For Max Beyer, the decisive factor is the numerous small border crossings. That he still goes to the trauma room to take care of an injured person who has just been hospitalized, even if in reality he has already finished work. That he constantly replaces sick colleagues, even if this violates the legal rest period. Let the break be subtracted from his salary, even if he mainly works all the time.
Beyer is an anesthetist in a hospital in Baden-Württemberg and his real name is different; for fear of problems with his employer, he wants to remain anonymous. The anesthetist will be on strike this Thursday. “Because like this,” Beyer says, “he can’t go on.”
The Marburger Bund doctors’ union has called on all doctors in municipal clinics to stop working for a day. In medical practices, operations will continue normally on Thursday, as will hospitals that are not municipally owned but are for example funded by private individuals or churches.
In 450 municipal clinics, however, there is the risk of severe restrictions, even if it is not yet clear how many of the approximately 60,000 doctors employed will follow the call for strike. Many hospitals are switching to emergency care, which also applies on weekends: acute severe cases, such as heart attacks or open fractures, are treated. However, scheduled operations are postponed, such as knee and hip operations or colonoscopies.
It is about more than money
In the midst of the crown pandemic, patients now feel what officials at the negotiating table cannot solve. The Marburger Bund and the Municipal Employers’ Association (VKA) have been campaigning for better working conditions for doctors like Max Beyer for six months. It is also about more money – the union wants 5.5 percent more salary, also due to high inflation – but something else is more important: doctors should finally have more free time.
In fact, anesthetist Max Beyer is entitled to two free weekends per month and a maximum of four hours on call, according to the collective agreement. On-call duty are extra long shifts in which Beyer first completes a normal working day and then stays longer in the hospital for acute cases: if someone needs emergency surgery at night, he or a colleague is there to start the anesthesia.
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He then spends 16 hours at a time in the hospital, and from time to time he and his colleagues do more than four of these services a month. “We just don’t have enough staff,” Beyer says. Even the rule with free weekends is not always respected and, if so, only through tricks including weeks of vacation.
The Marburger Bund is trying to leave at this very point. “The current rules offer too many loopholes,” criticizes Andreas Botzlar, who negotiates for the union. He wants to ensure compliance with the maximum limit of four hours of availability per month, and not just as a half-yearly average, as has been the case so far. The same goes for free weekends. In addition, on-call services, during which doctors are not required to be present in the clinic but are called in an emergency, must be limited to twelve per month.
Exceptions should continue to be allowed, particularly if patient safety would otherwise be jeopardized. In practice, however, this is discussed too often, says Botzlar. He wants to tackle this problem by making sure that every doctor who has too many shifts a month or too few weekends off gets paid.
“A strike that hurts no one does not lead to change”
Employers, on the other hand, criticize that the requests would pose unsolvable problems for the clinics. “Many of them no longer have the necessary flexibility in scheduling and cannot maintain patient care,” says their chief negotiator, Wolfgang Heyl, of the SZ.
However, he thinks a compromise is possible, with services, on-call time and free weekends there is room for maneuver. Exceeding the maximum limits must “continue to be fundamentally possible”. Critical to the strike, also in consideration of the high number of coronary infections. “Instead of stepping up further in this difficult situation, we should seek a solution together.”
Anesthetist Max Beyer sees things differently. The negotiations have been going on for six months now, he says, nothing has changed and the situation in his clinic is becoming more and more tense. During the pandemic, many colleagues resigned and even more were planning to leave soon. “A strike that does no harm to anyone”, says Beyer, “does not lead to any change”.