Once daunting, we now have nearly mastered the art of going to the doctor (and – bonus points here– the dentist!).
OK – it’s not so much of an art as it is understanding the local way things are done. I wish I had known some of this in advance – here’s the details in hopes that others may be forewarned!
So let’s start at the beginning: making that first appointment (Termin).
While at home in the States, I wouldn’t hesitate to phone up the office and get this done, here this is more of a minefield to navigate. First off, there is the language problem. While everyone has been complimentary about my spoken German, the fact is that I rely a lot on visuals and context, and still only understand about 70 – 85% of what is being said, and considerably less in the rapid-fire dialect favored by busy medical office staff. Having a phone conversation with one of these folks is simply not going to work. I did leave a message at a practice once, only to be schooled later in the fact that it would likely never be returned, because for most medical practices, there is only a specific time the phones are answered (stated on their websites, much to my confusion).
So, one must go in person to make the appointment. Although time consuming, this has 2 great advantages over the phone route: I can actually accomplish making the appointment, and I get to preview how we’ll get there via public transportation.
Still, even these in-person transactions are challenging; they require a certain level of courage be mustered up to prepare for a vocabulary challenge (even though I have heard the word Versicherung – Insurance – many times I still can’t quite recognize it on the spot).
It is quite feeling of accomplishment to have actually made the appointment, and I always leave the office clutching that magic little appointment card with glee, feeling like there is no challenge I cannot meet and conquer.
Next: showing up. First of all it’s vital to be on time. This is a given in Germany. I always arrive at least 15 minutes before the appointment so I can fill out, or attempt to fill out, the paperwork (all in German, even at the practices we went to specifically because they cater to English speaking people).
The offices themselves are mostly in residential buildings, above or below the living quarters (like our apartment, where there is an osteopath on the ground floor). One must be buzzed in to enter (no need to talk here – at least so far!). You check in at the reception, and are then asked to fill out your paperwork in a waiting room (in bigger practices there is more than 1 Wartezimmer, each designated with a letter).
At our primary care (Hausartz) office, the waiting room is like a living room. You are meant to greet your fellow waiters with a discrete “Guten Morgen.” In all waiting rooms, there is usually coffee, and always water, along with a large assortment of magazines (in German of course). Then you wait until your name is called from the outer hallway, always with your formal title. The names are often called quietly, I suppose to protect privacy. Additionally, I’m not accustomed to being addressed as Frau Sussman and so you can perhaps see how this whole process could be a somewhat disorienting. At least I have a German last name and so it is always well pronounced. How’s that for a nice change??
The Germans always add a 2nd “n” to the end when they write my last name out – Sussmann; no doubt at one point it was spelled that way, and likely with an ü as well.
In the exam room, just like in the States, there may be a medical assistant who gets some basic info, and then the doctor arrives. The exam room is anchored by a large desk, which the doctor sits behind to take your history. And then the physical exam is started. The doctor may return to the desk to write out a prescription (Rezept) and to make your next appointment at the computer.
At Dashiell’s pediatrician (Kinderartz), the office space is very child focused and friendly. Both waiting rooms have fun toys and books, and the art on the walls is all designed to engage children. At the children’s dentist office there is a giant pirate ship to climb on the in the waiting room (see-there’s that bonus I earned by getting to the dentist! I’m leveling up here). We were also amazed to see a TV on the ceiling for the kids in the chair to watch during their exam!
At D’s cardiologist visit, I was surprised that the cardiologist himself did an ultrasound. He took his time and was incredibly thorough, and spoke to me about what he saw as he went, almost exclusively in German (but being an older gentleman he spoke quite slowly so I could follow along). He then sent us to another purpose-built room for a stress test on a treadmill. This little booth had a giant glass window with a beautiful view straight down the Königsallee. D was used to getting wired up by then and took it all in stride.
When you leave the doctor’s office, you don’t pay anything (and there is no “co-pay” transaction at check in either). The bills arrive in the mail later, and you pay them through bank transfer (remember – there are no checkbooks here). Since we have privat insurance, I’m sending in the claims manually. Even so, the prices are really reasonable. The cardiologist visit, something you’d expect to be pretty pricey, was €335.00, which I imagine is a fraction of what it would be at home. The pediatrician wellness exam, which lasted 1.5 hours and included an eye and hearing exam, was about €235. An unexpected high cost was the vaccination they recommended for HPV, which was a staggering €163.00 (and the bill came directly from the pharmacy).
Incidentally, the flu vaccine is not as aggressively prescribed here. It’s indicated for only vulnerable people. My Hausartz said she had never vaccinated her own children for the flu. I find this interesting. The pediatrician’s office had run out of flu vaccine by the time I asked for it, so D is unprotected at this point…it’s on my list to get this done through our Hausartz over winter break. Maybe I’ll even try to phone up for the Termin!