Seeing a Doctor in Germany: Communication and Self-Advocacy

You waited three weeks for a slot. You have a cough that will not quit, a list of questions, and a picture in your head of a long, careful conversation. The doctor walks in, checks your chest, writes rest plus herbal tea, and is already standing. Four minutes. You sit there wondering if they even heard you.

A lot of people coming from the US, UK, South Asia, East Asia, or Latin America read that as “this doctor does not care.” It usually is not that. German GPs are trained to be brief, factual, and slow with drugs. The visit is a risk check, not a therapy session. Once you know that, you can still get a thorough answer. You just have to arrive with the facts stacked, not the story.

For finding a practice and booking, see How to Find a Family Doctor or Specialist in Germany.

What a German consultation actually looks like

German bedside manner is Sachlichkeit: get to the task, skip the cushion. Doctors see themselves as diagnostic technicians, not hospitality staff. Small talk, long rapport-building, and extended emotional reassurance are rarely part of the slot. You report symptoms, they examine what matters, they decide, you leave.

Primary-care visits in Germany often last about 7 to 10 minutes. That is not only culture. Statutory health insurance (gesetzliche Krankenversicherung, GKV) mostly pays GPs through a quarterly flat rate per patient, not by the minute. Practices stay afloat by seeing many patients. Longer talks tend to go to people with complex chronic conditions.

Two things stretch or shrink the clock:

• Rural practices often have fewer doctors and tighter windows than city clinics.
• Private insurance (private Krankenversicherung, PKV) bills under the doctors’ fee schedule (Gebührenordnung für Ärzte, GOÄ), so visits can run longer.

A short visit does not mean the doctor skipped the dangerous stuff. It usually means they checked for red flags, ruled out an acute emergency, and expect you to manage a routine recovery at home.

Why you got thyme tea instead of antibiotics

Walk into a German pharmacy (Apotheke) with a cold or mild stomach bug and you may leave with a standardised plant extract instead of a synthetic pill. That is not the doctor fobbing you off. German training leans toward salutogenesis: support what the body can do itself before suppressing every symptom with a strong drug.

Antibiotic restraint is taught as a professional duty. 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 antibiotic use also fell sharply in the 2010s under national resistance guidelines. If your cough is viral, a “no antibiotics” answer is the evidence-based one, not a brush-off.

Herbal medicine here is called phytotherapy (Phytotherapie). It is regulated as medicine, not as wellness folklore. From 1978 the Federal Institute for Drugs and Medical Devices (BfArM) ran Commission E, which published hundreds of monographs on safety, dose, and use. Those evaluations later fed into EU herbal rules at the European Medicines Agency.

When a GP wants you on a non-prescription product, they often write a green prescription (Grünes Rezept). Statutory funds stopped routinely paying for over-the-counter medicines, so this slip is an official recommendation you take to the pharmacy and pay for yourself.

1. The doctor assesses you and decides a non-prescription product is enough.
2. They issue a green prescription.
3. You take it to a pharmacy and pay out of pocket.

Industry figures put green prescriptions at over 42 million a year. About 70 percent of GPs use them regularly, and more than 90 percent of patients fill them. Typical examples: ivy or thyme extracts for cough, eucalyptus for sinus pressure, chamomile for irritated mucosa. St. John’s Wort (Johanniskraut) 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 bacterial infection, acute crisis, or a chronic condition that has clearly worsened.

Sick notes, eAU, and telling your employer

If you are employed, illness pay is strong and the paperwork is strict. Under the Continued Remuneration Act (Entgeltfortzahlungsgesetz, EFZG) your employer usually pays 100 percent of regular wages for up to six weeks per illness episode.

The old paper yellow slip (gelber Schein) was replaced on 1 January 2023 by the electronic sick note (elektronische Arbeitsunfähigkeitsbescheinigung, eAU). From 2025 the same digital path also covers time in rehab and preventive-care facilities. The practice sends the data to your health insurance fund (Krankenkasse) 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.

Digital transmission does not replace your duty to tell work. You must notify your employer immediately (unverzüglich) 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.

Statute says a medical certificate is required 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 (telefonische Krankschreibung) exist for known patients with mild symptoms (for example an uncomplicated respiratory infection and no red flags). A first note by phone can last up to five calendar days. 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. No start date is in force yet. Until the law actually changes, the rules above still apply. Check current practice policy before you rely on a phone note.

Specialist referrals and the 116117 code

Outpatient care splits into GP care (hausärztliche Versorgung) and specialist care (fachärztliche Versorgung). You can see a GP without prior approval. Many specialists still want a referral (Überweisung) if you want a timely slot.

You can usually book these without a GP referral:

• GP / family medicine (Allgemeinmedizin)
• Gynaecology (Frauenheilkunde)
• Ophthalmology (Augenheilkunde)
• Paediatrics (Kinderheilkunde)
• An initial psychotherapeutic consultation (Psychotherapeutische Sprechstunde)

For dermatology, cardiology, orthopaedics, neurology, and most other specialties, a GP referral is the normal path. If the GP judges the case urgent, they print a 12-digit urgency code (Vermittlungscode) on the referral. Enter it at 116117-termine.de or call 116117. Statutory patients with a valid code are supposed to get a specialist appointment within four weeks, usually within about 30 minutes’ travel for general specialists or 60 minutes for narrower sub-specialties.

Outside practice hours, call 116117 for the on-call medical service (Ärztlicher Bereitschaftsdienst) or go to a local on-call practice (Bereitschaftspraxis). That is for urgent but not life-threatening problems on evenings, weekends, and holidays. Hospital emergency departments (Notaufnahme) and 112 are for severe, time-critical crises. Private booking sites such as Doctolib are widely used as a parallel search; they are convenient, not an official queue. More on booking and Doctolib caveats: How to Find a Family Doctor or Specialist in Germany. Full detail on 112, 110, and 116 117: Emergency Services in Germany.

What to say in a few minutes

German doctors rarely fish for context with open questions. If you wait to be drawn out, the visit ends before your real worry is on the table. Match the format they expect.

Bring a short written list. Skip the life story. Put down:

• when it started
• exactly where it hurts or shows
• temperatures, if relevant
• what you already tried (pharmacy products, rest, work days missed)

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 differential diagnoses are you considering for these symptoms? (Welche Differenzialdiagnosen kommen für diese Symptome in Betracht?)
• What clinical reasons speak against medication at this point? (Welche klinischen Gründe sprechen gegen eine medikamentöse Behandlung zum jetzigen Zeitpunkt?)
• Which warning signs mean I should come back immediately? (Welche konkreten Warnsymptome erfordern eine umgehende erneute Vorstellung in der Praxis?)

You have a legal right under § 630g of the Civil Code 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.

Common mistakes newcomers make

Pushing for antibiotics on a viral cold. Asking for a broad-spectrum drug after a two-day cough creates friction. Rest (Schonung) and a green prescription are often the intended plan, not a refusal of care.

Thinking eAU tells your boss. The practice sends data to the insurer. You still call or email work on the first morning.

Using the hospital ER for a weekend fever. That queue is long for a reason. Non-emergencies after hours go through 116117 or an on-call practice.

Cold-calling specialists with no urgency code. Full lists and months-long waits are normal. Ask your GP for a Vermittlungscode when the case is urgent, then use 116117-termine.de.

Useful links

• Federal health portal: electronic sick note (eAU)
• 116117 Patientenservice
• 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