Can a DM cheat at D D

Practice management for physiotherapy, speech therapy and occupational therapy. Cheating unnecessary: ​​Anyone who knows deadlines can use them sensibly.

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1 company praxis Practice management for physiotherapy, speech therapy and occupational therapy ISSN interruption regulation correctly applied Formally correct due to vacation time Summertime is vacation time and therefore also interruption time. Anyone who exceeds the deadline between two treatment units risks being cut by the health insurance company. And those who make appointments nicer also risk contractual penalties or a complaint. It really doesn't have to be. That is why we have once again compiled all the essentials on the subject of deadline regulations for you, then it will also work with the billing after the summer holidays! Then I'll be gone, you can hear it sounding everywhere in the medicine practices in the summer months. Two weeks in Mallorca, three weeks in Portugal the Germans are a people who love to travel. It can quickly happen that the time between two treatments exceeds the set deadlines and the so-called interruption regulation comes into force. The National Association of Statutory Health Insurance Funds explains the principles: The legal basis for the interruption periods for therapeutic products that have already started is section 29 of the therapeutic products guidelines of the Federal Joint Committee. If the treatment is interrupted for longer than the deadlines, the prescription loses its validity. Arrange interruptions Failure to comply with the deadlines regularly represents a deviation from the frequency information resulting from the statutory health insurance prescription. This is only permissible if a different procedure has previously been agreed between the contract doctor and the therapist and the mutually agreed change is documented by the therapist on the prescription form. There is no need to cheat between the heads of the statutory health insurance and the federal associations of therapeutic agents: Those who are familiar with deadlines can apply them sensibly. are stipulated in the framework recommendation in accordance with 125 SGB V, which allow exceptions to the time limits of the therapeutic products guidelines. Possible examinations, exact procedures and consequences under contract law are then exclusively stipulated in the contracts at the state level, specifically for each specialty. In principle, the following applies: If something is not stipulated at the state level, the framework recommendations at the federal level apply, in case of doubt the therapeutic products guidelines. The therapeutic products directive stipulates that treatment must not be interrupted for more than 10 days (physiotherapy) or 14 days (speech therapy / occupational therapy). This regulation applies nationwide. However, there are differences in the exceptions that can be regulated regionally in each federal state / KV area. Within a federal state, a further distinction is made between the individual disciplines. In Bavaria, for example, there are >>> Aktuell GKV-HIS publishes data Changes in the TOP 15 7 Patients do not trust themselves when it comes to health Fate Health 13 Researchers develop new training methods for rheumatics Get on the pedals 15 Topic rehabilitation after stroke New Concept for cooperation 10 Offer on the Baltic Sea beach Beach massages as a self-pay idea 19 Physiotherapy practice offers first aid 20 Tips Many reactions to billing This is how you get your money 8 Never again discussions with private patients More sales no additional payment 21 Marketing plan with guaranteed success A month full of world -Days password for vacation

2 2 Up-to-date Once deep into the contribution payer's pocket, conjured up a cash bonus and the so-called health reform of the Federal Minister of Health Philipp Rösler is in place. In reality, however, it is just a question of securing the financing of an unsuitable system. Nevertheless, the service providers in the health care system in particular will benefit from the new income, including all owners of speech therapy, physiotherapy and occupational therapy practices. What leads to increased costs for the majority of the population ensures a secure future income for practice owners. Thanks to BMG, there will be no real cost reductions in the healthcare sector in the short term. And since the contributions for all patients are now being increased - and without a cap, one can confidently assume that the co-payments and co-payments will not increase any further. So everything stays fine on the income side. But the expenditure side also looks advantageous for practice owners: Because the future higher insurance premiums will have to be borne by the employees alone, they as employers will still not have any increasing ancillary wage costs. In principle, it could go on and on: Politicians are making more money in the health system and all service providers are looking forward to increasing sales and stable ancillary wage costs. So in the short term vain sunshine. But be careful: In the medium term, the question arises of how long the GKV insured will be fooled by politicians. As soon as they perceive the additional contributions as too high, they have to look for candidates for deletion on the expenditure side. So let's hope that the expenditure of the statutory health insurance will remain stable for as long as possible so that the remedies are not identified again as a deletion option. Sincerely, your comments Small reforms twice as good for practice owners >>> Continued on p. 1 Framework contract for occupational therapists is officially no exception for a break longer than 14 days. But, according to AOK Bayern on request: The interruption period can be changed by the prescribing doctor. If the interruption is too long, the regulation (VO) may become invalid. For physiotherapists, however, the framework contract in Bavaria provides for a completely different regulation. There is a clear agreement on exceptions that no longer need to be signed by the doctor, but only need to be discussed. The framework contract regulates the interruption regulations of Bavarian speech therapists even more clearly, there are standardized abbreviations for documenting interruptions. The example of Bavaria shows how complicated it is to solve even an apparently simple problem. No wonder that many practice owners complain that cuts are being made at random. Presumably, the cause is often not just arbitrariness, but simple ignorance of the employees at the health insurance companies. Every federal state cooks its own soup here. In Lower Saxony, for example, an interruption is possible in consultation with the prescribed doctor, but only up to a maximum of 28 days (occupational therapy), 21 days (speech therapy) or 19 days (physiotherapy). And then only a maximum of two interruptions per prescription. It is impossible to imagine what kind of control effort that means for interdisciplinary practices. We have compiled all the regulations for you on the following pages for each specialist discipline and each federal state. Is Cheating a Solution? Paying attention to something like this is too much work for us, explains Sigrun Berthold, receptionist at a ten-therapist practice in North Rhine-Westphalia: We just write the data on the prescription with pencil and then make the billed treatment data suitable for billing. If the frustration over the formally small and small of the health insurance companies is big enough, at some point the inhibitions are no longer too big to just make everything fit. What is called cheating in everyday practice is, from a legal point of view, fraud. AOK Lower Saxony also sees it this way: The legal assessment of a false or falsified confirmation of content (including the date) by signature or the induction by a third party corresponds to that of a legal >>> Continued on p. 3 Imprint Publisher: Buchner & Partner GmbH Lise- Meitner-Straße Schwentinental Telephone +49 (0), Fax 99 ViSdP: Ralf Buchner (address see publisher) Editor-in-chief: Heidi Kohlwes ISSN Issue price: EUR 15 subscription: EUR 12 Sources and authors of this issue: Heidi Kohlwes (ko) , Ralf Buchner (bu), Dirk Schnack (di), Katrin Schwabe-Fleitmann (ks) Layout: Mario Durst, Cologne Photos: fotolia: d._fang (1), YBond (9), M. Subatli (12), a . triling (13), G. Menzl (16), physio & vital (19), ISO K -photography (21); illustration27 (21); di company (11) practice 08/2010

3 Topic: interruption regulation 3 Assessment of a composite document in legal transactions. It must be assessed on a case-by-case basis whether the approval can be endangered by such errors. AOK Bayern goes one step further and makes its procedure clear in such cases: If criminal law aspects actually apply, we contact the public prosecutor's office; Otherwise there is the possibility of a warning, a contractual penalty, the settlement of any damage that may have occurred up to the revocation of the admission. And what about the patients? In this respect, patients should also be careful not to put their signature under a wrong treatment date. If a patient consciously acknowledges an incorrect treatment date and thereby causes damage, a claim can also be made against the patient, according to the AOK Lower Saxony. In fact, something like this will hardly happen in reality, because the health insurance companies are in tough competition with one another and will be careful not to mess with patients. At many practice receptions, the respective employees are not familiar with the framework agreements at the state level. And even if you have skimmed through the contract, the wording on the interruption rules is really not easy to understand. But only those who really know and understand the rules can adhere to them. Sigrun Berthold sat down with her boss and read the contract. Then they summarized the rules again for themselves. Now the appointments are consistently assigned correctly and lo and behold, I think we now have less work than before, Berthold is convinced. Because once you cheat at one point, this usually entails a large number of internal controls. Now we have to be a little more careful when making appointments and we also have to send around ten more prescriptions a month back to the doctors for changes, but that is nothing compared to before, recalls Berthold. We touched every single prescription every month to check every single treatment date! What if it does happen? If, despite all caution, a prescription has been continued even though the specified deadline has already passed, then the health insurance companies advise you to contact the insurance provider for clarification. The AOK Baden Württemberg thinks: The procedure depends on why the deadline could not be met. Illness should i. d. Usually do not constitute a reason for discontinuation of treatment. It is advisable to consult the doctor in attendance and, if possible, to mutually agree on a change in the treatment frequency and to document this on the prescription form. It may be necessary to obtain a new prescription for further treatment. So don't spoil your vacation time by having to worry about the health insurance companies. Take a look at our table and make sure that the interruption rules are correctly observed. (bu / ko) You can find more information on these topics on the Internet. ± This is how you handle appointment problems When making appointments, ask about possible vacation times for patients in order to avoid exceeding deadlines right from the start. Unfortunately, some patients only reveal such information when asked! Do not start prescriptions that allow only one or two treatment appointments. Many doctors assume that once a prescription is issued, it will always be billed in full, regardless of what is in your treatment report. Strictly adhere to the contractual specifications. The basis for permitted exceedances is always that the achievement of the therapy goal is not jeopardized. That is why this sentence belongs in the justification. A ready-made stamp or computer print can also be used for this purpose. If you missed a deadline and would like to correct it afterwards, contact a clerk of the relevant health insurance company on site. Ask whether an exception can be made in this case due to vacation, illness, etc. (if possible, do not point out that the deadline has already been exceeded). As a rule, the clerk will agree. Note the name of the employee and the date of the conversation on the regulation with the reference to the agreed special regulation and bill as usual. Attention: Regulations that have exceeded the deadlines run the risk of being withheld by some health insurance companies. This is legally questionable, but still a problem for you. Therefore, all problem prescriptions are copied or scanned (front and back) so that if payment is refused, improvements can still be made. With very few exceptions (see table), interruptions do not have to be signed off by the doctor. It is sufficient if you have consulted the doctor. As evidence of such a consultation, note down the date of the conversation with the doctor's practice. Reductions in the event that the deadline is exceeded are not permitted for the entire ordinance, but only apply from the actual deadline. Example: In the case of a prescription with 6 treatment appointments, there was a non-contractual deadline between appointment 4 and 5. The health insurance company then has to pay for appointments 1 to 4 in full. (bu / ko)

4 4 Topic: interruption rules Memo for the receptionist interruption rules easily memorized In every federal state, the health insurances and remedies associations can agree individual rules on the interruption rules. So that all employees can remember what to look out for, we have put together memo sheets for physiotherapy, occupational therapy and speech therapy practices for each federal state, which quickly and easily show all the essential rules. Simply download the notepad that is important to you as a file for printing. Interruption regulation for physiotherapists vdek nationwide start of treatment until (date entered) .. according to date start of treatment until (without date) ... <= 10 days interruption duration (between two appointments) ... <= 10 days frequency (if entered) .. .acc. VO frequency (without entry) ... according to the remedy catalog Deviating treatment start ... nnamda * Deviating / changed frequency ... nnamda * Therapeutically indicated interruption ... Abbreviation (T) nnamda * Illness patient / therapist ... Abbreviation ( K) Vacation / vacation patient / therapist ... Abbreviation (F) Abbreviation (T, K, F) or text too different. Start of treatment / frequency, date and hand signal on the prescription sheet at the bottom left on the back Source: Framework contract vdek / ifk, vsk, ZVK, VPT from, 6 number 4 AOK Baden Württemberg AOK Bayern AOK Berlin as vdek contract Start of treatment until (date entered) .. according to date of start of treatment until (without date) ... <= 10 days interruption duration ... <= 10 days frequency (if entered) ... according to. VO frequency (without entry) ... acc. Catalog of remedies Different start of treatment ... nnamda * Different / changed frequency ... nnamda * Therapeutically indicated interruption ... Abbreviation (T) nnamda * Illness patient / therapist ... Abbreviation (K) Vacation / vacation patient / therapist ... Abbreviation (F) Abbreviation (T, K, F) or text too deviating. Start of treatment / frequency, date and hand signal on the prescription sheet at the bottom left on the back Source: Framework contract AOK / ZVK, VPT, VDB, IFK from, 4 number 8 General rule: start of treatment until (date entered) .. acc. To start of treatment until (no date ) ... <= 10 days interruption duration ... <= 10 days frequency (if entered) ... acc. VO frequency (without entry) ... acc. Catalog of remedies Different start of treatment ... n.n.a.m.d.a. * Different / changed frequency ... n.n.a.m.d.a. * Therap. indicated interruption ... illness patient / therapist vacation / vacation patient / therapist ... nnamda * further training of the therapist ... nnamda * written reasons with the above reason, date and hand sign on the prescription sheet at the bottom left on the back of the VO Source: AOK framework agreement / VPT, ZVK, IFK, from, 5 number 6 AOK Hamburg * only after consultation with the doctor Interruption regulation for occupational therapists vdek nationwide Source: Framework contract AOK / ZVK, VPT, IFK, VDB from, 10 number 5 AOK Brandenburg as vdek contract start of treatment to (date entered) according to the start of treatment date to (without date) ... <= 14 days interruption duration (between two appointments) ... <= 14 days frequency (if entered) ... according to VO frequency (without entry) ... acc. Cure catalog Different start of treatment ... nnamda * Different / changed frequency ... nnamda * Illness patient / therapist ... Abbreviation (K) Vacation / vacation patient / therapist ... Abbreviation (F) Abbreviation (T, K, F) or Text to different start of treatment / frequency, date and hand signals on the prescription sheet at the bottom left on the reverse side Therapeutically indicated interruption ... Abbreviation (T) nnamda * Source: Framework contract vdek / dve dated, 6 number 4 AOK Baden Württemberg Source: Framework contract AOK / IFK from, 3 number 5 and framework contract AOK / ZVK, VDB, VPT from, 3 number 5 AOK Bremen / Bremerhaven as vdek contract as vdek contract Source: Framework contract AOK / DVE from, 4, point 7 AOK Bayern Source: Framework contract AOK / VPT, Marnitz-Bund, IFK, VDB, ZVK from, 17 number 5 Start of treatment to (date entered) according to date of start of treatment to (without date) ... <= 14 days interruption period (between two appointments) ... <= 14 days frequency (if entered) ... acc. VO frequency (without entry) ... acc.Catalog of remedies All interruptions over 14 days lead to the prescription becoming invalid. General rule: start of treatment until (date entered) according to date Start of treatment until (without date) ... <= 10 days interruption duration (between two appointments) ... <= 10 days frequency (if entered) ... according to VO frequency (without entry) ... acc. Catalog of remedies Different start of treatment ... n.n.a.m.d.a. * Different / changed frequency ... n.n.a.m.d.a. * e.g. Illness patient Written out reasons with the above-mentioned reason for interruption or different start of treatment / frequency, date and hand signal on the prescription sheet at the bottom left on the back Source: Framework contract AOK / DVE from i.d.f. from, 5 number 4 vdek Brandenburg Start of treatment to (date entered) according to date of start of treatment to (without date) ... <= 14 days interruption duration (between two appointments) ... <= 14 days frequency (if entered) .. .acc. VO frequency (without entry) ... acc. Catalog of remedies Different start of treatment ... nnamda * Different / changed frequency ... nnamda * Illness patient / therapist ... Abbreviation (K) Holidays / vacation patient / therapist ... Abbreviation (F) up to 21 calendar days Abbreviation (T, K , F) or text on the different start of treatment / frequency, date and hand signal on the prescription sheet at the bottom left on the reverse side Therapeutically indicated interruption ... Abbreviation (T) nnamda * Source: Common framework recommendation between the National Association of Statutory Health Insurance Funds and the BHV from, 17 (framework contract on State level does not contain any more specific regulation) AOK Hessen Source: Framework contract AOK / DVE from, 3 number 5 Start of treatment to (date entered) .. according to date of start of treatment to (without date) ... <= 10 days of interruption (between two appointments) ... <= 10 days frequency (if entered) ... acc. VO frequency (without entry) ... acc. Therapeutic product catalog Different start of treatment ... n.n.a.m.d.a. * Different / changed frequency ... n.n.a.m.d.a. * e.g. Illness patient End of the justified exception ...> 20 days VO becomes invalid despite the reasons Written out reasons with the above reason for interruption or different start of treatment / frequency, date and hand signal on the prescription sheet at the bottom left on the back Source: Framework Agreement AOK / ZVK, IFK, VPT , VDB dated, 17 number 5 AOK Bremen / Bremerhaven General rule: start of treatment by (date entered) according to date of start of treatment by (without date) ... <= 14 days interruption period (between two appointments) ... <= 14 days Frequency (if entered) ... acc. VO frequency (without entry) ... acc. Catalog of remedies Different start of treatment n.n.a.m.d.a. * Different / changed frequency n.n.a.m.d.a. * Therap. Indicated interruption Abbreviation (T) nnamda * Illness patient / therapist Abbreviation (K) Holidays / vacation patient / therapist Abbreviation (F) up to max. 28 days Abbreviation (T, K, F) or text for a different treatment start / frequency, date and Hand signals on the prescription sheet at the bottom left on the back Source: Framework contract AOK / DVE from, 17, paragraph 4 AOK Hamburg Interruption regulation for speech therapists vdek nationwide start of treatment until (date entered) ... acc. Date of start of treatment until (without date) ... <= 14 days of interruption (between two appointments) ... <= 14 days of frequency (if entered) ... acc. VO frequency (without entry) ... acc. Catalog of remedies Different start of treatment ... nnAmdA * Different / changed frequency ... nnAmdA * Illness patient / therapist ... Abbreviation (K) Holidays / vacation patient / therapist ... Abbreviation (F) Abbreviation (T, K, F) or Text to different start of treatment / frequency, date and hand signal on the prescription sheet at the bottom left on the reverse side Therapeutically indicated interruption ... Abbreviation (T) nnamda * Source: Framework contract vdek / dba, dbl, dbs from, 6 number 4 AOK Baden Württemberg as vdek -contract Source: Framework contract AOK / dba, dbl dated, 6 number 4 vdek Bayern General rule: Start of treatment until (date entered) according to date Start of treatment until (without date) ... <= 14 days of interruption (between two appointments). .. <= 14 days frequency (if entered) ... acc. VO frequency (without entry) ... acc. Catalog of remedies Different start of treatment ... n.n.a.m.d.a. * Different / changed frequency ... n.n.a.m.d.a. * Therap. indicated interruption ... abbreviation (T) nnamda * illness patient / therapist ... abbreviation (K) up to max. 4 weeks vacation / vacation patient / therapist ... abbreviation (F) abbreviation (T, K, F) or Text on the different start of treatment / frequency, date and hand signal on the prescription sheet at the bottom left on the back Source: Framework contract AOK / DVE from, 17 item 5 AOK Hessen Start of treatment to (date entered) according to date of start of treatment to (without date) ... <= 14 days interruption duration (between two appointments) ... <= 14 days frequency (if entered) ... acc. VO frequency (without entry) ... acc. Therapeutic product catalog Different start of treatment ... n.n.a.m.d.a. * Different / changed frequency ... n.n.a.m.d.a. * e.g. B. Illness patient ... up to a maximum of 28 days Written out reasons with the above reason, date and hand signal on the prescription sheet at the bottom left on the back of the VO Source: Framework contract AOK / DVE from, 17, item 5, start of treatment to (date entered) .. .gem. Date of start of treatment until (without date) ... <= 12 days of interruption (between two appointments) ... <= 12 days (also applies to a hospital stay of longer than 12 working days) Frequency (if entered) ... acc. VO frequency (without entry) ... acc. Remedy catalog Different start of treatment ... n.n.A.m.d.A. * Different / changed frequency ... n.n.A.m.d.A. * Holidays / vacation patient / therapist ... Abbreviation (F) no longer than (contiguous) 24 working days Appointment cancellation d. Patient / practitioner ... Short (A) no longer than (contiguous) 24 working days Therapeutically indicated interruption ... Short (T) no longer than (contiguous) 24 working days Illness patient / therapist ... Short (K) no longer (contiguous) 24 working days Abbreviation (T, K, F, A), date and hand sign on the prescription sheet at the bottom left on the back. Changes at the start of treatment / frequency must be signed off by the doctor. Changes made by the doctor can also be documented on a copy / scan of the VO. This copy with a note of the change must be submitted with the invoice. Source: Framework Agreement AOK / dba, dbl, dbs vom, i.d.f. from, valid from, 6 number 4 * only after consultation with the AOK Berlin doctor Start of treatment to (date entered) ... according to date of start of treatment to (without date) ... <= 14 days interruption period (between two appointments) .. <= 14 days Frequency (if entered) ... according to VO Frequency (without entry) ... according to the catalog of remedies Different start of treatment ... nnamda * Different / changed frequency ... nnamda * e.g. Illness patient ... In the case of justified exceptions, a new confirmation of benefits must be obtained from the health insurance company responsible. ZVLB dated, 5, item 8 as well as joint framework recommendation between the GKV-Spitzenverband and BHV dated, 17 (framework agreement at state level does not contain any more specific regulation) AOK Brandenburg Start of treatment until (date entered) ... according to the start of treatment until (no date) .. . <= 14 days interruption duration (between two appointments) .. <= 14 days frequency (if entered) ... according to VO frequency (without entry) ... according to remedy catalog Different start of treatment ... nnamda * Different / changed Frequency ... nnamda * Therapeutically indicated interruption ... Abbreviation (T) nnamda * Illness patient / Therapist ... Abbreviation (K) Vacation patient / Therapist ... Abbreviation (U) Abbreviation (T, K, F) or text for a different start of treatment / frequency, date and hand sign on the prescription sheet at the bottom left on the back of the part of the Ordinance intended for billing with the health insurance company. Source: Framework Agreement AOK / dba, dbl, dbs from * only after consultation with the doctor The memos are always structured in the same way: The general rules describe the normal case. Deviations from these rules result in the regulation becoming invalid once the deadline is exceeded. Exceptions to this can be found under the heading Justified Exceptions. This describes which exceptions the respective contract with the health insurance companies provides. These exceptions must be observed exactly, because if they are not observed, this in turn means that the ordinance becomes invalid from the time the deadline is exceeded. The point Formalities describes how to document justified exceptions on the ordinance. For everyone who would like to look at the original contract again, we have given the source for the notepad. With this you can make sure again that everything is correct! (bu) You can find the notepad for your federal state on the Internet at vdek nationwide start of treatment until (date entered) ... according to date start of treatment until (without date) ... <= 10 days interruption period (between two appointments) ... <= 10 days Frequency (if entered) ... in accordance with VO Frequency (without entry) ... in accordance with the remedy catalog Different start of treatment ... only after consultation with the doctor Different / changed frequency ... only after consultation with the Doctor Therapeutically indicated interruption ... Abbreviation (T) only after consultation with the doctor Illness patient / therapist ... Abbreviation (K) Vacation / vacation patient / therapist ... Abbreviation (F) Interruption regulation for physiotherapists applies in these KV areas the interruption regulation such as vdek nationwide: AOK-Berlin, AOK-Brandenburg, AOK-Bremen / Bremerhaven, AOK-Mecklenburg-Western Pomerania, AOK-Rhineland-Palatinate, AOK-Saarland, AOK-Saxony-Anhalt, AOK-Saxony, AOK-Thuringia , AOK- Westfalen-Lippe These KV areas have individual regulations for Unt Vomiting regulation: AOK-Baden-Württemberg, AOK-Bavaria, AOK-Hamburg, AOK-Hessen, AOK-Lower Saxony, AOK-Rhineland, AOK-Schleswig-Holstein Abbreviations (T, K, F) or text too different. Start of treatment / frequency, date and hand signal on the prescription sheet at the bottom left on the back Source: Framework contract vdek / IFK, VSK, ZVK, VPT from, 6 number 4 interruption regulation for physiotherapists

5 Topic: Interruption regulation 5 Interruption regulation for occupational therapists In these KV areas, the interruption regulations apply as vdek-nationwide: AOK-Baden-Württemberg, AOK-Berlin, AOK-Saarland These KV areas have individual regulations on interruption regulations: AOK-Bavaria, AOK -Brandenburg, AOK-Bremen / Bremerhaven, AOK-Hamburg, AOK-Hessen, AOK-Mecklenburg-Western Pomerania, AOK-Lower Saxony, AOK-Rhineland, AOK-Rhineland-Palatinate, AOK-Saxony-Anhalt, AOK-Saxony, AOK-Schleswig - Holstein, AOK-Thuringia, AOK-Westfalen-Lippe vdek nationwide start of treatment until (date entered) ... according to date start of treatment until (no date) ... <= 14 days interruption period (between two appointments) ... < = 14 days Frequency (if entered) ... according to VO Frequency (without entry) ... according to the catalog of remedies Different start of treatment ... only after consultation with the doctor Different / changed frequency ... only after consultation with the doctor Therapeutic indexed interruption ... Abbreviation (T) only by arrangement with the doctor Illness patient / therapist ... Abbreviation (K) Vacation / vacation patient / therapist ... Abbreviation (F) Abbreviation (T, K, F) or text for a different start of treatment / frequency, date and hand signal on the prescription sheet below left on the back Source: Framework contract vdek / dve dated, 6 number 4 Interruption regulation for occupational therapists Interruption regulation for speech therapists In these KV areas, the interruption regulations apply as vdek nationwide: AOK-Baden-Württemberg These KV areas have individual regulations for the interruption regulation AOK- Bavaria, AOK-Berlin, AOK-Brandenburg, AOK-Bremen / Bremerhaven, AOK-Hamburg, AOK-Hessen, AOK-Mecklenburg-Western Pomerania, AOK-Lower Saxony, AOK-Rhineland, AOK-Rhineland-Palatinate, AOK-Saarland, AOK- Saxony-Anhalt, AOK-Saxony, AOK-Schleswig-Holstein, AOK-Thuringia, AOK-Westphalia-Lippe vdek nationwide start of treatment until (date entered) ... according to date start of treatment until (without date) ... <= 14 days Interruption duration (betw. two appointments) ... <= 14 days Frequency (if entered) ... according to VO Frequency (without entry) ... according to the catalog of remedies Different start of treatment ... only after consultation with the doctor Different / changed frequency ... only after consultation with the doctor Therapeutically indicated interruption ... Abbreviation (T) only after consultation with the doctor Illness patient / therapist ... Abbreviation (K) Vacation / vacation patient / therapist ... Abbreviation (F) Abbreviation (T, K, F) or text on a different start of treatment / frequency, date and hand signal on the prescription sheet at the bottom left on the back Source: Framework contract vdek / dba, dbl, dbs dated, 6 number 4 interruption regulation for speech therapists You can find more information on these topics on the Internet .

6 6 Current expenditure on medicinal products GKV rose by an above-average 6.8 percent more in the 1st quarter of 2010. Expenditures that benefit statutory health insurance1 19% Other expenses 3% Service: All agreements, data and the benchmark controlling tool for the area of ​​KV Brandenburg Premium Plus customers can request it from the hotline or download it from the Internet at. Net administrative costs 5% Treatment / home nursing 2% Preventive care and rehabilitation measures 1% Travel costs 2% Source: GKV Statistics BMG The first quarter of 2010 brought above-average sales growth to the health care providers and increased expenditure for the statutory health insurances: 6.8 percent more the GKV had to invest in medicines in the first quarter of 2010. The Federal Ministry of Health reports on the financial development of the health insurance companies in the 1st quarter. Dental treatment (without dentures) 5% sick pay 4% dentures 2% pharmaceuticals from pharmacies and others 18% hospital treatment 34% aids 3% remedies 2% In the first quarter of 2010, the health insurance companies' expenditure on benefits rose by 4.5 percent per insured person. This contrasted with an increase in income of just 2.8 percent. In the larger service areas, the development of the expenditures developed very differently: the expenditures for medical fees increased by 4.8 percent per insured person. The growth in hospital treatments in the first quarter of 2010 was 5.3 percent. The increase in pharmaceutical expenditure was 3.9 percent per insured person. That is significantly lower growth than in the remedies area with 6.8 percent. Only the sickness benefit with an increase of 9.8 percent and the costs for early diagnosis and treatment care with an increase of more than 14 percent exceeded the growth in expenditure on medicines. The further prospects for owners of medical practices can certainly be described as positive. When looking at the financial development over the course of the year, one has to consider that the expenditures in the 1st quarter are regularly lower than the average of the following three quarters. If this also applies to remedies this year, then all practices can look forward to a whopping increase in sales! (bu) KV Brandenburg publishes benchmarks for 2010 Medicines budget grows by 6.45 percent The KV Brandenburg has finally reached an agreement with the health insurance companies in Brandenburg on a cure agreement for 2010. Thereafter, the volume of therapeutic products will grow by 6.45 percent to more than 104 million euros. However, the benchmarks are declining for some Prignitz-Oberhavel doctor groups. In Brandenburg, the volume of drug expenditure exceeded the 100 million euro mark for the first time. A total of euros are available in Brandenburg for spending on medicinal products in 2010. If one compares this with the expenditure on medicinal products in Brandenburg in 2009 (95 million euros) it becomes clear that doctors can prescribe medicinal products without fear of recourse to medicinal products. Havelland- Fläming It is important for occupational therapists and speech therapists that in 2010, for the first time, not all occupational therapy and speech therapy prescriptions are classified as special practice features in advance, but only in certain areas of indication. In the test agreement of the KV Brandenburg, all indications for the special features of the practice in advance can be found on page 45. Physiotherapists are also resourceful there. Berlin Uckermark- Barnim Oderland- Spree Lausitz- Spreewald The benchmarks of the specialist groups have not developed in line with the volume of therapeutic products. By considering the special features of the practice in advance, the benchmarks for pediatricians, for example, have been reduced by more than 18 percent. For neurologists, the decline was between 35 percent (M / F) and 41 percent (R). Surgeons (+9 percent) and ENT doctors (+8 percent) are pleased about the significant increase in their benchmarks. In the case of individual groups of doctors, the benchmarks determined after deducting the special features of the practice were so small that they could not be stipulated. Since the new benchmarks for 2010 were only published in June, the benchmark (2009/2010) that is better (larger) applies to the first half of the year. The new benchmarks will only apply without restrictions from July 1st (bu)

7 Current 7 GKV-HIS publishes data Changes in the TOP 15 With a growth of 14.9 percent compared to the previous year, the first quarter of 2010 was the best first quarter for the medicinal products industry in Germany since the health care information system of the statutory health insurance system (GKV-HIS) was in place. . The general trend in spending is not quite as nice. There are considerable differences here in the details. There have also been shifts in the list of the most commonly prescribed remedies. More than one billion euros in sales of medicinal products in the 1st quarter of 2010 (including additional payments) that was only available in the 1st quarter At that time, however, it was almost 30 million euros less than this year. The total shows that the drug market is still lucrative and the sales rates are above the average of the development of expenditure.If you read the growth rates of the first quarter of 2010 compared to the previous year, you get almost dizzy: 14.9 percent growth in the national average, Saarland (+ 2.6%), Baden-Württemberg (+ 3.6%) and Rhineland- Palatinate (+ 5.6%) only grew single-digit, all others double-digit. The front runners are Mecklenburg-Western Pomerania (+ 21.2%), Lower Saxony (+ 22.8%) and in first place is Westphalia-Lippe (+24.7%) (see Table 1) .. Such percentage increases are great, however Hardly any practice is likely to be able to post such increases in sales in the first quarter. The increases compared to the previous year are only so high because the first quarter of 2009 was the second worst quarter since the GKV-HIS was established. So if you want to know how the sales figures have really developed, follow the sales development in the individual federal states. If one compares the development of expenditure on medicinal products in the statutory health insurance in the 1st quarter of 2010 with the expenditure on medicinal products in the 4th quarter of 2009, everything looks very different. The national average then results in a 0.2 percent decline in spending on medicinal products. The losers are Saarland (-10%), Rhineland-Palatinate (-9%) and Baden-Württemberg (-5.6%). The winners are Lower Saxony (+ 3.9%), Thuringia (+ 6.1%) and Saxony (+ 7.8%) (see also Table 2). The podiatry complex treatment once again recorded the greatest increase among all therapeutic products. In the 1st quarter of 2008 this service was not even mentioned in the TOP 15 of the remedies (top-selling remedies). In the 1st quarter of 2009 it was already in 14th place ahead of the KG device. In the first quarter of 2010, podiatry was in 12th place, just behind KG-CNS children. If it stays at this increase and everything looks like this, the turnover with podiatry at the end of the year should be higher than the turnover with KG-CNS children. There has been another shift at the top of the TOP 15. In contrast to the previous year, significantly more manual therapy was prescribed in the first quarter of 2010 than KG-CNS adults. When it comes to sales, the difference is not quite as clear. (bu) Table 1 Health care expenditure of the statutory health insurance in comparison to the previous year Change in 2009/2010 health insurance (net values) in T Euro in% Baden-Württemberg, 6% Bavaria, 8% Berlin, 2% Brandenburg, 2% Bremen, 3% Hamburg, 4% Hesse , 2% Mecklenburg-Western Pomerania, 2% Lower Saxony, 8% North Rhine, 4% Rhineland-Palatinate, 8% Saarland 277 2.6% Saxony, 0% Saxony-Anhalt, 2% Schleswig-Holstein, 1% Thuringia, 6% Westphalia -Lippe, 7% total, 9% Table 2 Remedies expenditure in the course of change IV 09 / I 10 KV in T Euro in% Baden-Württemberg, 9% Bavaria 796 0.6% Berlin, 6% Brandenburg 835 3.5% Bremen - 30-0.5% Hamburg, 4% Hesse, 3% Mecklenburg-Western Pomerania 265 1.7% Lower Saxony, 9% North Rhine, 2% Rhineland-Palatinate, 0% Saarland, 0% Saxony, 8% Saxony-Anhalt 155 0, 6% Schleswig-Holstein, 6% Thuringia, 1% Westphalia-Lippe, 6% total, 2% service: You can find all current data as usual on the Internet at or you can request it from the Premium-Plus hotline. There you can also get specific evaluations for your region free of charge, e.g. for your doctor communication.

8 8 Current Lots of reactions to the topic of billing How to get your money too In the last print edition (up) we reported in the article How to get your money about the physiotherapist Marion Becker, who returned her prescriptions unprocessed with the next billing submits. We then received a statement from the AOK Lower Saxony, which we would like to print unchanged: The AOK Lower Saxony works with modern software that enables an intensive and systematic review of the accounting documents submitted. Machine-defined test criteria apply to all similar issues regardless of how often accounting documents are submitted again. From the perspective of AOK Lower Saxony, it is only conceivable that the automated check will be tricked if the data set or the regulation has been changed. But even this method, which, as we would like to emphasize, is only presented theoretically, cannot be considered safe: Regulations submitted multiple times or copies and duplicates are identified automatically and manually when the invoice is received and checked separately. If illegal manipulations are found there, it becomes critical for the service provider. The service provider anonymized in the post may have the impression that everything is being paid for because certain returns have not yet reached her. This can be due, for example, to the billing center commissioned by you or to the fact that the Lower Saxony contracts allow an invoice to be audited within up to twelve months. In any case, more promising than the method recommended by Marion Becker is for therapists to talk to the service team of the accounting department in the event of unclear issues. It quickly becomes clear in which cases it is worth submitting again or which errors you can avoid in the future. Ultimately, our common concern should be to protect correctly billing service providers as well as health insurance companies from unsubstantiated claims. We received another, extremely constructive reaction to the above article from speech therapist Britta Raatschen from Baden-Württemberg. In her practice she has developed a drug prescription control film. This is a transparent cover into which the recipe is inserted and on which the fields to be checked are marked or commented on with a water- and abrasion-resistant pen. Their conclusion: works great and costs almost nothing. So we have almost no responses. Provided by the practice for speech therapy, Britta Raatschen.

9 Current 9 The patient's view of the health reform Solidarity instead of an increase in contributions The patient ombudsman association in the north has presented a concept that is intended to enable the statutory health insurance to be financed based on solidarity. It differs in important points from the concept of Federal Health Minister Philipp Rösler. All those insured by statutory health insurance are entitled to optimal care and should therefore continue to benefit from advances in medicine regardless of their income. Such statements by the Federal Ministry of Health question not only opposition politicians, there is also increasing skepticism among patients as to whether optimal care will still be possible, i.e. affordable, in the future. After all, the ministry admits in the same breath: In order to solve the financing problem, everyone involved must therefore tackle the task collectively: drug manufacturers, doctors and hospitals must save. But that alone will not be enough. The insured must therefore be prepared for an increase in health expenditure in the long term. The consequence is, among other things, an increase in contributions from 14.9 to 15.5 percent of gross wages. More solidarity from the insurance community The former Schleswig-Holstein Minister of Social Affairs Günther Jansen does not consider an increase in contributions to be a bogeyman alone. As chairman of the patient ombudsman association Schleswig-Holstein (the association is supported by various institutions such as consumer associations, welfare associations, health insurance companies and the medical association), he criticizes developments that, in his view, affect the solidarity of the insurance community. As examples, he cites demands for higher cost sharing and additional insurance or premiums. He also identified a greater dependency of the statutory health insurance on the state as the wrong way to go. Jansen warns: At least in health insurance, people who often work hard or who have worked for a lifetime should not be expected to have to ask the state for subsidies as those in need of social security. Jansen has presented a concept with framework conditions that, in his opinion, are necessary for the financing of solidarity health insurance. As a basis, he calls for clearly formulated benefit claims of the insured and an undisputed competence and composition of the Federal Joint Committee, on whose guidelines all service providers can refer. According to Jansen, the contribution rates could be calculated using the following criteria: Return to the same burden in the equal contribution payment of employees. In Rösler's concept, employees will be charged 8.2 percent from 2011, while employers will only be charged 7.3 percent. Introduction of a flexible compulsory insurance limit, which can be raised to the level of the compulsory pension insurance limit if necessary. This is not included in Rösler's concept. Inclusion of other types of income in health insurance with a proportional contribution solely by the income recipient up to the compulsory insurance limit. So far, no government has implemented this variant, which has been discussed over and over again for decades, and it does not play a role in Rösler's concept. The patient ombudsman's association has also taken up another well-known demand. Although it does not require a subsidy from the statutory health insurance fund from tax revenues, it is something from the past. Because for decades the state has repeatedly imposed services on the statutory health insurance funds that, strictly speaking, have nothing to do with health insurance. These are, for example, non-contributory insurance during parental leave, benefits relating to pregnancy and maternity such as care services during pregnancy or childbirth, contraception benefits, maternity benefits and sick pay for caring for a sick child. The federal government is now participating in these statutory health insurance expenses through tax subsidies, but Jansen sees further obligations. In his opinion, the GKV should gradually reimburse the costs that were transferred to it over decades to relieve the public finances for socio-political tasks, these would be amounts in the billions. Jansen does not rule out that a calculation based on this could initially even lead to a reduction in health insurance premiums. But he also considers higher contributions to be easier to negotiate under the conditions mentioned than financing via the detour of higher taxes combined with reduced benefits. (di)

10 10 xxxxxx News Rehabilitation after a stroke New concept for cooperation Contact: AOK Baden-Württemberg Heilbronner Strasse Stuttgart Tel .: AOK Baden-Württemberg and the University of Heidelberg want to test a new examination concept for rehabilitation after a stroke from autumn 2010. The CEO of AOK Baden-Württemberg, Dr. Rolf Hoberg, known at the 1st specialist congress for rehabilitation research and care management on July 6, 2010 in Berlin. Therapists do not appear in this concept, however. The aim of the practical test is a rehab that is individually tailored to the individual, which helps to shorten the overall duration of illness and to avoid the need for care, explained the CEO. In the future, the rehabilitation of older stroke patients should achieve this goal with a comprehensive consultation with a doctor in addition to an intensive examination. Hoberg criticized the current lack of transparency and networking of rehabilitation with hospital treatment and home nursing and emphasized: Rehabilitation can only get out of the offside trap if there is a significantly better interaction between medical treatment and prevention. However, Hoberg did not mention networking and cooperation with speech therapists, physiotherapists and occupational therapists. The reason for the current practical test were the results of the ARISE study (Applied Rehabilitation Research Interdisciplinary Stroke Survey), which was carried out by the Institute for Gerontology at the University of Heidelberg. The study has clearly shown that when deciding whether and which rehabilitation services should be given to stroke patients, age plays only a subordinate role. Physical, psychological and cognitive characteristics must be taken into account in order to achieve the fastest possible and, above all, permanent recovery, said the head of the institute, Professor Dr. Andreas Kruse in Berlin. The doctor can now recognize these characteristics in the assessment and can then tailor his decision to his patient much better than before. The background to the research concept is the skyrocketing costs in care. By 2020, the number of people over 80 would increase by around 50 percent, according to Hoberg. That means additional expenditure of 28 billion euros for the health insurance companies. Instead of deporting old people into care, their physical, psychological and cognitive characteristics should be identified through detailed examinations and taken into account during rehab. This is the only way to achieve a quick and permanent recovery, demanded the AOK boss and made it clear: Neither the state nor health insurance companies could easily raise this amount. It is therefore desirable to be able to lead a life to the end as long as possible without serious illnesses. (ko) World premiere for specialist lexicon of physiotherapy service: Springer Lexikon Physiotherapie Zalpour, Christoff (Ed.) 1st Edition, 2010, about p. 750 Fig., Geb. ISBN:, 95 Euro retail price From anatomy to kinesiology, manual therapy and Psychomotor to CNS, more than just key words for physiotherapy, more than 65 authors from all over the world have compiled the first comprehensive specialist lexicon Physiotherapy, which has been available in bookshops since the end of May. Professor Dr. Christoff Zalpour as editor of the encyclopedia in a press release from the University of Applied Sciences Osnabrück. The lexicon not only provides explanations with up-to-date, practical information on specialist terminology, but also provides information on related topics and the medical nomenclature relevant to physiotherapy, it says. Over 400 clinical pictures are listed with all the important facts and practical tips for medical and physiotherapeutic examinations and treatment. Each keyword entry is also listed in English in order to facilitate research in international databases. The main contributions or essays, which address currently discussed topics such as clinical reasoning, differential diagnostics in physiotherapy or the Physiotherapy Evidence Database (PEDro) developed by physiotherapists for physiotherapists, formed a break from the classic lexical style. A working group was set up for the creation of the specialist lexicon with almost pages, which initially brought together all the relevant terms in physiotherapy and created an index. The lexicon has been available in bookshops since the end of May. According to the press release, it should be revised and updated on a regular basis. And the comprehensive feedback from specialist circles already shows that the reference work covers an important demand in the field of physiotherapy literature. Zalpour adds that such a technical lexicon, which is continuously updated, is indispensable for physiotherapy in particular, which has taken decisive steps towards independent science in recent years. (ks)

11 xxxxxx Up-to-date 11 Citizens debate about prioritization As early as April of this year, we reported on the prioritization debate among the citizens of Lübeck. Twenty citizens of the city discuss over four weekends about just and sensible priorities in medical care. The results are now available. Perhaps the pensioner Margot Wolters, the nurse Kerstin Rückert, the chef Stephan Schröder and 15 other participants at the Lübeck Citizens' Conference have now made history. In any case, this group of laypeople has done pioneering work because it was the first time in Germany outside of expert circles to develop the basis for prioritization in medicine. Prof. Heiner Raspe from the Lübeck Institute for Social Medicine took the initiative this year and randomly asked people in Lübeck about setting priorities, about half of whom answered. The result was surprising: 82 percent of the respondents wanted to help decide which services the health insurance companies would take over. Interest especially among older citizens Around 200 people also expressed a general interest in taking part in a citizens' conference on prioritization. From this set, 40 people were filtered according to certain criteria such as age and gender, of which 20 were ultimately drawn. Eleven men and seven women between 20 and 76 years of age kept up the difficult project work on four consecutive weekends. One participant dropped out for health reasons, another for unknown reasons. It is noticeable that only one participant was younger than 39 years of age, the interest in the topic, especially among young men, was low, according to Raspe. It became clear that after careful discussion, the topic in no way scares people off, but rather creates transparency and thus trust in the health system based on their experience. In their opinion, prioritization is based on basic values ​​such as human dignity, equality, solidarity, need, efficiency, information, transparency and self-determination. It is their conviction that all other basic values ​​must be subordinate to human dignity. It is important to the citizens' conference that people who cannot represent themselves are protected from discrimination. The 18 citizens identified life support and urgency of treatment, needs-based distribution, waiting time, patient's will, quality of life, cost efficiency, innovation and progress in medicine as well as verifiability of effectiveness as criteria for prioritization.The criteria of personal responsibility and self-negligence, family care and professional ability were controversially discussed in the group. There were different opinions on these points as to whether they should be a criterion for prioritization. On the other hand, they were unanimously of the opinion, which patient receives a service first? Members of the Lübeck Citizens' Conference asked themselves such difficult questions. that calendar age, social status and occupation are not criteria that should be taken into account when prioritizing. The group also recommended a national committee that deals with the same questions, discusses and establishes basic values ​​and criteria for prioritization. As representatives in this body, they would like associations and chambers from the health system, health insurance companies, but also citizens. They want to see the influence exerted by lobbyists and the medical industry controlled. In order to promote personal responsibility, citizens consider incentives for personal health care and a healthy lifestyle to be sensible. Not an easy decision The way to the results was arduous, as conference participant Stefan Jack revealed. How complex the task they were asked to be became clear when discussing case studies. For example, the citizens were given the task of choosing a person from four individual fates described who would be the first to receive an artificial hip joint. First of all, you quickly made a gut decision. The more you learned about the background, the harder it was to make a decision, Jack reported. When discussing such examples, the group felt that they needed criteria in order to be able to make a decision. At the same time, after observing moderator Jens-Peter Dunst, it became clear to them what responsibility this entails and what pressure doctors are under when dealing with these questions. The group sees its results as a vote that could contribute to a broad social debate, for example in the form of further citizens' conferences in other regions. The results of the citizens' conference are to be commented on in the autumn as part of a scientific symposium from the perspective of various health care disciplines. (di)

12 12 Current physiotherapy after breast cancer surgery helps Study: McNeely ML, et al. Exercise interventions for upper-limb dysfunction due to breast cancer treatment. The Cochrane Database of Systematic Reviews 2010, Issue 6. Exercise can significantly improve fitness in women after breast cancer surgery. This is the conclusion reached by scientists from the University of Alberta in Canada. In particular, the mobility of the shoulder is significantly improved through targeted training. There were concerns that too much exercise soon after surgery might cause pain, delay healing, or lead to lymphedema, project leader Margaret McNeely, assistant professor of physical therapy at the University of Alberta, told the Health Behavior News Service. Her team therefore looked for studies that compared breast cancer patients who had participated in sports with corresponding groups of women who had not completed any physical training. The Canadian researchers found 14 suitable studies in which around 720 women participated. About 200 of them were undergoing breast cancer treatment at the time of the examination, the rest had already survived the disease. Sports such as tai chi, walking or jogging as well as strength training were examined for the study. In most of the studies, the women had exercised at least three times a week. Conclusion: The physical performance and thus the quality of life could be increased in almost all study participants. In some studies, certain physical therapy exercises were also evaluated, which should improve the mobility of the arm within a week after an operation. The women were actually able to move their arm earlier and, for example, reach over their head better. However, McNeely said, the wound fluid could increase. Therefore, it makes sense to start with the exercises about a week after the operation. The benefits of sports programs for breast cancer patients no longer seem to be in dispute: In addition to the Breast Cancer Moves initiative, the DAK has been the first statutory health insurance company to offer 12-week exercise programs for breast cancer patients in around 30 cities across Germany since October 2008, insured persons from all insurance companies are open. (ks) The Cross with the Cross Movement Virus for Kids More and more children complain of back pain. That is the result of a nationwide Forsa survey of 100 paediatricians on behalf of the German Salaried Health Insurance Fund (DAK). For therapists as movement experts, this means developing new programs for the little ones who have it in their back. The main cause of the increased number of back problems in children is a lack of exercise, according to the DAK press release. In the current study, the majority of the doctors questioned stated that the number of children with back pain had increased sharply (13 percent) or slightly (44 percent) over the past ten years. At 61 percent, 11 to 14 year olds are particularly affected. But already six percent of 6- to 8-year-olds complained of lower back pain. 98 percent of doctors were of the opinion that children do too little sport in their free time. Instead, you would sit in front of the television or PC for hours. In addition, the parents do not stimulate the motor development of their children enough, said 91 percent of the medical professionals. And 60 percent of paediatricians consider physical education in schools to be too little or too bad. More than half (53 percent) cited poor or improper nutrition as the reason for the increasing number of back pain in children. Parents should firmly integrate exercise into everyday life and set an example in terms of health, said 96 percent of the experts. More than 90 percent were in favor of regular participation in sports clubs or common sports activities in the family. In contrast, only 49 percent recommended physiotherapy. Based on these results, the DAK will start a nationwide awareness campaign on the subject of back pain in July. In 13 German cities, Professor Ingo Froböse from the Sport University Cologne will give free active lectures. We just have to infect our children with the motor virus. Parents should always be a role model, especially when it comes to sport and health. (ks)

13 Currently 13 Patients do not trust themselves when it comes to health. Fate Health When it comes to health, patients often do not trust themselves. A survey shows that one in three adults in Germany is more likely to see responsibility for their health in others. Giving up responsibility for one's own health is a surprising idea in Germany. Especially with male and young patients, therapists should take into account that they often rely on advice and help from others in matters of health. A representative study by the Scientific Institute of the Techniker Krankenkasse (TK) for Benefit and Efficiency in Health Care (WINEG) on the subject of patient satisfaction shows that only every second man relies on the advice of others, among women every fourth. I find it worrying that young people in particular tend to trust others instead of taking responsibility for their own health. Almost one in two of the 18 to 30 year olds said this, said WINEG Director Dr. Frank Verheyen. It is also interesting that many people apparently see the question of whether symptoms go away again as fate. Because more than one in four (28 percent) ascribes it to luck or bad luck whether they will get well again in the event of illness instead of believing that this is in their own hands. People ignore the fact that the success of therapy in many diagnoses depends heavily on how well the patient works: In particular with chronic ailments such as cardiovascular diseases or diabetes, it is crucial that the patient takes an active role in the therapy, said Verheyen. Almost every second respondent described himself as chronically ill in the WINEG study. In order to win patients over to active cooperation, Verheyen sees doctors as being asked: They have to awaken the patients' awareness that their own commitment is decisive for the success of the therapy and what consequences a lack of cooperation can have for them. Because, continues the WINEG director: Patients cannot hand over responsibility for their health to their doctor. He gives them the therapy plan and prescribes the necessary medication. As soon as the patient has the prescription in his hand, the success of the therapy is literally in his hand. TK also points out, however, that doctors often contribute to the patient's lack of sense of responsibility. The reasons can be the dominant demeanor of the practice owners or the belief that the involvement of patients is a burden on everyday practice. In this context, the health insurance fund refers to previous results of studies, according to which the majority of patients would like to be included in decisions. (di) BGF: But with professional guidance, please! Health promotion in the company can lead to a change in lifestyle. A Dutch research team has found that company advice or physical activity exercises have a positive effect, particularly on risk groups among workers who are prone to cardiovascular diseases. They observed both a reduction in body fat and body weight. The scientists from Amsterdam examined 31 studies from 1993 to 2008. All studies should include measures to promote health in the workplace with the aim of increasing the physical activity of employees or changing eating habits. Finally, objective indicators such as body weight, body mass index, body fat, blood pressure, blood lipids, blood sugar should be communicated to evaluate the success. The measures included individual counseling for employees, information and advice in groups and the implementation of movement exercises under supervision, mostly by superiors. In a total of 12 studies, the participants were workers at particularly high health risk for cardiovascular diseases; in the other studies, they were mixed groups. The duration of the interventions varied significantly, as did the time at which the effects were measured, between eight weeks and three years. The researchers came to the conclusion that workplace health promotion measures have a positive effect on reducing body fat, one of the strongest risk factors for cardiovascular diseases. The body weight and the body mass index had also been reduced, so that the risk groups in particular benefited from the interventions in the company. Movement exercises under the supervision of the supervisor showed only modest effects, the scientists emphasized. (ks) Free abstract: Groeneveld IF et al: Lifestyle-focused interventions at the workplace to reduce the risk of cardiovascular disease a systematic review (Scandinavian Journal of Work, Environment and Health; 2010; 36 (3):)

14 14 Current Physiotherapists from all over the world meet in Amsterdam World Congress of Physiotherapists 2011 Physiotherapists from all over the world will meet from 20 to 23 June 2011 in Amsterdam. The World Confederation for Physical Therapy (WCPT) expects more than physical therapists. This is reported by the German Association for Physiotherapy ZVK. All speakers have the opportunity to submit abstracts of their presentations in English by September 15. Sylvie Eloi, managing director of PhysioCongress & Medien GmbH, a subsidiary of the ZVK, which organizes the joint appearance of the German-speaking associations at the world congress, explains the most important international health issues and their consequences, but also opportunities for physiotherapists. In addition to professional policy issues such as the development of quality standards, questions of professional practice are also on the program: How can you, as a practice owner, promote health, for example through prevention or rehabilitation? Information about the WCPT and the World Congress 2011 is available at www. wcpt.org. The focus of the congress is modern physiotherapy all over the world. According to a ZVK press release, it is used to exchange information and ideas as well as to establish contact at an international level. The world congress with its lectures, workshops, films and video presentations has been taking place regularly since 1953. This year there are five different focus topics: Global health deals with the balancing act between the present and the future Another aspect is professional training: How can the physiotherapist get fit for his practice in order to meet the requirements of tomorrow, says Eloi, the constant balancing act between present and future. And finally, it's about scientific research. This aspect is aimed primarily at physiotherapists who work in science, but also at those who are looking for contacts with foreign colleagues. Registration for the world congress is expected to be possible from September onwards. The costs have not yet been determined, but according to ZVK information, as at the last congress, they will be around 350 euros. The WCPT is the umbrella organization of national physiotherapy professional associations. Each nation can only be represented there by one professional association. For Germany this is the ZVK. 101 national associations are currently registered as members, representing more than physiotherapists in total. (ks) Children prefer to learn from adults The study is published in The British Journal of Developmental Psychology. Small children prefer to orient themselves towards adults rather than their peers when they are learning something new. This is the conclusion reached by scientists from the Max Planck Institute for Evolutionary Anthropology in Leipzig, who observed young children in a fictional game. 44 German-speaking children aged three and four who attended a municipal day-care center took part in the study. Study leader Hannes Rakoczy and his team showed the little ones a video in which either a boy or a man talked about the right way to dax a game that the researchers had come up with. Both the man and the boy gave different rules. Then the children should then dax themselves while the psychologists observed them. Conclusion: The scientists found that the trust in the adults was very high, apparently so great that the little ones even intervened corrective if they had observed that someone was not following the instructions of an adult. The children were much more likely to imitate the Dax variant that the adult had specified. This was also shown in another experiment in which a doll told the little ones that it was now their turn to be daxed. In half of the cases, the doll then followed the man's rules, and in the other half, the boy's instructions. The study showed that the children clearly protested when the doll did not follow the adult's rules. They even tried to teach her what they believed to be the correct Dax method. (ks)

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