The Austrian politicians have complicated the matter by adding in a point system. This innovation was a political decision made by legislators. The point value is related to the frequency of the diagnosis and is complicated. There is some cost shifting from the public to the private sector. There are approximately 30,000 doctors in Austria, of which 6,000 are in postgraduate training.
General practitioners have three years of postgraduate training and specialists have six years.
At the end of the six years, specialists have a choice as to whether to compete for a very limited number of hospital appointments. The specialists that receive hospital appointments are chosen by the hospitals and not by other doctors. They go on salary as civil servants. When private patients go into a hospital the doctors on staff may bill them privately above the scheduled rate. The advantage for the patient is that they have a choice as to which hospital doctor sees them.