Austrian Medical Chamber
Austria
Address: Weihburggasse10-12, A-1010 Wien, Autriche
EMO member: Austrian Medical Chamber (Österreichische Ärztekammer), www.aerztekammer.at
Head of Delegation: Dr Michael Adomeit
The Austrian Medical Chamber
According to the Austrian Medical Act, the Austrian Medical Chamber represents the professional, social and economic interests of all doctors engaged in medical activities in Austria. Furthermore, it acts as umbrella association under public law for its nine members, the medical chambers in the Austrian provinces. Membership is obligatory for every doctor wishing to pursue medical activities in Austria.
Activities and Services
Legal responsibilities of the Austrian Medical Chamber include, besides others, admission to and administration of the medical register, as well as recognizing foreign medical qualifications. Furthermore, the Austrian Medical Chamber is the competent authority for issuing medical diplomas and for conducting specialist and GP qualifying exams. Further competencies comprise the elaboration of concepts, expert opinions and proposals regarding the Austrian health care system, including the right to comment on draft bills or enacting guidelines on medical fees, on the medical code of conduct etc., as well as concluding contracts with social insurance institutions and collective agreements. Executing disciplinary legislation and arbitration also belong to the responsibilities of the Austrian Medical Chamber. Moreover, the Chamber is involved in the elaboration of specialist and GP training programs, and it has its own institution offering CME/CPD for Austrian medical doctors called Austrian Academy of Doctors (Akademie der Ärzte). The Chamber provides counselling for its members in issues relating to professional law and in international matters. Information for members is provided on the website and in the journal of the Austrian Medical Chamber (Österreichische Ärztezeitung).
Education and training
Medical training in Austria is characterized by a dual system. Degree courses in medicine, which have a minimum duration of at least six years, can be taken at public and private medical universities. In the course of a comprehensive reform, obligatory practical training was integrated into medical university studies, in order to better prepare students for medical practice.
In order to work as a general practitioner, the medical training regulations currently prescribe 42 months (3 ½ years) of training, structured in 36 months of hospital training and 6 months of training in a GP practice or a group practice recognized by the Austrian Medical Chamber. However, the total duration will be raised to 45 months in 2022 and subsequently to 48 months in 2027.
At the end of training or after 30 months of training at the earliest, the GP trainees have to complete a written final qualifying exam in general medicine. The completion of the examination is a prerequisite for engaging in independent medical practice.
CME/CPD
In Austria, the practice of the medical profession is subject to mandatory CME/CPD requirements. This requirement is established both in the Austrian Medical Act and by the Regulation on CPD (DFP-Verordnung), a decree issued by the Austrian Medical Chamber. Since 2016, every licensed doctor, GP or specialist has to provide evidence of CME/CPD to the Austrian Medical Chamber on a regular basis. Within a period of 5 years, at least 250 DFP (CME) credits have to be collected. CPD activities can be documented in an online CPD account to which the CPD provider transfers credits. CME/CPD events are accredited by the Austrian Medical Chamber via the “Austrian Academy of Doctors”. Accreditation is given both to CPD providers and individual CPD activities. Non-compliance with CME/CPD requirements entails sanctions which may range from a written reprimand to an occupational ban in the case of firm refusal to meet the CME/CPD obligations.
E-Health (e-card, ELGA, e-Medikation)
In 2005, the so-called “e-card” has been introduced in Austria. The e-card is a personalized chip card of the electronic administration system of the Austrian social insurance institutions (health, pension, accident or unemployment insurance). The system supports administrative processes between the insured person, the employer, the contracting parties (doctors, hospitals, pharmacies etc.) as well as the social insurance funds. The card provides personal identification data such as name and insurance number and every patient is obliged to show it when visiting a doctor or hospital. By reading the e-card via the secure data network the doctor or hospital checks if a person is insured and which health insurance institution is responsible for paying the medical treatment. This data is requested online from the e-card system and is not stored on the card.
As the e-card is based on a key card principle, it also allows access to ELGA, the Austrian electronic health record (Elektronische Gesundheitsakte). ELGA aims to elaborate an information system that provides doctors, hospitals, care facilities and pharmacies access to a patient’s health record. Various health care facilities create different health records such as medical reports. ELGA processes this data and makes it accessible electronically for different users via a link. Since December 2015, hospitals in Austria are obliged to implement this system.
In Austria, the project of introducing “e-Medikation” as a feature of the electronic health record (ELGA) is in progress. E-Medikation is an application in the form of a database containing information on the medications that have been prescribed and dispensed. However, e-Medikation is not equivalent to purely electronic prescribing, and the patient will continue to receive an ordinary paper prescription. It will be mandatory for all self-employed doctors under contract with a health insurance fund. Physicians practicing only on a private basis, without holding a contract with a health insurance fund, can decide voluntarily if they want to use it. Patients have the possibility to opt out from the e-Medikation feature, or from ELGA as a whole.
Quality assurance
The obligation of medical quality assurance is stipulated in the Austrian Medical Act. For this purpose, the Austrian Medical Chamber established the Austrian Society for Quality Assurance and Quality Management in Medicine (ÖQMed) which is legally required to perform quality evaluation and quality control of medical practices at least every five years. Further responsibilities of ÖQMed include the elaboration of quality criteria for single practices and group practices, as well as the maintenance of a quality register on national level.
| Number of physicians in Austria (as of January 12th2018)
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| Total number of physicians: | 45 596 |
| –male physicians: | 24 004 |
| – female physicians: | 21 592 |
| General practitioners: | 13 523 |
| – male: | 5 539 |
| – female: | 7 984 |
| Self-employed GPs: | 6 590 |
| – contract with social insurance: | 4 002 |
| – no contract with social insurance: | 2 588 |
The basic health service has always been prioritised in preventive work. As early as in the 1940s we had our network of maternity and childcare instruction clinics. The Finnish mortality rate in maternity and perinatal groups is very low, even inside the European Union (EU). As the family doctor system emphasised the availability of medical care, at least in its beginning, there was a fear of preventive care decreasing. Fortunately this did not happen. Basic healthcare has taken responsibility for most of the preventive activities. The family doctors have understood the significance of this work for the welfare of the citizens. More than half the Finns already belong to the family doctor system, so the availability of the medical care has improved and there are no more queues for general practitioner (GP) consultation. Medical care takes place mostly in the hours of consultation and home visits are rare. There is a home care system in our health centres where nurses, together with the family doctor and with social care home helpers if needed, try to support very sick people in living at home. Home visits of doctors are still very rare, but the aim is to increase them in the future. Our system is also more focused on hospitals than any other systems in the EU, but this will be changed. Our family doctors function in health centres comprising several doctors, with x-ray and laboratory services produced by the health centres themselves at their disposal. Finland is very sparsely populated and particularly in the north of the country the health centres function more like hospitals. There are no common borders for the developing functions, even with expertise, so there are many healthcare units where the GPs operate more as if for specialised care. In more crowded areas, the health centres and the hospitals will increasingly co-operate, unified by the lab and x-ray functions, when the data systems develop and the same unit can serve both health centre and the central hospital.In developing healthcare, the pressure of increasing costs is high and the quality requirements have emerged. There are more and more investigations done to solve the overlapping and interpenetrating functions of hospital care, basic healthcare and social care. The evidence-based care has come where the medical care is always based on evidence. There are regional medical programmes increasing the quality and emphasising the differentiation, improving the co-operation and data chains. The regional care programmes are done in co-operation with specialists, GPs and nurses.Several quality programmes and projects have been started. Instead of regional care-taking programmes, the thinking is moving towards care chains, especially including the problems of interfaces. The aim is to improve the status of patients, offering high quality care and good co-operation between health and social care systems. The patient should always be in the right place to be taken care of and so the economic gain would be clear. The real time data change is obligatory for good care.Our healthcare system is based on strong basic healthcare in the health centres. The availability of services can be more important than the right to choose the doctor. The GP’s position as a gatekeeper has been emphasised and the family doctor system has made it possible. In the doctors salary system the availability of medical services has been emphasised, meaning that only a part of doctor’s income is salary: the rest is comprised of fees for service and fees for capitation. The fee for service system will direct the activities of the GP and emphasise preventive activities, especially in the last salary contracting movement.
