Seven of the biggest healthcare culture shocks in Germany

Scared of falling sick when living in Germany? Don’t be. The country’s healthcare system is among the world’s best – even if things can be a little different to what you’re used to. To lessen the shock, here’s The Local’s guide to the cultural quirks that might trip you up.

Published: Thu 20 Jun 2019 05:00 CEST
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Dealing with the healthcare system in a foreign country can be one of the most daunting things about living abroad. When you’re ill, the last thing you want on your visit to the Hausarzt (GP) or the emergency room is to encounter unfamiliar medical conventions that might come as a shock when you’re feeling more than a little delicate already.

To help you brace yourself, we’ve teamed up with ottonova, a private health insurer offering special rates and English-language support to expats earning over €61,000 a year in Germany, to show you exactly what to expect when using the country’s healthcare system.

1. Getting naked is normal

Germany’s penchant for naked saunas and nudist sunbathing is well known, but it still comes as a shock to many foreigners that this Freikörperkultur (free body culture) also applies to healthcare. Doctors won’t bat an eyelid at asking you to strip off your underpants in front of them as they continue talking to you, or calling in a specialist to greet you as you sit there topless. And nurses will think nothing of sending you down a hospital corridor with your buttocks on show, or expecting you to relieve yourself in a bedpan in front of your hospital roomies. Try not to be embarrassed – because they certainly won’t be.  

Find out more about ottonova’s expat health insurance packages

2. Honesty is the best policy

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Got bronchitis? Why on earth didn’t you come to the doctor sooner?  Don’t do regular exercise or eat fruit every day? Tut, tut, tut. Of course, bedside manner varies from doctor to doctor, but most are uncompromisingly frank, and it’s not uncommon to find yourself being reprimanded if your behaviour isn’t up to scratch. Suck it up – in Germany, the Götter in Weiß (Gods dressed in white) know best.

3. Things don’t always happen quickly

While German healthcare is generally regarded as being of good quality, the system can be slow, particularly if you have public health insurance. Don’t be surprised if you have to wait weeks or more for an appointment with a Facharzt (specialist), especially in big cities. For some foreigners (looking at you, Brits), this might make you feel right at home, but for others used to more efficient service, it takes some mental adjustment.

Taking out private insurance will help you get seen more quickly. For example, with ottonova’s health insurance you can consult an English-speaking doctor via video call, often with a waiting time of under a minute.

4. Hospitals aren’t hotels

Need a stay in hospital? Make sure you come equipped. Many hospitals don’t issue basics like towels, gowns, soap and other toiletries, so you’re expected to bring your own. If you find yourself in hospital after an emergency, you’d better hope you have a friend who can bring in your pyjamas quick-smart.

Make sure you’re covered with ottonova’s expat health insurance

5. Medical degrees are mandatory... for the patient

Well, not really. But it might feel like that at times, thanks to the German medical tradition of issuing diagnoses with their Latin names (a practice known as Fachchinesisch). It can be hard to prise more detail out of your doctor in layman’s terms, particularly if your German isn’t much better than your Latin, but don’t start worrying if they brush you off with “everything’s fine” – it’s likely that convoluted Latin term simply meant you’ve got a cold.

If your German - or Latin - isn’t up to scratch, ottonova’s 24/7 Concierge Service is always on-hand to offer further explanation. Mirabile dictu!

6. Spas aren’t just for fun

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The culture of going to a therapeutic spa (das Bad) is a long-standing one in Germany, with many people believing ‘taking the waters’ can help cure or prevent your maladies as much as any medicine. So much so that you might find your spa break is covered by your health insurance (always check first). Likewise, naturopathic and homeopathic remedies, massages and other natural cures are often covered -- and are with ottonova’s health insurance for expats without any additional costs.

7. Prices won’t break the bank

Though healthcare isn’t free in Germany, costs are generally covered by your public or private health insurance, usually without a deductible, and are considerably cheaper than in other countries. So while the monetised nature of health may still be a culture shock for Brits used to receiving free treatment under the National Health Service, others, particularly US expats, may find themselves pleasantly surprised by how reasonable the cost of healthcare and medications can be in Germany.

In some cases, ‘going private’ may even be cheaper than public health insurance as the amount you pay for public health insurance depends on your income, so higher earners end up paying more. However, if you opt instead for private health insurance, the costs are calculated based on your current health status so could be even cheaper than public health insurance.

This content was produced by The Local Creative Studio and sponsored by ottonova.


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