Where do physicians who aspire to further training as specialists come from? A statistic of the Hessian Medical Association provides information. The results can be transferred nationwide. Well over half of the trainees were female. A good third of the doctors in further training did not come from Germany. Important findings for the search for a successor in the sale of a practice.

Currently 6,331 doctors are in further training, the majority of them were female (58 %). The majority of doctors chose internal medicine (27.7%), followed by surgery (17.2%), anaesthesia (9.5%) and general medicine (6.5).

Foreign doctors

The further training register of the State Medical Association of Hessen shows an increasing proportion of foreign doctors. According to the register, 27 percent of the physicians in further training in Hessen came from abroad, 62 percent from third countries outside the European Union (EU). The majority came from Syria, followed by Egypt and Serbia. The majority of European doctors in continuing education came from Romania, followed by Bulgaria and Greece. The statistics list the proportion of doctors with foreign passports; they do not refer to the place of medical studies.

In addition, foreign investors are interested in purchasing German medical practices, medical care centres and clinics. Here, however, difficulties in legal structuring must first be eliminated.

Licence to practise medicine in Germany

This is accompanied by an increasing number of applicants for approbation from abroad. From our experience, many applicants have considerable problems in the licensing procedure. This is not solely the fault of the authorities. Problems usually arise at the time of application because documents, confirmations or translations are missing or the authority is simply not competent. In this case there is a considerable need for advice for applicants.

This can also be relevant in the search for a successor. Doctors should take this into account when selling their practice.

Search for a successor

The search for a successor should never be limited to a certain type of “doctor”. Every interested party is different. Practice sellers should take this to heart – even if they would like to see it differently.

In addition to “experienced specialists”, doctors in further training can also be potential successors. It is not uncommon for us to already bind further training assistants in a practice purchase contract in order to increase the chances of a successor on both sides. The target group for further training assistants is not exclusively male. Women have long since overtaken men in medical studies. The practice sales staff must be aware of this. But even otherwise the differences are not necessarily great. During the consultation it is noticeable that the interests and demands of the buyers have changed considerably: With all genders, many issues are increasingly revolving around the compatibility of work and family, including appropriate childcare. Digital patient management, security and organisation round off the topics.

Optimisation of the practice before selling the practice

Practice sellers must work on structuring their own practice procedures, digitising them if necessary, but also making them more attractive for the potential target group and their wishes. Both the advice given to doctors in the context of the practice purchase agreement and the advice on practice optimisation are striking: Increasingly gaining importance

  • Tax and economic evaluation of the practice figures
  • Adaptation of existing contracts (overview, duration and comprehensibility)
  • Legal Due Dilligence
  • Improvement and documentation of practice procedures, including potentials for digitisation
  • Analysis of the practical environment – i.e. the regional conditions on site

In this way, doctors increase their chances of finding a practice successor or to an attractive practice purchase price. Only they do not always know how.

Grants and subsidies from the state

Practice sellers should therefore know that they are entitled to state subsidies. These may well include reimbursement of 50% of the consulting costs and more. The consulting subsidy can be an introduction to finding a successor and optimizing the practice. For example, there are special subsidies for consulting services related to succession and business development. Eligible for funding are, for example, consultations on practice strategy, digitalisation, quality assurance, cooperation, organisation and practice processes, environment and succession.

The Associations of Statutory Health Insurance Physicians often offer additional services for doctors in structurally weak regions.

Facilitation of the practice purchase contract

The knowledge of all practice contracts, an overview of the economic situation of the practice as well as proper documentation ultimately also facilitate the drafting of the practice purchase agreement.

Medical structures in the region

In some areas, it is not only individual doctors who are affected by the search for a successor, but also entire communities and other health professionals, including pharmacies and medical centres. Sometimes a doctor with the authority to refer patients or even the only specialist / family doctor on site is no longer available. This also means a potential loss of revenue for other health care professions and, if necessary, their search for a successor. Patients would ultimately have to look beyond their region and seek doctors in other places. Initiators of a consultation on practice succession are therefore sometimes third parties.

A case from Hahn-Lehmden (district of Ammerland), which searched for a successor via video message (source: NDR), is an example of how even communities are now looking for a successor. This shows that regional politicians, patients and other parties involved can also support the practice succession. Here, too, experience by experts is helpful in the search for a successor.

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