[The Calculated Physician's Fee in the Doctor's Fee Scale (EBM): A Normative Parameter for Medical Doctors in the...

The "calculated physician's fee" is important part of the ongoing discussion on health policies and the Doctor's fee scale (EBM). It is the fictional gross fee that a community doctor can receive when he selects employee relationship instead of being freelance. In order to determine the significance for real physician fees, the gross fees per minute for a community physician have been analysed in different ways: Version 1) Opportunity principle: The gross fee per minute is € 0.90. The basis is the senior physician salary plus the supplement shown in the "calculated physician's fee" (18.66% for entrepreneurial activity, 27.50% for additional work time). Version 2) Empirical value: The gross fee per minute in the outpatient sector is € 1.13 and, net of GKV, € 0.94. The fee for the calculated hospital sector is € 0.93. CONCLUSION: The value of the "calculated physician's fee" should be raised in accordance with the extra time worked. Considering senior physician's salary as an opportunity cost for community physicians appears to be correct, but the gross fees per minute for community doctors are only financially attractive when one provides services outside of the EBM. Also, the yearly adjustment of the benchmark influences the profits of community physicians. Further developments in calculating the EBM are complex, but provide an opportunity to counteract regional gaps in outpatient care.