Lower Saxony doctor shortage may deepen as federal austerity plans threaten outpatient care

The prognosis

A new forecast commissioned by the Association of Statutory Health Insurance Physicians of Lower Saxony (KVN) paints a mixed picture of general practitioner supply through 2040. While the overall shortage may be less severe than previously feared due to a declining population, the number of planning areas classified as underserved is projected to jump from two today (Sulingen and Munster) to sixteen. The study was led by Stephan L. Thomsen of the University of Hannover.

Ultimately, the decisive factor for care will not be the number of doctors alone, but their distribution across regions.

Reform risks

KVN Vice Chairman Thorsten Schmidt warned that the federal government's planned health reforms, designed to stabilise health insurance contributions, could undermine the cautiously optimistic baseline. If implemented, the measures would make it impossible to continue outpatient care in its current form from 2027 onward. Schmidt fears older physicians and psychotherapists may retire early or switch exclusively to private practice rather than work under tougher conditions.

Instead of continuing to work under more difficult conditions, they prefer retirement.

Regional disparities

The impact would be felt most acutely in rural and structurally weak regions, where doctor shortages are already severe. The KVN stressed that even if the total number of physicians declines only modestly, an uneven geographic distribution could leave many communities without adequate primary care. The aging population, which brings higher disease susceptibility, adds further pressure.

By the numbers

Currently, around 5,420 general practitioners work in Lower Saxony. The KVN expects that figure to fall to roughly 4,870 by 2040. The two charts below illustrate the projected decline in GP numbers and the sharp rise in underserved planning areas.