Seeing a Doctor in Germany: Communication and Self-Advocacy

Many newcomers in Germany leave a family-doctor visit feeling brushed off. The appointment took weeks to get, then lasted only a few minutes instead of a long talk, and the advice was rest plus herbal tea instead of a strong prescription. People from the US, UK, South Asia, East Asia, or Latin America often take that as a sign the doctor does not care.

It is not that simple. Some doctors are warm and take their time, and some are brusque or rude. One visit is not “German doctors” as a whole. Even so, many practices still run on short slots because training and billing reward a quick check for serious problems more than a long conversation. In that kind of appointment, you get further with clear symptoms and questions than with a long personal story.

How to find a practice and book is covered in How to Find a Family Doctor or Specialist in Germany.

What to expect in the appointment

Family-doctor visits in Germany often last about 7 to 10 minutes. Public insurance mostly pays a quarterly flat rate per patient, not by the minute, so practices stay afloat by seeing many people. Longer talks tend to go to patients with complex chronic conditions. Rural practices are often tighter. Private insurance can buy a longer slot because it bills under the doctors’ fee schedule.

Task-first is common: symptoms, a quick exam, a decision, then you leave. Small talk is often skipped. That is how the system is set up, not a judgment of you, and a short visit usually means they checked for warning signs, ruled out an emergency, and expect you to recover at home. Switch practices if the manner itself is the problem.

Why you got thyme tea instead of antibiotics

For a viral cold or a mild stomach bug, a German family doctor will often skip antibiotics and send you to the pharmacy with rest plus a standardised plant extract. Holding back a strong drug on a viral infection reduces side effects and slows resistance. German training also leans toward supporting what the body can do itself first before using a synthetic medicine. OECD Health at a Glance 2025 puts Germany at about 12 defined daily doses of antibiotics per 1,000 people per day, against an OECD average of 16. Outpatient use also fell in the 2010s under national resistance guidelines.

Herbal medicine here is regulated as medicine, not as a wellness extra. From 1978, Commission E under the Federal Health Office published safety and dose monographs. The Federal Institute for Drugs and Medical Devices (BfArM) took that work over later, and the monographs fed into EU herbal rules at the European Medicines Agency.

When a non-prescription product is enough, the doctor often writes a green prescription. Public funds no longer routinely pay for over-the-counter medicines, so you take the slip to the pharmacy and pay yourself. Industry figures put green prescriptions at over 42 million a year. About 70 percent of family doctors use them regularly, and more than 90 percent of patients fill them. Typical products are ivy or thyme for cough, eucalyptus for sinus pressure, and chamomile for irritated mucosa. St. John’s Wort sometimes appears for mild low mood. It interacts with many medicines, including the pill, so say what you already take. Synthetic drugs still appear for a bacterial infection, an acute crisis, or a chronic condition that has clearly worsened.

How prescriptions and pharmacies work

For public insurance, covered prescription drugs are issued as an electronic prescription since 1 January 2024. You redeem it with your electronic health card, the official prescription app, or a printed barcode. A pink or red paper slip is only a fallback when the digital system fails. You usually pay a €5 to €10 co-pay at the pharmacy. Children are often exempt. Annual co-pay caps are covered in Health Insurance in Germany.

A blue slip is a private prescription: you pay in full and claim reimbursement from private insurance if your plan allows. A yellow slip is for narcotics and other controlled substances and uses a special security form. Green stays the over-the-counter recommendation you pay for yourself, as in the section above.

Ibuprofen, paracetamol, cough drops and similar routine medicines are sold only at a registered pharmacy, not in supermarkets or drugstores such as dm or Rossmann.

After hours, pharmacies rotate duty shifts on nights, Sundays, and holidays, with a statutory surcharge of about €2.50. If the doctor marks the prescription as urgently needed overnight, public insurance covers that fee. Look up the duty pharmacy for your postcode at apotheken.de or follow the red “A” night sign. 116 117 will not refill a prescription.

Sick notes, eAU, and telling your employer

If you are employed, illness pay is strong and the paperwork is strict. Your employer usually pays 100 percent of regular wages for up to six weeks per illness episode.

The old paper yellow slip was replaced on 1 January 2023 by the electronic sick note (eAU). From 2025 the same digital path also covers time in rehab and preventive-care facilities. The practice sends the data to your health fund by midnight on the examination day. Your employer then pulls the certificate from the fund through payroll software. You do not hand a paper copy to HR.

That digital step does not replace telling work, so you still notify your employer immediately on the first morning you are off, before you even get to the doctor, with the fact that you are ill and a rough expected duration.

The law requires a medical certificate if you are off more than three calendar days, so the doctor must issue it by day four. Many contracts demand an eAU from day one. Read yours before you assume you have three free days.

Telephone sick notes exist for known patients with mild symptoms, for example an uncomplicated respiratory infection with no warning signs. A first note by phone can last up to five calendar days, but you have no right to insist on it; the practice decides. Follow-up notes usually need an in-person visit unless the first note was already issued after an exam. The federal government has said it wants to end telephone sick notes and require a certificate from day one, but no start date is in force yet, so check the practice’s current rule before you rely on a phone note.

When you need a specialist referral

Public insurance (GKV). You can see a family doctor without a referral, but many specialists still want one if you want a timely slot. You can usually book gynaecology, eye care, paediatrics, and an initial psychotherapy consultation without going through the family doctor first. For dermatology, cardiology, orthopaedics, neurology, and most other specialties, a referral is still the normal path. If the case is urgent, ask the family doctor for a 12-digit urgency code (Vermittlungscode) on the referral. That code unlocks the statutory appointment service at 116 117, which is supposed to get you a specialist slot within four weeks. How to book with the code is covered in How to Find a Family Doctor or Specialist in Germany.

Private insurance (PKV). The usual talk is that you do not need a referral and can book specialists directly. Be careful: many cheaper tariffs use a primary-care gatekeeper model, so reimbursement can drop if you see a specialist without a prior referral. Check your policy before you skip the family doctor.

What to bring and what to say

Because the slot is short, doctors often do not ask open questions that pull the full story out of you, so if you wait to be drawn out the visit can end before your real worry is on the table.

Bring a short written list: when it started, exactly where it hurts or shows, temperatures if relevant, and what you already tried. Functional facts land better than mood. “Pain has stopped me sleeping for three nights and I cannot work a full day” tells them more than “I feel awful.”

Three precise questions usually get a real answer:

• What diagnoses are you considering for these symptoms?
• What speaks against medication at this point?
• Which warning signs mean I should come back immediately?

You have a legal right to inspect and copy your records, lab results, and imaging. Ask for copies after tests. That file travels with you if you change doctors or want a second opinion.

Useful links

• Federal health portal: electronic sick note (eAU)
• 116117 Patientenservice
• apotheken.de (duty pharmacy lookup)
• OECD Health at a Glance 2025: Germany
• Green prescription background (AESGP / Pharma Deutschland)
• Society for Phytotherapy
• EMA: herbal medicinal products
• Employers’ association (BDA): eAU for employers

Related pitfalls

Common mistakes to avoid

Short warnings linked to this guide. Each item highlights a costly or legal slip newcomers often make.

1. Booking a private doctor on public insurance

   Medium

   Many doctors treat both public-insurance and private patients. Ask before you book whether the doctor takes public insurance and whether you need a referral. A practice that bills only privately sends the invoice to you, and public insurance will not pick up that bill after a normal visit.

2. Asking for antibiotics on a two-day viral cough

   Minor

   German family doctors often treat a short viral cold with rest and a green prescription for pharmacy products that insurance may not pay. Pushing for antibiotics on day two clashes with that practice and does not speed recovery.

3. Assuming the electronic sick note emails your boss

   Medium

   The practice sends the electronic sick note (*eAU*) to the health insurer. The employer pulls a confirmation from the insurer. You still call or email work on the first morning you are out. Skipping that call can count as an unexcused absence even when the note exists.

4. Using the hospital ER for a weekend fever

   Minor

   Outside surgery hours, a fever usually starts with the on-call family-doctor service or a call to 116117. The hospital emergency department is for emergencies. A non-urgent visit means a long wait and can leave you with a bill if the case is not covered as emergency care.

5. Calling specialists without an urgency booking code

   Medium

   Specialist waits of several months are normal if you call offices with no referral. For an urgent case the family doctor can issue a 12-digit urgency code (*Vermittlungscode*). That code lets the 116117 appointment service place you faster, often within four weeks.