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HEALTH

Herbal tea and sick leave: An American’s ode to the German attitude towards health

The Local's editor Rachel Stern writes about how she learned to embrace the German attitude towards health - by seeing first hand how society handles sickness.

Herbal tea and sick leave: An American’s ode to the German attitude towards health
A man with a fever drinks an 'Erkältungstee', or tea for colds. Photo: DPA

Groggily opening my eyes after general anesthesia at a Berlin hospital, I was greeted by a gentle nurse’s voice. “Would you like a Kräutertee (herbal tea)?” she asked.

I slowly sipped it, smiling while thinking how, if I were in my native US, “herbal tea” would have likely been replaced by “more morphine”.

The warm beverage, favoured by many Germans to treat everything from the common cold to post-surgical drowsiness, has to me become analogous to attitudes here towards health and well-being. There’s not a quick plow-through and get-back-on-your-feet mentality, but a steadfast (and societally accepted) rationale for recuperation. 

Whatever the severity of the illness, Germans usually see taking time off work to fully recover, however long that may be, as a necessity and not a luxury. 

READ ALSO: Working in Germany: The 10 rules you need to know if you fall ill

Six weeks and then some

Sechs Wochen (Six weeks)?” I echoed the doctor before my foot surgery, when he suggested the amount of time I should be krankgeschrieben, or given sick leave. I had not envisioned taking any time (other than the day of the operation itself) as surely I would still be able to sit at a desk afterwards, crutches cast to the side.

Despite having lived in Germany for seven years at that point, I realized how much my “get up and get on with things” American attitude towards sick leave (or lack there of) was still present. As of 2018, the average US worker took 2.5 days of sick leave, compared to 18.5 in Germany, according to the country's umbrella organization of public health insurance

In the US – where there is no legally mandated paid leave for illness – many employees cite economic reasons for showing up at work with a flu, boxes of tissues dotting their desks. Not only do they fear monetary losses, but also that their job could be at stake if they aren't viewed as “irreplaceable”.

Most Germans wouldn't think so highly of their colleagues for showing up to work sick. Photo: DPA

And if employees must miss work, as was the case of a former colleague in San Francisco with a broken arm, they often dig into already scarce vacation days.

Yet in Germany, where workers receive up to six weeks fully paid sick leave per year – and additional weeks at 70 percent pay – it’s seen as a taboo to show up to work unwell and likely infect your colleagues. Many managers encourage their employees to rest and recuperate until they're ready to perform at 100 percent again.

READ ALSO: What we could all learn from the German attitude to sickness

Furthermore, if you fall ill during vacation time (which is legally a minimum of 20 days for employees, but often includes one to two additional weeks), many companies allow you to claim this time back. 

Any need to recover is due cause for taking time off, with mental health issues such as depression or burn-out now the third most common reason for Krankenstand (sick leave) in Germany.
 
While some argue that this is due to workplace conditions in Germany becoming more demanding and stressful, others say there is simply more awareness and openness to viewing mental health as just as vital as physical health. 
 

 No pride in presenteeism

In short: the German idea of time off when you need it, whether for warding off a fever, spending precious time with a new child or hibernating in Mallorca, is as alive and well as it encourages people to be as a result of it. 

This explains why, unlike for many in the US, there’s no pride in “presenteeism” – the idea of working while sick to prove that you’re a diligent worker, both to yourself and others. Germans might have another word for it: foolish.

While I didn’t take a full six weeks away from the office, I realized I didn’t need to, ahem, get my foot in the door right away. Rather I could leave it where it belonged for awhile – propped on a pillow while I drank yet another cup of tea.

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HEALTH

What you should know about Germany’s plans to roll out e-prescriptions

Germany is taking a big step towards a more digital-friendly health system, with plans to roll out e-prescriptions nationwide. Here's what you should know.

A person holds the e-Rezept app in a pharmacy in Oldenburg, Lower Saxony.
A person holds the e-Rezept app in a pharmacy in Oldenburg, Lower Saxony. Photo: picture alliance/dpa | Mohssen Assanimoghaddam

What’s happening?

From January 1st 2022, people in Germany will receive their prescriptions digitally (known in Germany as an ‘e-Rezept’) from healthcare providers.

Patients should be able to get their prescription from their doctor via a QR code sent to an app, which can then be transmitted to a pharmacy. The pharmacy can then let the patient know whether their medicine is in stock (or if they want to order it), and when it is ready for collection. 

This model is to be mandatory for people with statutory health insurance from the start of 2022, replacing the good old paper prescription.

However, the QR code can also be given to the patient by the doctor on a piece of paper if a patient does not have access to or doesn’t want to use a smartphone. 

READ ALSO: The changes around doctors notes in Germany you should know 

How exactly will it work?

In theory this is the plan – you’ll visit the doctor or have a video consultation. After the examination, the doctor will issue you with an electronic prescription for the medication that has been prescribed to you. 

A prescription code is automatically created for each ‘e-Rezept’, which you will need so you can get the medicine at the pharmacy. As we mentioned above, patients in Germany can either open this QR code in the free e-prescription app developed by Gematik and the Health Ministry, or receive it as a printout from the doctor. 

Next, you can take the prescription QR code (either in the app or as a printout) to your pharmacy of choice to get the medication needed.

One of the major differences and timesavers under the new system is that you can also select the pharmacy you want to get the prescription from digitally, order the medication (if needed) and you’ll be alerted when the prescription is ready. You can also arrange to have it delivered if needed. 

A doctor’s signature is not required, as e-prescriptions are digitally signed. 

The aim is that it will save on paperwork, time at the medical office and trips to the pharmacy. 

Some patients have already been receiving digital prescriptions. The ‘e-Rezept’ was tested out successfully in selected practices and pharmacies with a focus on the Berlin-Brandenburg region of Germany. The test phase started on July 1st this year.

Pharmacies and doctors’ offices nationwide have also been given the opportunity to test the new system from the start of December. 

“This will enable practice providers and pharmacy management systems to better prepare for the mandatory launch on January 2022 1st,” said aponet.de, the official health portal site for German pharmacies

The new e-prescription app.
The new e-prescription app. Photo: picture alliance/dpa | Mohssen Assanimoghaddam

READ ALSO: 10 rules to know if you get sick in Germany

There is some leeway though – if there are technical difficulties, paper prescriptions can still be issued in individual cases until the end of June next year.

The National Association of Statutory Health Insurance Physicians estimates that it could take until mid-2022 until all users are equipped with e-prescription applications nationwide.

The obligation does not apply to privately insured people from January next year. Private insurance companies can decide voluntarily to make the preparations for their customers to use the e-prescription.

What’s this about an app?

To be able to receive and redeem prescriptions electronically, people with statutory health insurance need the Gematik ‘das e-Rezept’ app. 

One issue is that the app appears to only be available at the moment in German app stores. We’ll try and find out if there are plans to change this and widen out the access, but it seems likely for that to happen. 

Germany’s Covid-Warn app, for example, was initially only open to German app stores but was gradually widened out to many others. 

As mentioned above though, those who don’t have access to an app will be able to use the paper with the code on it to access their prescriptions. 

READ ALSO: Everything you need to know about making a doctor’s appointment in Germany

Has it all gone smoothly?

As you might expect, there have been a few hiccups. 

Originally, the introduction nationwide was planned for October but was postponed due to many providers not having all the tech requirements set up. 

Now though, more than 90 percent of the practice management systems have been certified by the Association of Statutory Health Insurance Physicians – a prerequisite to issue the e-prescriptions.

The e-prescription is part of Germany’s far-reaching plans to digitise and streamline the health care system.

The head of Gematik GmbH, Markus Leyck Dieken, recently spoke of a “new era” that is “finally starting for doctors and patients” in Germany. 

Useful vocabulary:

Prescription – (das) Rezept

Doctor’s office/practice – (die) Arztpraxis

To order – bestellen 

Pharmacy – (die) Apotheke

Video consultation – (die) Videosprechstunde

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