Patients rights

Patients have clearly defined rights. In general, the following applies:

• Doctors may only act with the agreement of the patient.
• Doctors always have to inform their patients completely about their disease, its history, and treatment options.
• The burden of proof in treatment and education failures lies in certain circumstances not entirely on the patient.

Ideally, a doctor and a patient should have a relationship of mutual trust. The doctor should respect the rights of the patient and, if necessary, make the patient aware of these rights. Somehow, however, things do not always run so smoothly. If conflicts arise between a doctor and a patient, it is helpful to know and demand your rights.

And if a patient believes that a doctor has made a mistake, it is possible to take steps, such as getting help from a lawyer or going to the relevant medical association (Ärztekammer).

If there are any conflicts between patient and doctor, it's helpful to know and use the law.

Patients have the right to inspect their own medical records. That includes most of the notes and other records that the doctor has prepared about the patient and the progression of their illness. This includes all documents for the current and future treatments, in particular medical history, diagnosis, tests (results), findings, therapies and their impact, interventions, and consents, explanations and medical reports. With electronic records, the doctor must hand out a copy of the medical records to the patient, he may, however charge for the copy.

X-rays, and other documents that cannot easily be copied, must be handed over to the patient by the doctor. This might be important if you want to seek the opinion of another doctor. The doctor may demand that the patient return the documents later.

Limitations

The doctor is not required to reveal personal judgments or comments that may have been noted in the medical records to the patient. For example, this might include notes about a difference of opinion with the patient. The doctor is permitted to reserve such comments or make them unreadable in the documents before handing over the documents to the patient. This does not apply to any judgment made by the doctor about the diagnosis or treatment of the patient – even if the doctor later changed their mind.

In rare cases, the doctor may refuse to grant the patient access to some or all of their records; for example, when the information could interfere with therapy in the case of illnesses or with other rights of third parties. The doctor must, however, provide a detailed explanation of this.

Problems

Sometimes doctors refuse to show or hand over records to a patient. The best course of action in this case is to once again make very clear to the doctor that you wish to exercise your legal right to view your records. If that has no effect, the responsible medical  association (Ärztekammer) or the state data protection office (Landesdatenschutzbeauftragte) can assist you further. You should only sue in court for the release of the records if this has not worked.

In principle, all patients have the right to freely choose their doctors. Members of statutory health insurance funds, however, can only choose between doctors approved by their health insurance. Theoretically, they can be treated by unapproved doctors; however, they must pay for this treatment themselves.

Patients, who serve a sentence, cannot freely choose their doctors and must be treated by the prison doctor.

Changing doctors

A person who does not feel good with their doctor has the right to change to another doctor. The previous doctor is required to give the patient all records, X-rays and similar documents.

All patients have the right to ask a second doctor, in addition to the treating doctor, for an opinion. This may be sensible if the patient is not sure whether the doctor's diagnosis is correct or whether the suggested treatment is the right one.

Many people also like to reassure themselves by getting a second opinion when they are faced with deciding for or against a difficult operation.

This right may be limited if the patient is taking part in a "family doctor program" ("Hausarztprogramm") or disease management program ("Chronikerprogramm") with their health insurance fund.

Members of statutory insurance funds

Many doctors understand that patients still want to consult a colleague to obtain another medical opinion and protect itself. This is part of the ambulatory healthcare payment.

Members of private insurance funds

Some private insurance policies do not pay for a second opinion. If in doubt, check your contract or ask your insurance company.

Limitations

This right may be limited if the patient is taking part in a "family doctor program" ("Hausarztprogramm") or disease management program ("Chronikerprogramm") with their health insurance fund. These programs give the patient various benefits. The health insurance fund may waive the practice fee partly or entirely, or may reduce the patient's dues.

In return, the patients in these programs forego certain rights. In some programs, the patients are bound to their family doctor for a longer period of time - for a year, for example. A visit to a specialist doctor then requires a referral. It can be difficult to obtain a second opinion.

Information about programs offered by various health insurance funds can be obtained from the insurance company.

If you have a difference of opinion with your doctor, it is best to discuss it with them first, to clear up any misunderstandings. It may also be a good idea to bring a relative or friend along to this discussion. If this is not successful, the mediation boards of the state medical associations offer further help. You should only consider taking legal action once other possibilities have been exhausted or are no longer practical.

In any case it may be helpful to seek advice and discuss the next course of action at an AIDS service organization.

Mediation boards

The mediation boards of the State Medical Associations (Ärztekammer) help in cases of conflict between doctors and patients. The doctors and lawyers who work there will check whether the doctor has made any mistakes. Both the doctor and the patient must agree to the process. The mediation board does not come to a legally binding decision; rather, it simply suggests a solution. The aim is to come to a mutual understanding or reach an agreement without going to court.

Even if no agreement is reached, such a process is often very useful for the patient. An expert assessment is usually produced, free of charge. This may be very valuable in a later court case. The mediation board's process uses written documents. The patient may require the assistance of a lawyer, the costs of which must be paid by the patient.