in hospitals. Apart from institutionally opening up access of hospitals to ambulatory treatment the legislator has provided the hospitals with further advantages and clearly created distorted competition by introducing the concepts of integrated care and ambulatory healthcare centres. The advantages of the office-based specialists' higher flexibility and management competence will be lost. Ambulatory care will be placed in settings producing the highest costs. A much more reasonable alternative, namely the development of specific models of co-operation will be proposed in the following text.
authors.affiliation: GFB--Der Fachartztverband, Bremen.
authors.forename: Jörg-Andreas
authors.initials: JA
authors.lastname: Rüggeberg
mesh_terms: D005858:Germany; D006801:Humans; D008505:Medical Staff, Hospital / Q000592:standards; D008511:Medicine / Q000592:standards*; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D011785:Quality Assurance, Health Care; D013038:Specialization