Dr Wagener explained the primary responsibilities of the Medical Board, which include providing input on legislative drafts and ensuring doctors’ adherence to established regulations. The Medical Board represents the collective interests of medical professionals, including doctors, dentists, pharmacists, and psychotherapists; membership is mandatory for any individual practising within these four healthcare disciplines.
Dr Wagener offered to mention that the Medical Board has 4,300 members at present, which entails a substantial workload. Across 2022, the Board handled 2,600 cases, including 126 formal complaints lodged against doctors.
The Medical Board’s most demanding role revolves around its disciplinary function, which entails conduct oversight of medical practitioners. Dr Wagener elaborated on the various levels of sanctions, prescribed by law, for doctors who breach ethical standards. These sanctions span from warnings and reprimands, to fines, before more severe penalties: the imposition of specific practice conditions, temporary suspension of practice rights, and, in the gravest of instances, permanent disbarment, prohibiting a doctor from practising for life.
The Medical Board’s wish is to have the authority to administer the more mild sanctions, namely warnings and reprimands, without necessitating legal proceedings. Dr Wagener underlined the exceedingly long waiting times and disproportionate nature of court proceedings for issues which do not warrant a doctor’s suspension.
“The Medical Board, therefore, must be reformed to work more efficiently and more quickly. An ad hoc bill aimed at this has been languishing in a drawer at the Ministry of Health for years. Despite being labelled a priority project, it has yet to be implemented,” Dr Wagener explained. He hopes, through an incoming minister, the bill for the Medical Board’s reformation will finally see movement through the legislative process.
In the realm of healthcare policy, Dr Wagener advocates for a formal agreement between the National Health Fund (CNS) and psychotherapists. While he notably serves on the Medical Board as a psychotherapist, Dr Wagener has a psychiatric background, and he underscores the importance of simplifying access to psychotherapy - particularly for patients navigating financial constraints.
Patients currently receive only a 70% reimbursement for psychotherapy expenses, leaving them responsible for covering the remaining 30% of consultation fees over weeks or months. Dr Wagener stressed that this financial burden is often insurmountable for many individuals, and third-party payment options for social reasons are not accessible for psychotherapy. He underscored the pressing need for action to rectify the issue.
On the subject of doctor shortages in a number of specialisations, Dr Wagener said that “there is no way around acknowledging that the shortage is more pronounced in certain areas.”
For instance, “we practically have too many dentists in Luxembourg, and this is not because dentists prefer the climate in the Grand Duchy, but simply because they have more favourable compensation structures in their field.”
Dr Wagener highlighted the disparity between financially lucrative specialisations and less attractive ones, expressing concern about the widening gap and its associated challenges. The Medical Board, therefore, advocates for fundamental changes in this regard.
Bill 8013, designed to enhance the appeal of medical and healthcare professions, had the potential to alleviate the overall shortage by enabling doctors to form partnerships.
This concept is particularly appealing to younger professionals seeking improved work-life balance and an alternative to self-employment. However, Luxembourg offers limited opportunities for doctors to explore this model. “You can either go to the Centre Hospitalier de Luxembourg (CHL) or work for the state. There aren’t many other options,” Dr Wagener lamented.
Bill 8013 would have made this possible, but the legislation was practically dead on arrival after attracting a relentless barrage of criticism, according to Dr Wagener. He acknowledged there are “certainly some legitimate concerns,” stating that, “The fear is that this will attract foreign investors to Luxembourg and that these companies will only focus on the money. But the investors are already here and doing nothing is not the solution.”
Instead, he stresses the importance of establishing a robust legal framework. For example, by introducing “a requirement that such a company must be managed by a doctor.” The Medical Board urges the next government to reintroduce Bill 8013 into the legislative process to address these critical issues.
