Welcome to “Medical Mavericks,” a new series from MedPage Today featuring interviews with healthcare professionals working in unconventional fields of health and medicine.
To kick off the series, we spoke with Philip Kampmann, MD, head emergency physician at Oktoberfest. First held in Munich, Germany in 1810, Oktoberfest has since evolved into an annual event celebrated around the world. The festival lasts 16 to 18 days and honors Bavarian culture with beer steins and wine, festival rides, traditional music, bratwursts, and more.
While gathering millions of people for beer and good cheer sounds like an excellent time, accidents do happen. That’s where Kampmann and his team, who are in the midst of their fourth year running the medical station at the festival, become essential to keeping the tradition alive. From tracking down a runaway patient with a brain bleed to relieving the burden on Munich’s healthcare system, read on for insights into Kampmann’s work at the world’s largest beer festival.
This interview has been edited for brevity and clarity.
What is your medical background and how did you get involved with Oktoberfest?
Kampmann: I studied in Munich, and now work as a general practitioner. We have a big practice: It’s three places in the suburbs of Munich, where we have 70 people working together. There are 20 doctors, and we offer care for family medicine, general medicine, and all that. When I studied, I worked as a paramedic for an ambulance service called Aicher Ambulance, and later became the chief medical officer, helping with medication and making training programs.
For Oktoberfest 2018, the government of Munich had to make ausschreibung [a request for bids for a business contract], where they ask a lot of companies to make angebot [offers] to provide medical services. So, the government of Munich chose us to do that for the first time; I was suddenly the head officer for the Oktoberfest. Due to the Coronavirus we had to pause the Oktoberfest in 2020 and 2021, so now it’s the fourth time for us.
For 130 years, it was the German Red Cross, the Bavarian Red Cross. But due to the international programs, the city of Munich had to choose the cheapest provider. We made a good offer in 2018 and got the job. But we don’t know if we’re getting it next time. They repeat the “ausschreibung,” and at the moment it’s a mixture of price and quality. If the politicians choose just based on price, maybe we have no chance, but if they also combine it with quality, then we may get lucky.
Can you tell me about your role at Oktoberfest?
Kampmann: I have the role of a chief medical officer; I coordinate all the other doctors working here. On the weekend is when we expect a lot of patients. We are 12 doctors at the moment here, together with 110 paramedics at the most busy times. And I have to coordinate the doctors. I have to see if there are problems. I have to react if there are a lot of patients, if we have to dismiss this one and send them to the hospital.
When the Oktoberfest is in Munich, we have nearly twice as many people as normal living in Munich, but we don’t have twice the hospitals or twice the rescue system. So, we try to keep the patients here and treat them here [at the festival] so they can go home and don’t have to visit the hospital.
Since last year, we have a CT scanner here to do a scan of the brain and the skull and the spine. We even have a study in the New England Journal of Medicine. It’s due to a special situation, since we are now forced to try to keep the number of patients going to the hospital very low. This is because, I don’t know how it is in the States, but in Germany we have a problem with getting enough nurses, doctors, paramedics, and all that stuff. So especially at a time like the Oktoberfest, they are working more than ever and we have to relieve the burden for the hospitals and the paramedic system. And that’s what we do.
Can you tell me about patient volume and the typical patients you’re seeing?
Kampmann: If it’s a nice day on the weekend, we have about 500,000 visitors at the Oktoberfest. So, it’s the city of Nuremberg who is in Munich. And that’s a lot of people. Of course, most people come happy to the Oktoberfest and leave happy. But some people they have injuries, and of course there is a lot of alcohol, but they also have cardiac failure or cerebral problems.
On our first weekend, on the Saturday, we had 650 patients altogether. On a normal weekend day, it’s typically more than 500 people a day. And over the whole Oktoberfest, we think we will treat more than 7,000 people — and that’s a lot of work. If you think about it for the whole system, if the 7,000 people couldn’t be treated here at the Oktoberfest, we would have to send them to the hospitals. And that would be a real problem and maybe a game stopper for the Oktoberfest.
But I think all of us, the police and the fire brigades, they are important to keep this running. Because if there weren’t any people like us, the Oktoberfest couldn’t work.
What percentage of patients end up having to be sent to a hospital?
Kampmann: This year we are really great. We have less than 3% of the patients sent to the hospital. So that’s really perfect. And if they have a problem that has to be treated in the hospital, of course everybody gets hospital treatment who needs it. But if you think 3% of 7,000 people, that’s not very much and that’s great work for us.
Have you had any unusual patient cases at the festival this year?
Kampmann: Just in the beginning, on the first Saturday, we had a nice old man who had too much alcohol and fell down on his head. He took some medication against blood pressure and something like aspirin, which is dangerous for bleeding in the skull, for intracerebral bleeding. So, we convinced him to do a CT scan, but he didn’t wait for the result. He just left, just on his own. So, the radiologist came up and said, hey, there’s bleeding on the CT scan, and we had to find him. I found him via his mobile phone. He lived in Munich, and he went home!
His wife was on the phone, and she was like, “What was he doing? Okay, send me an ambulance, quick!” And then we sent an ambulance to him, brought him to the hospital that already had the pictures of the CT scan, and he survived. Lucky!
So, we saved a life, and that’s a nice story. And that’s what we try to do. We have to see if the people need hospital treatment, then of course they go to a hospital. Or if we can treat them by ourselves, and then maybe they can go home and visit the doctor the next day so they don’t add a burden for the paramedic system.
With the “runaway” patient, it sounds like he provided background on his medications, but do you typically find it challenging not having access to patient records?
Kampmann: Yeah. That is a problem because we also have a lot of foreign people, visitors, tourists, and they come to us and normally are not prepared for a medical emergency. If they have a lot of alcohol, they are not able to tell you all the medication they take and all the problems they have. So, it’s a little bit of fishing and searching and trying to get information from everywhere — maybe call family members or whatever.
What are your favorites parts of the job?
Kampmann: My favorite part is the team play. We are a lot of people here. We all like what we do. We try to work together — no, we don’t try to work together, we work together. And the best part of everything is the teamwork, trying to save lives together, working together, doctors, paramedics, hand-in-hand. And that’s the reason why I like it, because it’s not work. We love what we do and if you love what you do it’s not work. We do it for fun, even if it’s a special thing in an emergency situation to talk about fun, but for us, we like what we do.
When you are the head of the medical staff, you also have to represent it. For example, 2 days ago, we had a deputy chief of the fire department from Indianapolis visiting to see what we do. We also have a lot of press contacts, and we show what we do to the mayor, to politicians here, to important people. You get in touch with interesting people and I like that.
Anything else readers should know?
Kampmann: Come to the Oktoberfest, see it for yourself! We hope maybe we will have the next 4 years, then you are really invited to visit us and to see our work at the medical station. It’s the world’s biggest beer festival, so there’s always something to see and to celebrate.