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It’s annoying when you’re standing in front of a closed door at the doctor’s. © Sebastian Kahnert/dpa/dpa-tmn
The doctor refuses to give a sick note – or does not accept any new patients at all. Anyone who experiences something like this may ask themselves: Are they even allowed to do that? Here comes the overview.
Berlin/Düsseldorf – “It was unbelievable what I experienced at the doctor”: Many people have stories like that to tell. At the same time, doctors always have reason to be stunned by patients. There are rights and obligations on both sides – and it’s good to know them. Experts explain what is possible and where the limits are.
Can a doctor refuse new patients?
There is a difference between those with private insurance and those with statutory health insurance. For those with private insurance, the doctor is free to admit someone new at any time – or not. The following applies to statutory health insurance patients: “As part of statutory health insurance (GKV), there is generally an obligation to treat patients,” says Prof. Martin Stellpflug, chairman of the Medical Law Working Group in the German Lawyers’ Association (DAV).
However, there is an exception: “If a doctor’s practice is absolutely full, that is, if the doctor is caring for enough patients in accordance with the statutory health insurance requirements,” explains the medical law specialist, “then the practice can also refuse new patients.”
If the patient has a medical emergency, this in turn overrides this exception. By the way, a new patient with private insurance also has to be treated.
Can a doctor terminate an existing treatment relationship?
Yes, that is possible, says Sabine Wolter, health expert at the North Rhine-Westphalia Consumer Center. She refers to reports from statutory health insurance doctors who increasingly complain about insults and attacks from patients in doctor’s offices.
“Wherever there is a serious loss of trust, the doctor does not have to provide further treatment,” says the consumer advocate. “For example, if treating a patient is unreasonable for him because he has repeatedly shown himself to be aggressive.”
Can a doctor go on a long vacation so that I have to stay in front of a closed door?
There are clear vacation rules for statutory health insurance physicians. They state that they may be absent for a maximum of three months in a twelve-month period. “There are four reasons to close the practice: illness, vacation, further training or military exercises,” says Martin Stellpflug.
If the doctor closes the practice for more than a week at a time, he must inform his association of statutory health insurance physicians. “But it doesn’t require approval,” says the lawyer. “I think that two to three weeks is normal, but four weeks of absence is still within reason.”
But there must be representation. And this must be communicated: either on a notice board, on the Internet or on the answering machine. Or you can bring a representative into your own practice.
In principle, all of this also applies to psychotherapists. Since the weekly sessions cannot simply be transferred to a substitute because of the trusting relationship, the therapy is usually paused. If longer vacations are planned, solutions must be found on a case-by-case basis. “And if a psychotherapist plans to take a two-month break, for example, he must inform potential new patients about this before treatment,” says medical lawyer Martin Stellpflug.
Can a doctor close the practice for a few days without notice?
If this happens, there are usually understandable reasons. After all, even a doctor can get sick. However, the practice team then has to ensure that appointments are canceled. “Dates must be adhered to by both sides,” says Martin Stellpflug. “The doctor has an obligation to inform here.” He can also provide information with a notice on the door or via the answering machine.
The topic of strike: This is generally forbidden for GKV doctors. A strike is therefore often not called that, “but it amounts to a practice closing,” says the lawyer. For example, if you close to go to a demo, you also have to cancel existing appointments.
Can a doctor refuse to give me a sick note?
Of course he can, says Sabine Wolter. “It is always the doctor’s professional opinion whether he writes someone off sick or not. He is not allowed to issue a sick note as a courtesy.” Doctors are not only allowed to refuse the sick note, but even have to do so if the requirements are not met, according to the German Medical Association.
Can a doctor privately bill someone with statutory health insurance without informing them beforehand?
Clear answer: no. “All services that fall outside the statutory catalog of services must be agreed upon in advance,” says Sabine Wolter. If a patient is simply handed a bill after treatment, something has gone wrong.
For those with statutory health insurance, the doctor bills the health insurance company directly. The so-called individual health services (IGeL) usually have to be paid for by yourself if you decide to use them.
In order for the doctor to be entitled to payment, advance notice is necessary, explains the consumer advocate. “I need to be informed and explained, receive a cost estimate and at the end an invoice.” If everything goes correctly, there will also be a paper stating that the statutory health insurance does not cover this service. You must then confirm by signature that you want the service at your own expense.
Cardiologist, ophthalmologist, gynecologist: Time and time again, people have the experience of not being able to find a specialist practice. © Sina Schuldt/dpa/dpa-tmn
“IGeL services are not necessarily medically necessary, so as a patient I always have time to think about it,” says Sabine Wolter. “I don’t have to spontaneously say whether I want it or not.” It may also be worth asking the health insurance company again. Some things are taken over as part of a bonus program.
Can I request to see my treatment records?
According to the law, the patient has a right to access, says Martin Stellpflug. “The doctor must immediately grant access to the patient file upon request.” Since a ruling by the European Court of Justice (ECJ), he has also had to do this free of charge.
Unable to work? The relevant decision should be made solely from a medical perspective. © Benjamin Nolte/dpa-tmn
