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Time for health

Working together for health: the inaugural meeting of the Grüne Aue citizens’ co-operative in May 2022 in a packed community hall in Hermaringen.
Photo: Grüne Aue surgery/Leon Frerot

Phones off, slippers on. As soon as we enter the surgery, we notice that things are different here. All the rooms are bright and furnished with high-quality wooden materials. In the waiting room, a fireplace creates a cosy atmosphere. You’d think you were in a café rather than a doctor’s office. ‘It was important for us to create a welcoming atmosphere, because when we feel comfortable, other encounters take place,’ says Anne-Gritli Göbel-Wirth, a specialist in gynaecology and obstetrics who is training to become a general practitioner. Together with her husband, Sebastian Göbel, she has developed a new health concept called ‘Lebensgarten Grüne Aue’ (Grüne Aue Garden of Life), which is unique in Germany.

‘Please take a seat’: the waiting room of the Grüne Aue surgery in Hermaringen.
Photo: Grüne Aue surgery

Focus on relational medicine

‘Right from the start, it was important for us to see how we could support people locally in their respective developmental and life stages and take time for their treatment,’ adds Sebastian Göbel. The basis for this is a solidary and non-profit citizens’ co-operative, which allows more time for consultations, an extended range of therapies, health education and relationships – including between the people themselves. In addition to a health-promoting approach that contributes to a sustainable regional health culture, the aim is also to empower people to help shape it. ‘Health is a two-way street: one part is people receiving support when they need it, but another huge part is the sense of purpose that comes from having an impact on society, giving something and getting involved,’ explains Anne-Gritli Göbel-Wirth. ‘It’s also important for us as a medical-therapeutic team to give meaning to our work again. With a concept like this, we can also attract young colleagues to Hermaringen, as many doctors today are looking for a sense of purpose in their work,’ adds Sebastian Göbel.

Enabling diversity

The surgery team is not only breaking new ground in terms of solidarity, but also in terms of therapeutic standards. Therapeutic pluralism is a top priority. In addition to regular GP care, naturopathic and anthroposophic services are also available. ‘As part of our consultation, we point out the options, but naturally the decision on the form of therapy is ultimately up to the patient,’ says Sebastian Göbel. This comprehensive service is made possible by the monthly contributions of the members of the citizens’ co-operative. The idea is that each member pays a maximum of EUR 20, families EUR 35 and people on low incomes EUR 10. Support in the form of a sponsoring membership or donations is also possible.

Recognising skills shortages

This model could be an answer to the current skills shortages. According to a study by the Robert Bosch Stiftung, there will be a shortage of 11,000 general practitioners in Germany by 2035. This means that 40 per cent of all rural districts will be undersupplied or at risk of being undersupplied. ‘We need new approaches to healthcare because, on the one hand, illness is on the rise in our society, with loneliness becoming one of the biggest factors in poor health, and, on the other, there is a shortage of GPs, especially in rural areas. As a result, many of our young colleagues no longer want to work in this system,’ says Anne-Gritli Göbel-Wirth. ‘Here in the Heidenheim district, half of all GPs will have reached retirement age in five years’ time. Here alone, there will be 35,000 people without GP care if there are no young colleagues to replace them,’ adds Sebastian Göbel.

Sebastian Göbel has focused on nutritional issues, particularly therapeutic fasting. He regularly organises group events on the subject.
Photo: WALA
For Anne Gritli Göbel-Wirth, dialogue with the people of Hermaringen is important.
Photo: WALA

Creating space for encounters

This citizens’ co-operative is the first of its kind to offer extended healthcare. It was founded in May 2022 with 333 members. There are now 450. Eighty-five per cent of the monthly contributions come from people in the immediate area. The income is used primarily to provide time for individual consultations, but also to promote civil dialogue. This requires a great deal of motivation and commitment – a strong team is needed. Anna Lotta Rohmeyer and Kai Näbert complete the quartet of doctors on site. ‘We want to create spaces for development that strengthen dialogue and where everyone benefits from the community’s experience,’ says Anna Lotta Rohmeyer.

Practice instead of theory

To this end, the surgery team is in regular contact with the local population through what is known as ‘participatory citizens’ dialogue’, to meet local needs and create a platform for everyone to get involved: free services and organisations run by people for people. It’s a concept based on solidarity that is successful and encourages people to take action. In addition to the participatory citizens’ dialogue, there are health education events organised by the medical team, with many practical group offerings and lectures on health topics, such as courses on fasting, the use of bandages and compresses and how to deal with life crises such as life-threatening illness and anxiety.

Kai Näbert understands health not as a state to be achieved, but as an ongoing process.
Photo: WALA
Anna Lotta Rohmeyer wants to create new spaces for encounters.
Photo: WALA

A comprehensive understanding of health

A comprehensive programme based on member demand. The discussion on health in the participatory citizens’ dialogue revealed that, in addition to physical health, it is especially important to have a meaningful and self-determined life. This is in line with the research of Dutch physician Machteld Huber, who has studied the various dimensions of health in depth. ‘We see our work in the “Lebensgarten” as cultural work. For us, this means caring for and nurturing the people who place their trust in us,’ explains Kai Näbert.

Wonderful coincidences

The fact that the dedicated team ended up in Hermaringen was also the result of a personal encounter: Sebastian Göbel and the mayor of Hermaringen go to the same hairdresser. The latter learned that the municipality of Hermaringen had been desperately looking for a GP for 13 years and acted as an intermediary. It was a success: after a building project planned in Hermaringen fell through, nothing stood in the way of setting up the idea for a holistic surgery. ‘Of course, we had to put a lot of thought into it beforehand and overcome some legal hurdles, but we also had to paint a vivid picture of the project in discussions with local councillors and citizens,’ says Anne-Gritli Göbel-Wirth. ‘We really have done pioneering work and hope that this will lead to many more initiatives. The path ahead is clear.’