Greedy doctors and expensive treatments

Though I am a regular reader of TT, this is my first post here, and I really regret that it’s a rant.

I have been in Germany for over 5 years now. In these years I had visited the doctors only a couple of times. But this is the first time I have faced a really greedy one.

It all started last month when my wife caught cold, and also had cough. We avoided taking medicines for some days (as she was pregnant, and our gyno. had advised not to take any medicines). But as her condition got worse, our gyno. recommended an Internist.

This lady (the Internist) was all excited to have us as her patient (I understand, it is because we have private insurance). She said she would have to make a thorough check-up. She then made a quick check with stethoscope, and "found" that my wife had a "hole" in the heart. We told her it couldn’t be true, as we had a general check up few months back and the doctor didn't find any problems with her. But she was determined, and suggested more checks, to be "sure". She then used all the instruments she had (ECG, Spirometry, Sonograph for throat) and took 4 test tubes of blood, and urine. (Unfortunately she could not use X-ray since my wife was pregnant). After all the tests she concluded that everything was normal according to the test results, but she was still not convinced, so she recommended a Cardiologist. And she prescribed a medicine for cough, which we would have got even without prescription. We never went to the cardiologist.

Finally now, she has sent us a bill for 300 EUR, and has written that my wife had "acute Bronchitis".

Though our insurance company would refund us the money for this bill, I really don't know why I should encourage such doctors? I would like to know the views of others and what you would have done?

Anyway I have decided that I would never see her again, and would never recommend her to any of my friends.

I noticed the little note on her door really late ...

"Ich gehe zu einem Arzt.
Weil er leben muß.

Und dann gehe ich zu einer Apotheke.
Weil er auch leben muß.

Und dann werfe ich die Medizin weg.
Weil ich will auch leben."

some medications are okay during pregancy, if it was a cold, why did you not take your wife to a HNO (ear, nose, throat specialist) and to an Internist.
I would got back to the Gyn and tell them, and show them the bill, for Broncitis.

That's the problem with private insurance schemes. The information gap means doctors can just take the mick, tell the patient anything, recommend the most expensive course of tests and treatment, and know that they'll get their money. I had to pay about 500 euros for about five x 5-minute appointments with some alleged shoulder specialist about my busted collar bone. Every time was the same: "Looks okay, but come back in 2 weeks as you can't be sure." Never did anything but I still had to pay all that dosh. Bloody joke and if you've got the balls for it, I'd tell that doctor to go and sing for her money and that you'll defend yourself with a lawyer if need be. Lotta hassle though.

It's the system here - and dentists are even worse for it - they just love to bullshit you with false crap you don't need. Finally I found a doc who is also a friend of mine - I go to see him whenever I'm stuck - just last week I had an MRI scan on my spine - whole thing was done inside an hour - class - and no extra bullshit.

I should add that he himself has little to no respect for most (medical) doctors or dentists here and has a doctorate in physics - something requiring understanding rather than learning OBH. The specialists he has referred me to have all been dynamite guys & girls - mostly profs who couldnt be fucked raping me for more money.

Some of the German docs are evil, evil, evil. Fortunately for me, the dentist who tried to screw my insurance company skipped out of town (and the country) due to craptastic practices. Haha, fucker.

parnell, was your MRI ok?

Ah yes, the medical gravy train. Surpasses DB in all respects.

It can work bad the other way too. If you have doctors that are associated with insurance companies so they give better rates can not give you enough treatment to save on costs..

Well, in my opinion is better to have private insurance than public..
I had to make an appointment for an orthopedic and call first to Dr. Öttl (recommended in another thread) The assistant gave me the "Wir machen keine konservative Therapie" bullshit. I told her that she did not know what kind of "therapie" I was going to need and then she said that anyway they were totally booked until the end of March (I called around the 2nd Feb.). So made an appointment with another orthopedics (Had an appointment in like 9 days...but an appointment).
The funny thing is that, a week later, my bf fell while skiing and damage his knee!I rang Dr. öttl again to make an appointment for him and when I said he had private insurance...voila! appointment next day at three!! I could not belive it! Anyway, the good thing is that he only streched the ligaments but nothing serious...but that makes me wonder about the unfairness of this health system...and I cannot wait to change to private!!

@parnell: maybe you could recommend us your doctor!

Edit: great to have TTM to complain!!

I guess its good that you can get quite major stuff like MRI and CT scans done relatively quickly, but as I and others have mentioned, the situation is really open to abuse. In effect, the doctor is rewarded for not tracking down any problem too quickly.

I spoke to the (rather sexy) MRI scan man at Pasing about the difference between private and state insurance. We (the privately insured) had a separate waiting area, little queue and I was scanned the day after my first appointment with the OS.
He said that basically private patients keep the whole lot running, the state system just couldn't run without the extra cash that private patients bring in.
As for the conservative therapy, state insurers see surgery as a last resort for knees as it is cheaper for them short-term not to operate. Private insurers would rather pay for the surgery and have you back at work quicker (and paying the premiums), which is why private premiums increase dramatically in most cases the older/iller you get, particularly for long-term complaints which aren't going to be fixed quickly or at all (asthma, diabetes, depression...).
If healthcare is run like a business, then you cannot blame doctors for making business decisions.

I was mates with a doctor and I asked him one day why i was seeing SO MANY people walking round Munich with eye patches compared to the UK.
"That is the latest scam" was his answer. Grit in eye = 2 week eye patch.

This kind of scamming happens in the public system too. and is a natural result of the absaloute purchaser-provider split in the German health system.

A single Kasse as was the proposal of the SPD-Greens would start to wed out this kind of corruption but the CDU/CSU and of course the FDP reject that kind of universal health care. In the latter case becasue so many of their clientele milk the system.

RA, a lot of people, including English speakers in Munich CAN'T AFFORD to join a private Kasse.

Katrina, I KIND of agree that the privately insured "keep the system running". BUT in the sense that Germany has a massive over provision of health care sevices and without this kind of deal that goes on with private patients a lot of these CORRUPT doctors etc would have to close their business.

If I was a financial controller at a large organisation in Munich, I'd be going through the books of the internal krankenkasse and coming down like a ton of bricks on some reguarly used nearby providers of health care services, if not sacking staff who were involved in corrupt deals.

@Katrina

I would like to see their actual cash flow sheets. I really doubt that this person's statements are accurate. How much does the state pay for a MRI compared to the private insurance? How many patients from both private and state are seen each day. I would surmise that the truth is that the provate insurance people look better, are more educated, smell better and are wealthier. This results in the health care practitioner prefering them as patients. I also believe that there may be less restrictions that a private insurance will allow, resulting in more...unethical...tests being done. But, I believe it is the other way around. The state funded actually allows these companies to have the private patients. Otherwise the whole system would collapse.

Brokenm, put it this way. Public patients pay for the nice house in Starnberg but the upgrade from BMW to Porsche is paid for by the private patients.

There needs to be a balance, and yes I can see that abuses do occur. It is however a financial choice for a doctor to give up his/her Kassenzulassung and only take private patients.
In the case of MRI for knees, I believe that where a state-insured person would only have 2 views taken, a privately insured person would have 4. Unnecessary? I don't know, I'm not a health care professional.

Katrina,
Let's say with two views, they can be 90% certain, but with four 95%. You will receive better care by having that additional 5%. But the value of that increase is not worth it when you have to make more universal decisions. So yes, private care does equate to better care. But there are not as many private care patients. My point was that when they have a room of thirty people lined up to get the public care and a smaller room for four people with private care. I would believe the costs would be more dependent on the public care. Now this changes when the reputation increases and they choose to only accomodate the private insured with legal restrictions forcing them to have a view public insured as well. I would be interested to find out as my emphasis in my MBA was in health care management, but this was in US based.

Hate to generalise and make hasty conclusions, but from my experience of out-of-town doctors/hospitals/operations, it seems that the service 'in the provinces' is much better.

I'm privately insured, but even got away with a free visit to the doctor for a post-appendectomy check-up!

It's a much smaller world outside the big smoke... and often it's a doctor's reputation that counts, not what car he drives.

Guess this is not much comfort to those who must register in town...

Good analogy!

Okay, change the senario- I am private, I pay my appointments, then maybe once a year, send my stuff in to be reimbursed. I saw a Doc today, first time this year, as I maybe have the Flu or Mono! I thought its a cold, and just dealt with it. But, 90% of my coworkers are Kasse, and boy do they go to the doc, for every little ailment, pain or muscle cramp- and that is bullshit! And then they get written sick for a week due to diahhrea!
Maybe because I am not your average Joe off the street, and I ask questions, I have never felt I recieved a 'padded' bill. And the docs I see, I am very happy with- today I was at Dr. Wagner on Mühlbauerstr 9.

@ Carm, the €10 per quarter charge that public kase patients pay has the one advantage of making people think twice before going to the doctor.

It is a SERIOUS financial drain on the health system that people run to the doctor for every little thing.
Personally I'd institute a UK style system where you register with your one local docotr and he or she refers you to a specialist IF you need it and speicalists can only take referrals on the public system.

This would end the problem of people running to an eye specialist if they get grit in their eye rather than going to their standard doctor, let alone just blinking under a running tap.

But of course the VERY powerful doctors lobby (think FDP) want to have this "free market" so they can make a LOT of money.
Germany is one of the highest spenders on health care but the outputs aren't that special.

It ISN'T just going on bureaucracy of the kasse (though many kasse does mean more admin of course. The Kasse hvae made great strides over the last few years in reducing admin costs. It's the doctors who are placing leaches on the system rather than patients sore bits.

Yeah, people need to start taking responsiblity for their health, and docs need to help people understand they need to treat the whole body and not just the 'grit' without going over the top.

The private system has even better incentives for patients to think twice, as in most private schemes you get a refund of several hundred Euros at the end of the year if you choose not to claim anything.

dude said he couldnt see what was wrong with my spine - I have a very minor displacement of my L5 but not enough to cause discomfort he said - so its possible I just strained a muscle squatting or something... but its an old injury and I was just glad that nothing mechanical was damaged.

@ RA
Dude useta work in pharma and took the job with our firm to concentrate on his kids and stuff - so he's not available for outside things - he's more a friend than a doc really - but sooooooo professional - u go in - he says shit and thats it , if he doesnt kno stuff he'll send u to a TOP mate of his who knows what's who... its like every profession really - most folks are journeymen , very few stars out there.

Maybe, but I'd still rather be here than on the UK's Negligible Health Service.
My mum's been seeing her GP and so-called "specialists" in the UK for at least five years now, yet they still haven't come up with anything approaching a definite diagnosis and, quite frankly, don't seem to give a monkey's! Every time they say "it could be this", then at the next appointment, which is generally anywhere from three to six months later, they decide it's probably something else. So they do more tests and then wait until the next appointment to announce the results!

On the other hand, I recently had to call a Notarzt and dialled the number printed in the local paper. Four people turned up (Johanniter) and carried out a basic checkup (blood pressure, pulse, blood sugar[?]). It transpired that they'd come with an ambulance and a separate Notarzt car, but nobody needed transporting anywhere.

The bill? €525! It seems that this is their Pauschale, meaning this is the basic charge per callout, regardless of medical necessity, and any "medical" stuff costs extra. If I'd known that in advance, I'd have at least tried to get them to take us to Venice for the weekend or something. The other time we had a Notarzt round, he came on his own and the bill was less than €100 (IIRC). So you can imagine the shock when this bill fluttered through the letterbox!

But at least they turned up! In the UK, the waiting list for an ambulance is a fortnight, I think.

I know my comment is not related to the original question but thought the title was appt ! I went to the Doc's today and as they usually do, he asked about work etc ... the usual blah blah .. I said I was busy and slightly stressed at work ... so he prescribed some tablets, which were available in the Doctor practice, called ORTHO EXPERT at 23€. From speaking to a few people since it turns out they are just fancy Vitamin tablets ... was I ripped off ? And am I within my rights to ask for (cheaper) alternatives ??

You entered into a contract of sale of your own free will...

If I was really cynical I'd ask if it doesn't posibly say unverkaufliches Muster" on the packet...

Caveat Emptor.

You're brilliant.

I've fought quite a few doctor's bills. The privately insured are expected to act as the crutch of the system. One doctor charged me 360 EUR for removal of a small mole - stupidly, I'd gotten his Kostenvoranschlag ("so ungefähr 100 EUR") verbally and not in writing.

No idea why the public system doesn't introduce a substantial "Verhaltensbonus" like the private insurers have.

There is a "Verhaltensbonus" being built into the public system.

The €10 rules for example.
They are fine tuning that.

Right, but that's nothing comparable to the private system's rigging.

Example:

500/month
if you don't submit any costs the first year, you get 3 months back. = 1500 EUR
submit nothing the second year, you get 4 months back = 2000
and so on up to 6 months refund.

If you're an employee and your co. pays half, this means you end up not paying for insurance. (I'd argue that what the boss pays in social costs, she can't put in my wallet, so of course I still pay, but most ppl aren't motivated that way.)

The state system has something like a 140 EUR refund max.

And the 10 EUR thing seems like a bizarre regressive tax to me. If you're a single parent trying to house, clothe and feed 3 kids on 1300/month, 10 EUR is a lot of grocery money if one gets a bad cold.

Especially when folks run to a specialist for every little thing. Pretty sure my Hausarzt could handle a cold without referring me. My gynie has a telephone Sprechstunde and also answers emails.

I've had a few problems here and am state insured. I never see a bill, well almost. The health care here is miles better that what I got in the U.S. with "excellent" health insurance there. Good thing I like it here since I am uninsurable now in the U.S. due to pre-existing conditions.

I even give my doc and extra tenner each quarter for one of his senior patients that is either too tight or too poor to come in and pay. They usually wind up in the hospital when they don't get regular care.

All in all, I am pleased with the health care I have gotten. Well except for my rip off dentist.

FF

hi. i don't really want to start a new thread, so i'll post within this one and cross my fingers i get some answers and maintain a little aminosity. i have an eating disorder: i was clinically diagnosed and hospitalized for the first time when i was about 19, but i've suffered since mid-teens (an am now early twenties). i though a trip oversees might be the answer. it was, for two weeks. and then old habits just jumped right back into place. i have a german boyfriend who is wonderful and supportive but hasn't really helped me in finding help here in germany. is it possible? are there treatment facilities here? can i, as a non-german, access help? i have health insurance because i am currently employed by a german company. i'd really love to find some help.

lol, wrong word (don't know where it came from), 'anonymity' is the right one. sorry

You need someone to talk with, and I am sure in Hamburg there are enough English speaking therapists. Ask around, or wait until someone here responds.

Hmmm - mine started that way but a few years ago they changed saying "you only get the refund on doctors & dentists but not the hospital part of insurance as you cannot influence that". That is of course a major part of the whole insurance cost - and they only go up to 3 or maybe 4 month's worth...

Will probably have to flee the country on retirement / redundancy...