It is a bleak picture that the head of the Kassenärztliche Vereinigung (KV) Berlin, Burkhard Ruppert, paints of outpatient medical care in the capital. “Already today some regions of our city are critically undersupplied, especially in the eastern part of Berlin.” Despite funding programs and new practice models, the situation threatens to deteriorate further. Ruppert calls for a systemic change and more responsibility from politics and patients.
It is not the first time that the head of KV Berlin has sounded the alarm. The real wave, Ruppert says in his wake-up call published on Thursday, “is still rolling toward us.” – “We are experiencing a double demographic development: Our society is aging—and so is our medical workforce.” By 2025, more than a third of Berlin’s doctors were already over 60 years old.
By 2040 it will be almost half. “We do not know whether the incoming medical workforce will be sufficient to close the gap that has arisen.” In addition: more and more young doctors want to work part-time—for understandable reasons. That means: more heads in the system, but less physician time.
At the same time, Berlin is growing. The strongest growth is in the areas where care is already weakest. This applies, for example, to Marzahn-Hellersdorf, Treptow-Köpenick, and Lichtenberg. “In the same districts, the disease rate is above the Berlin average.”
Crisis Situation Expands
Although the KV has long been countering this: “We promote nine new practice openings and practice takeovers with startup funding, support hires and practice assistants, and accompany doctors on the path into outpatient care.” Despite rising numbers of doctors, the level of care hardly improves. “The strong population growth in Berlin is eroding our gains.”
The emergency in the eastern districts threatens to reach other parts of the city as well. “We need a system change,” demands the head of KV Berlin. The notion of “having access to all medical services anytime, anywhere and without coordination” is described by him as outdated. What is needed is a mandatory and intelligent patient management system. “Guided by the principles: digital-first, outpatient-before inpatient.”
The SPD-led Senate Department for Science, Health and Care stated on Friday, at the request of , that the “context” concerning outpatient care described by Ruppert is known to them. The concerns are taken seriously. As early as 2023, a working group of the Joint State Body for Ensuring Outpatient Care had been established, and it continues to exist.
Under federal law, the provision of outpatient contract medical care, however, is the task of the Associations of Statutory Health Insurance Physicians. The Senate Department for Health welcomes the engagement of the Berlin Association of Statutory Health Insurance Physicians in the areas of practice establishment funding and consulting as well as the creation of own facilities in districts with lower levels of care.
Notably, through the establishment of own facilities, the preference of younger doctors to work in employed positions is also supported. Moreover, the state of Berlin supports the endeavours of the Länder to enable the Associations of Statutory Health Insurance Physicians to also establish Medical Care Centers (MVZ).
Also in March 2025, at a hearing in the Health Committee of the Berlin House of Representatives on the status of hospital reform, the head of KV Berlin again pointed to the problems in outpatient care. In the eastern part of the city there are now 130 vacant general practitioner posts with significant replacement difficulties, “even though we are funding the whole thing with 60,000 euros,” Ruppert said at the time.
