In Germany, over seven million people have diabetes mellitus. More than six million people suffer from osteoporosis and around a quarter of the population has thyroid disease. "Metabolic diseases are increasing steadily, while the number of medical personnel in this area is increasingly falling victim to financial savings," said DDG President Prof. Dr. Monika Kellerer. In a position paper, the DDG, DGE and DZD draw attention to this deficiency and present a catalog of measures to promote training and continuing education.
In the last three decades, the number of chairs in this field has almost halved. "At present, only eight out of 38 medical faculties still have a corresponding clinical chair with the right to direct," said Prof. Dr. Günter Stalla, president of the DGE, explaining: "The system of diagnosis related groups (DRG) puts so-called ‘communicative medicine’, which includes diabetology and endocrinology in particular, at a disadvantage.
This development leads to an undersupply of specialists, a shortage of young talent in these specialist areas and less research, which has a further negative effect on the quality of care. More and more patients have to wait for an appointment for months or can no longer find a specialist to provide care for them. ”The corona pandemic in particular has shown how important stable metabolic control and close-knit care are for diabetes patients. “Our disciplines will be bled dry if we do not act on a political level,” the endocrinologist warned.
Care and research are an essential part of the National Diabetes Strategy adopted in the summer. The DZD already supports translational diabetes research in Germany and the urgently needed networking of university and non-university research, both on the federal and state (Länder) level. "However, for this networking to be successful over the long term, independent clinical chairs in diabetology and endocrinology are urgently required," said DZD board member Prof. Dr. Dr. h.c. mult. Martin Hrabě de Angelis. "Unfortunately, there is still a tendency at many university hospitals not to fill vacant chairs again or to downsize the few existing hospitals."
In a joint position paper, the DDG, DGE and the DZD therefore call on policymakers not only to maintain existing capacities but also to expand them. To this end, they have compiled a catalog of measures that includes the following:
- All medical faculties should have chairs for diabetology/endocrinology.
- The subject must be better covered in the curricula for medical students, and attractive career paths in research and patient care must be developed for the next generation.
- The transfer of research between bench and bedside should be strengthened via sustainable target positions in clinic and science for clinician scientists and medical scientists.
- Clinical treatment capacities in diabetology/endocrinology must be expanded. To this end, ‘communicative medicine’ should be better represented in the patient classification codes of the diagnosis related groups (DRGs).
- The comprehensive care of particularly vulnerable groups (children and geriatric patients) must be ensured through appropriate financing.
The complete position paper can be viewed here: https://www.deutsche-diabetes-gesellschaft.de/fileadmin/user_upload/06_Gesundheitspolitik/03_Veroeffentlichungen/Positionspapier-Lehrstuehle-DDG-DZD-DGE.pdf
Recommendation of the Health Forum concerning Clinician Scientists: https://www.dlr.de/pt/Portaldata/45/Resources/Dokumente/GF/Clinician_u_Advanced_Clinician_Scientists_12-2018.pdf