title: [Medicine between humanitarianism and competition: the patients' point of view].
abstract: BACKGROUND
  An open medical market is supposed to be a promising tool for preserving the meagre resources of the German public health care system. The competition between humane and economic practice induces conflicts which burden physicians as well as patients. To analyse this problem by scientific means, inpatients were interviewed with the help of a standardised protocol.
  
  
  METHODS
  During 10 weeks 524 inpatients were interviewed. The structured questionnaire consisted of nine closed-ended questions with multiple-choice answers. Question 3 included a free amendment. The gender ratio was balanced, and the age pattern represented the typical patient collective of our clinic.
  
  
  CONCLUSIONS
  The majority of patients expect negative changes in their medical service and the social attitude towards patients and physicians due to promoted medical competition. Besides an increasing financial load, losses in trust, self-determination, and therapeutic freedom are expected. Instead a responsible transparency will not be achieved. Patients still judge the economically dominated reforms on the German health care market with scepticism or even hostility. In their point of view future discussions must aim at a more modern attitude towards health economics in order to bridge the schism they perceive between medical competition and humanitarianism. The understanding of strong financial management as a prime condition for stable social security is the basis of synergies to deal with upcoming reforms.
authors.affiliation: Klinik und Poliklinik für Chirurgie, RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen, Deutschland. ckrones@ukaachen.de
authors.forename: C J
authors.initials: CJ
authors.lastname: Krones
authors.forename: R
authors.initials: R
authors.lastname: Rosch
authors.forename: G
authors.initials: G
authors.lastname: Steinau
authors.forename: V
authors.initials: V
authors.lastname: Schumpelick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000533:Altruism; D001294:Attitude to Health; D003625:Data Collection; D004465:Economic Competition; D004470:Economics, Medical; D005260:Female; D018166:Health Care Reform; D006801:Humans; D007297:Inpatients; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012943:Social Security; D011795:Surveys and Questionnaires