Good old-fashioned health care

Germany and its health care system. What a circus show… Don’t get me wrong, the quality of health care is exceptional, and the people in it have been nothing but friendly and caring. But what a disorganized chaos this system is. My God, it is so old-fashioned here.

I already noticed about one and a half year ago, when I had my mental-physical breakdown episode, that there was something odd about the system. I couldn’t eat, I couldn’t sleep, I could barely stand up. I had to see a doctor. Getting one was easy enough, and the assistants and doctor made me feel quite comfortable (not easy with a patient experiencing panic attack after panic attack). However, when I arrived, around 8am, I had to wait my turn. There were no appointments. So I sat there for three and a half hours, going through regular bouts of panic. They double checked my everything, took blood, to make sure that I was physically okay. My results would be in the next day, so I had to be there again at 8am. It – again – took another three hours or so before the doctor discussed the results with me. (I was 100% healthy – it was just my brain going through one of its episodes.) There was no way on earth that they could have discussed these results with me on the phone, or sent them to me via e-mail. They take their data protection quite seriously. Too seriously sometimes, if you ask me. Partly for this reason, Germany is still in the stone age in many regards. Nothing is done digitally (although the pandemic has facilitated some change on this end). I digress. Waiting times. You always have to wait for hours, at the general practicionar, at the kid’s doctor (whatever these are called), at the women’s doctor (*not me, my wife, but she, too had to wait). Notably, my dentist is very punctual. When I make an appointment, the waiting room is empty, I can walk straight in, and he gives me excellent service without waiting times.

Another typical aspect within the German health care system, and all of the health care professionals mentioned above, is that they are often impossible to reach. It should be said that when you reach them, however, they are amazingly helpful. It is understandable that health professionals are hard to reach, people need care, and there are quite a few of us. However, what I never understood, is why they don’t have an automated phone queue. I have rarely heard one here. Usually you get the busy tone. At the kid’s doctor, they do have a queue with some elevator music, which basically cuts the connection after a minute or so. What this means is that you constantly are trying over and over again, until you are successful. This week, we spent one and a half day regularly calling the kid’s doctor to plan a newborn check-up. Isn’t that ridiculous? Maybe I’m spoilt, but I think this is a system that with rather minor investment could be optimized by a lot. It has been in place very successfully in many other countries for decades. It makes life much easier. Anyway, this also brings me to my next point.

Physical availability. There are just not enough professionals to be available. So it happens quite often that you are sent off with the message ‘maybe try somewhere else’. I mean… What? Where? This morning we reached the kid’s doctor to make an appointment for the first checkup for my newborn daughter, and they indicated that there would be no way on earth that this was going to happen with them. They were full for the next weeks. They advised us to try the hospital, and so we did. Here we were summoned for within the next 45 minutes after the call. There was no other possibility in the next two weeks. Also interesting – but we made it. The hospital told us to arrange for a couple more tests, a hearing test, a third check up for the end of August, and an ultrasound. They couldn’t help us with any of it. So we were back at the kid’s doctor. This time we decided to simply drop by, which saved us a lot of time. They could give us a referral to yet another hospital for the ultrasound, (where we were told to be there tomorrow morning) and also mentioned that they would have no time to do the third check-up (due from the end of August) any time soon. They were full until the end of September, where they then gave us a slot at the last possible day this check-up is advised. When we asked whether there would be other possibilities to get this check-up earlier elsewhere, they indicated that it was probably the same everywhere. Don’t get me wrong, this is not really a complaint, the health care we receive, when we receive it, is top notch. I just don’t understand how these health care professionals operate, and why availability is so low (it seems a structural – not temporal problem). In my home country, I never experienced any of this. It seemed so streamlined… Here in Germany, everyone is running and running and running, there is hardly any time to answer phones or handle the patients that need care on short notice. Maybe the budget is too tight to staff some receptionists that do just that? To me it seems like a complete lack of division of labour. How can it ever be efficient? (I guess I see similar things going on in my university, where every person is held responsible for everything.)

Finally, one of the things that strikes me most, is that there seems zero communication between institutions. For me, this is really odd. In the Netherlands you can manage your personal details with a digital login, which can also be used as a digital signiture. This includes all the details of where you live, who is your health care provider, where you are insured, where you study/work, and probably several other things that I missed here. Through this network, information can be shared between authorized institutions. It is horribly convenient, and saves a lot of time. When I asked about this in Germany, people looked at me with blank stares. *Blink, blink.* Did I really trust these institutions to hold my data? Data safety! Data safety! Data protection needs to be maintained at all costs. What they forget is that all these institutions will have your data anyway. The difference is that in the Netherlands you don’t have to run from office to office to handle all these things, but rather you do it via the click of a button, or via a secure login on your phone. In a world full of overwhelm, I am happy to get rid of all these horrible administrative back-and-forths. But it seems to me that in Germany, this will not happen any time soon.

Sorry, I just had to get this rant off my chest. I know that I live in a country with the extreme luxury of having excellent physical and mental health care coverage and insurance. We get all we need, when we need it. It’s just not very efficient, and this pains my brain. I’ll get over it, eventually.

Published by Robin Heinen

Father of one but almost two | Husband | Entomologist and Ecologist | Postdoctoral Researcher @ TUM | Traveler | Coffee Addict

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