Doctors also want to use video chat to make diagnoses

This is what the family doctor's office of the future could look like: Patients no longer have to sit in the waiting room; instead, the doctor makes a diagnosis via video chat and recommends a medication or prescribes bed rest. Only in more serious or complicated cases does the doctor decide that the patient should come to the practice or go to a specialist.

This is not allowed in Germany. Not yet, says Franz Bartmann, board member of the German Medical Association. According to him, a group of experts from the chamber of physicians and lawyers has come out in favor of allowing diagnoses via the screen or by telephone in the future, at least in exceptional cases, reports the dpa. At the next German Medical Congress in May 2018 in Erfurt, doctors' representatives are expected to officially decide on the matter. "It is highly likely that this will also be adopted," says Bartmann.

Currently, doctors are only allowed to offer follow-up treatments via video consultation if they have already treated the patient in their practice. They can see, for example, whether a wound is healing well. "The changes in remote treatment are important to strengthen telemedicine in Germany," says Bartmann. For example, competent diagnoses from a distance could help ensure good health care in rural areas despite a shortage of doctors, says Gisbert Voigt from the board of the Lower Saxony Medical Association.

In pilot projects, for example in North Rhine-Westphalia and in Berlin, nurses from old people's homes had brought the family doctor to the residents by video link. "In this way, doctors and patients are less likely to have long journeys and waiting times. This is also practical in the city," says Voigt. In pilot tests, family doctors have also already consulted specialists via video link.

Health experts at the consumer center support the doctors' push. "In countries like Switzerland and the United Kingdom, telemedicine is already part of standard care," says speaker Susanne Mauersberg. "It is equally as good as direct doctor-patient contact for certain fields of medicine." Mauersberg believes "video consultation hours will be a normal part of care in the future."For just under one in two Germans, talking to a doctor on screen would be no problem, the Bertelsmann Foundation found in 2015. In other surveys, however, patients' approval ratings were lower.

Several thousand Germans already communicate online with doctors abroad, for example with the online practice DrEd in the UK. They first fill out questionnaires about their condition and lifestyle habits, then communicate with the doctor via chat, phone or video conference. The doctor sends her prescription to a pharmacy, which delivers the medication to her home. "Men in particular appreciate our discreet, uncomplicated service, for example in cases of erectile dysfunction or hair loss," says DrEd managing director David Meinertz. Patients have to pay for online consultations themselves. Only some private health insurers cover them.

Health insurers pay too little

The consumer protection agency generally finds such offers good, says Susanne Mauersberg. She would also support it if the statutory health insurance companies paid for such consultations and if such online practices were also to exist in Germany.

In Germany, only a few hundred of the nearly 379,000 licensed physicians offer video consultation hours, according to certified providers of corresponding software. In the view of the medical associations, the main reason for this lies with the health insurance companies, which would pay too little for video consultations. For software that lets doctors talk securely to patients, they have to pay 30 to 70 euros a month. At the same time, they are allowed to bill a maximum of 800 euros per year and only for comparatively inexpensive follow-up treatments.

The vice president of the German Medical Association, Martina Wenker, also says: "Many older colleagues still doubt the sense of telemedicine."Younger doctors, on the other hand, are more open to technology and to the fact that it is changing their job description. "For many rural doctors like me, however, the Internet is still too poor to offer video consultations," says pediatrician Voigt from Melle, near Osnabruck. The Osnabruck family doctor Micha Neubert is already a step further, he offers an online consultation since the beginning of the year. "I want to offer my patients a service, but at the moment I'm still making losses with it."

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