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HEALTH

7 things to know about visiting a doctor in Germany

Going to the doctor when you're living abroad is a necessary part of life, but it can feel a little daunting. Here are some cultural quirks to look out for in Germany.

A doctor's waiting room in Germany.
A doctor's waiting room in Germany. Photo: picture alliance / dpa | Daniel Karmann

Germany is known for having one of the best healthcare systems in the world. 

But there are some cultural differences that can take a bit of getting used to when you’re not from the country. 

Here’s a look at what you should keep in mind. 

You might have to pay at the doctor

People used to a healthcare system that’s free at the point of contact, such as the NHS in the UK, may be a little confused if they are asked to pay money at a doctor’s appointment. 

But the fact is that certain things will not be covered by your health insurance in Germany, and some optional extras could require that you have to dip into your wallet. 

For instance, many gynaecologists may offer to carry out an optional pelvic ultrasound check during a Pap smear test. If it’s not covered by your insurance, they will state in the appointment that it is an extra cost so you can decide if you want to pay for it or not. 

You should also ask if you have to pay for it upfront at the practice or if it will be sent out as a bill. 

Similarly, other specialists may also offer extra services that you could pay extra for. 

READ ALSO: ‘It works’: Your verdict on the German healthcare system

You’ll get different types of prescriptions

Another point to watch out for is that there are different kinds of prescriptions. A prescription (Rezept) given out on pink slips is usually given to people on statutory health insurance. People have to pay a reduced contribution – usually around €5-€10 – when picking up prescription medicine at the pharmacy. 

Patients with private insurance in Germany are more likely to be given a blue-coloured prescription slip. Private customers have to pay for their medicines in full before their insurance company reimburses them. You can also be given a blue slip if your public health insurance doesn’t cover the treatment.

Green slips include treatment that the doctor recommends. Meanwhile, yellow prescriptions are issued by the doctor for special controlled substances and are only valid for seven days. 

Polite waiting room etiquette

Germans may not be well known for being super friendly. But there are a few unexpected spots which are very welcoming. And one of those places is the doctor’s waiting room. 

Yes, it can be very surprising for foreigners when they are greeted with a little “Guten Morgen!” or “hallo!” in the waiting room when someone arrives. It’s customary for patients to give a polite hello and goodbye in the waiting room.

A person being vaccinated against Covid-19 in Hamburg in 2021.

A person being vaccinated against Covid-19 in Hamburg in 2021. Photo: picture alliance/dpa | Christian Charisius

… But you may face a stern receptionist or doctor

Ask a group of international residents about their experience of going to the doctor in Germany – or indeed other German-speaking countries – and you will likely hear about how the bedside manner is “different”.

This is because some doctors, and even receptionists, have a stern and direct approach when dealing with patients, which can be intimidating for newcomers to the country.

It can also be a little weird if you have to take some clothes off for an examination. You probably won’t be handed a gown, towel or even asked to undress behind a curtain. Everything is out in the open in Germany!  

Don’t worry though – none of this is personal. It’s just a different way of doing things. 

If you do come across a grumpy doctor, the best way to handle it is to either accept it or find a different doctor.

Be prepared to wait

Most Hausarzt (GP) practices in Germany operate on a drop-in basis during set times, known as Sprechstunden (consultation hours).

This means you can simply pop in during a two or three-hour window. During these times, it’s also first-come, first-served.

The advantage of this system is that it’s possible to see a doctor, for example, on a Wednesday morning without an appointment, as long as you have time to wait.

But if you are in a rush, or have a strict schedule, then the drop-in approach can be time-consuming. Depending on when you arrive, it could mean a short wait of several minutes or up to an hour.

The best advice is to arrive just as the doors open to secure a place near the top of the queue.

You can also book an appointment or Termin. But even if you book, you’ll probably still face a wait of at least 15 minutes. 

You are usually referred to a specialist

In Germany, if you are covered by public health insurance, you usually have to visit a GP to be referred to a specialist doctor.

There are exceptions in some cases, such as for gynaecologists and ophthalmologists where you can make an appointment without a referral.

If you have private insurance you can book appointments with specialists more easily.

READ ALSO: How to get a faster appointment with a specialist in Germany

Visit (or call) a GP for a sick note

If you’re sick from work then you have to get a sick note – Arbeitsunfähigkeitsbescheinigung or Krankschreibung – after three days of illness to give to your employer. Some bosses may require this sick note earlier, so check your contract or ask HR. 

Generally, you have to visit your doctor to get this document. But during the pandemic, people have been able to get a sick note over the phone from their GP for mild respiratory illnesses, including Covid-19. 

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

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HEALTH

‘Breaking point’: Why German pediatric wards are filling to capacity

Overcrowded patient rooms, days-long stays in the ER, transfer of sick babies to hospitals more than 100 kilometers away: the current wave of respiratory syncytial virus (RSV) infections in Germany is pushing children's hospitals to their limits. 

'Breaking point': Why German pediatric wards are filling to capacity

The German Interdisciplinary Association for Intensive Care and Emergency Medicine (Divi) said on Thursday that there was a “catastrophic situation” in children’s intensive care units. 

According to the physicians, a wave of respiratory syncytial virus (RSV) infections can be expected every year starting in the autumn. 

Yet this year “there are fewer and fewer pediatric hospital beds available overall” as well as a lack of nursing staff, Divi Secretary General Florian Hoffmann explained Wednesday on ZDF’s Morgenmagazin.

Because all beds were full in one case, a child was transferred from the Hannover Medical School (MHH) to Magdeburg on Friday night, a distance of around 150 kilometers. 

“My colleagues had called 21 clinics,” said Gesine Hansen, Medical Director of the MHH Clinic for Pediatric Pneumology, Allergology and Neonatology, told DPA. 

The child, who was about one-year old, had an RSV infection, which can be life-threatening, especially for babies and children with pre-existing conditions.

READ ALSO: 7 things to know about visiting a doctor in Germany

‘Catching up’

Some health experts have said that hospitals are now filled to capacity because children had minimal social contact during the pandemic and are now catching up on infections.

According to the Robert Koch Institute (RKI), an estimated 5.6 severe cases of RSV respiratory illness occur worldwide per 1,000 children in the twelve months after birth. 

Within the first year of life, 50 to 70 percent would typically have experienced at least one infection with RSV, and by the end of the second year of life, nearly all children should have experienced at least one infection. 

In the wake of protective measures against Covid-19, however, many such infections had temporarily failed to materialise. 

‘Breaking point’

According to Divi, hardly any clinics had a free crib or free pediatric intensive care bed in the past few days.

“Children have to lie in the emergency room for days,” Hoffmann said.

Yet the peak of the current wave of respiratory infections in children has by no means been reached, Hoffmann said. “The situation in practices and clinics will get even worse in the coming weeks.”

“We are at the breaking point,” said Matthias Keller, head of the Children’s Hospital Dritter Orden Passau already. The rooms are often double-occupied, he said. In some cases, there were too few monitors and not enough equipment for respiratory support.

READ ALSO: Flu season makes a comeback in Germany

A child with RSV being treated at the Olgahospital in Stuttgart. Photo: picture alliance/dpa | Marijan Murat

“Some patient rooms are like bed storage areas, where you really have to crawl over the beds to get to the sick child, because the parent bed is lined up with the patient bed,” said Keller, who is also chairman of the South German Society for Pediatric and Adolescent Medicine.

This has far-reaching consequences for other young children who need treatment. When an infant who has just been resuscitated is admitted to a children’s hospital that is actually fully occupied, a three-year-old has to wait there for the third day in a row for his urgently needed heart operation.

‘Responsibility of politicians’

A wave of infections usually lasts six to eight weeks. In Bavaria, Lower Saxony and Berlin, as well as North Rhine-Westphalia, clinics are reporting a “maximally tense situation,” reported Divi on Thursday.

The Düsseldorf University Hospital, for example, is experiencing a wave of influenza among its young patients in addition to the RSV wave, which is “causing massive problems primarily for children up to elementary school age,” said University Hospital spokesman Tobias Pott.

In the Rhineland, “all beds are completely full” at times, said Jörg Dötsch, president of the German Society for Pediatric and Adolescent Medicine. An ER waiting time of six to seven hours is not uncommon, he says. 

“It is very unpleasant when children and their families have to virtually camp out in the emergency room,” says Dötsch, who is also director of the Clinic for Pediatric and Adolescent Medicine at the University Hospital in Cologne. 

READ ALSO: Healthcare in Germany: How to get a faster appointment with a specialist doctor

What are the solutions?

At their meeting on Thursday in Hamburg, intensive care physicians and intensive care nurses will discuss approaches to solving the crisis. 

One solution may be to temporarily bring nursing staff from adult facilities into the children’s hospitals, says Hoffmann, who is also a senior physician at Dr. von Hauner’s Children’s Hospital at the University of Munich. 

But above all, he says, many more pediatric nursing staff need to be trained. “We need to strengthen nursing,” he explained. “Only then do we have a chance.”

Others said more money needed to be invested in pediatric medicine and vaccines, even if it is less profitable.

“The fact that children’s lives are currently in danger is the responsibility of politicians,” said Jakob Maske, spokesman for the Professional Association of Pediatricians and Adolescents.

“Nowadays medicine has to be profitable – not cure diseases, but make money.”

READ ALSO: How private investors are buying up healthcare practices in Germany

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