Einschränkung der freien Psychotherapeutenwahl durch die neuen Psychotherapierichtlinien

Das Prinzip der freien Psychotherapeutenwahl ist mit den neuen Psychotherapierichtlinien seit April 2017 faktisch infrage gestellt bzw. teilweise aufgehoben worden. Insofern der einzelne Patient die Anstrengung auf sich nimmt, sich einen Platz in einer Kassenpraxis zu suchen und letztlich auch findet, bleibt die freie Psychotherapeutenwahl bestehen. Allerdings besteht diese schon nicht mehr in vollem Umfang, wenn die Terminservicestelle der Kassenärztlichen Vereinigung von den Patienten zur Vermittlung einer “Psychotherapeutischen Sprechstunde” und einer “Akutbehandlung” in Anspruch genommen wird. Wer auch dann noch Behandlungsbedarf hat und darauf angewiesen ist, dass seine Krankenkasse ihn bei der Suche nach einem Therapieplatz unterstützt, der ist darauf verwiesen, einen dieser Plätze zu nehmen, die ihm von der Krankenkasse angeboten werden. Zumindest in der Theorie soll die  Terminservice-Stelle Patienten ein anderer Therapeut vermittelt, wenn keine emotional tragfähige Beziehung und damit Arbeitsbeziehung möglich ist. Inwiefern das in der Praxis auch so umgesetzt wird bzw. werden kann, bleibt abzuwarten.

Die TK schreibt in diesem Zusammenhang Briefe an ihre Versicherten in denen beispielsweise zu lesen ist:
“Gründe wie beispielsweise bevorzugtes Geschlecht oder Alter des Psychotherapeuten Sprache, zeitlich erreichbarer Korridor oder Vertrauensverhältnis/Empathie sind zwar individuell nachvollziehbar, begründen allerdings nicht, dass kein zugelassener Therapeut in Anspruch genommen werden kann (Systemversagen).” (Zitat aus Briefen der TK an ihre Versicherten)

Man kann diesen Satz schwerlich anders interpretieren als dass vom Patienten erwartet wird, letztlich jeden Therapeuten zu akzeptieren, der ihm von seiner Krankenkasse vorgeschlagen wird, wenn er nicht in der Lage ist, selbst einen Therapieplatz für sich zu finden.

Ab Oktober 2018  sollen die Terminservicestellen der KVen in dringenden Fällen auch probatorische Sitzungen zur Einleitung einer Richtlinienpsychotheapie vermitteln, wobei es dem Patienten gestattet sein soll, zumindest einen Therapeuten abzuwählen, mit dem er sich eine Psychotherapie nicht vorstellen kann. Die zweite Vermittlung der TSS muss dann aber wohl vom Patienten akzeptiert werden. Damit wäre ein weiterer Meilenstein in der Abschaffung der freien Psychotherapeutenwahl für Kassenpatienten erreicht. Mehr dazu hier.

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