The result of the positive PCR test is available, the employer has already been informed, and the first symptoms are noticeable.

What is still missing is the sick note from the family doctor.

Since June 1, however, this can no longer be issued by telephone.

Patients must present themselves at the practice.

A decision that both patients and doctors criticize.

Marie Lisa Kehler

Deputy head of the regional section of the Frankfurter Allgemeine Zeitung.

  • Follow I follow

"We still need the option of reporting sick by phone because we have a number of positives that we don't want in the practices," says Christian Sommerbrodt, for example.

The general practitioner runs a group practice in Wiesbaden and is a member of the representative assembly of the Hessen Association of Statutory Health Insurance Physicians (KVH).

Many patients are confused.

For two years they had been told that if they tested positive they would have to isolate themselves strictly.

Now they are being summoned back to the practices, where they may meet patients for whom infection with the virus could have serious consequences.

"We're going backwards here.

The anger about it is dumped on us,” says Sommerbrodt.

His employees try to smuggle patients who are proven to be corona-positive past the other people waiting so that no contact can be made at all.

An additional organizational effort, as Sommerbrodt says.

He finds the return of the patients to the practices quite good - especially those who complained about simple symptoms such as a respiratory infection.

Because that also means a return to everyday life - and, after two years in which the focus was on protecting vulnerable groups and containing the disease, a withdrawal of the protection requirements appropriate to the infection process.

In addition, personal contact is difficult to replace.

But for cases in which there is a clearly positive result, “the measure could have been continued and limited to this small group of patients.

Video consultation hours only in 40 percent of the practices

The possibility of calling sick leave was introduced at the beginning of the corona pandemic.

The aim was to keep the risk of infection in the practices as low as possible.

Potentially infected people should also avoid unnecessary journeys, such as by bus and train, in order to reduce the risk of infection.

Depending on how the pandemic develops, the possibility of calling sick leave should be reactivated, according to the Joint Federal Committee of doctors, health insurance companies and hospitals.

Daniel Schilling, board member of the health insurance company IKK Südwest, also criticizes the decision.

The telephone sick note has "achieved a tangible benefit for both patient and doctor and was well received by both sides".

In acute cases, contact with the doctor has been made less complicated.

This also served to reduce bureaucracy and digital progress.

"I don't think it would be expedient to only link this added value to the pandemic," says Schilling.

According to a note from the Federal Joint Committee, patients infected with corona should use the video consultation service.

However, not all doctors in Hesse offer this option.

According to the Association of Statutory Health Insurance Physicians, 3435 practices currently meet the requirements for billing video consultations via KV Hessen.

That's around 40 percent - not even every second person.

The situation is different for registered psychotherapists and child and adolescent psychotherapists.

Of the more than 3,200 representatives of this professional group in Hesse, around 2,500 enable their patients to have sessions via video.

“Half of all appointments end with me inviting people to the practice”

Even if video consultation hours are by no means offered by all practices, the pandemic has nevertheless ensured that this option is used more frequently - both by doctors and patients.

In the fourth quarter of 2019, only six doctors in Hesse billed the Barmer health insurance company for video consultations, in the first quarter of 2020 there were already almost 1000. This number almost doubled by the end of the year.

"The number of billed video consultations is currently declining again, but it remains well above the level before the pandemic," said a spokesman for Barmer.

The Techniker Krankenkasse observed a similar development.

According to the health insurance company, more than 22,500 patients agreed to a video consultation in the first quarter of 2021.

In the fourth quarter of 2019 it was just 23.

The Wiesbaden general practitioner Sommerbrodt, who says he likes to try out digitization in everyday practice, also offers his patients video consultations.

So far, however, this has hardly provided any relief in everyday practice.

The time he has to spend as a doctor is the same, but the billing is much more complicated.

"Half of all appointments end with me inviting people to the practice," he says - which means that the desired time saving becomes more of a double burden.

Because by no means every clinical picture is suitable for remote diagnosis.

In the case of unclear abdominal pain, palpation cannot be replaced, says Sommerbrodt.

It is not easy for many patients to assess when it makes sense to appear in person at the family doctor and when a video conversation is sufficient.

According to Sommerbrodt, there is still a need for learning.

On all sides.