Is there a free choice of doctors also in other EU countries?

According to the decision by the European Court on May 13th 2003 (C-385/99) on the medical treatment in another member state of the European Union, patients are entitled to get an ambulant treatment in another EU member state. They can get reimbursed the costs but only up the amount they would get for the same treatment in their home country.

From May 1st 2004 this applies also for the new EU member states.

Contact your health insurance company before the start of a treatment.

Please note that dentures are subject to such an approval in Germany. The medical and cost plan must be handed in to your health insurance company and be approved by it before the start of the treatment.

Your rights as a patient

Some information on this page may belong only for patient's who are living in Germany. Please contact your health insurance in your country to get more informations about your rights in your country.

As a principle, every patient has the right to freely choose which registered doctor he wants to go to and how long he or she wants to be treated by this doctor. A lack of trust is already an important reason to change the doctor within the same quarter of the year or during the treatment. In such cases the consultation of the health insurance company is important so the question of cost reimbursement can be solved. With the exception of emergencies or doctors on duty also the doctor can decide freely whether he wants to carry out the treatment.

The right of detailed information about the planned treatment methods (their procedure, duration, risks, and side-effects, alternatives)

Every patient has the right to be fully informed about the different treatment possibilities and in case of doubt to question the treatment. The doctor is obliged to inform about the planned treatment. At any stage a second opinion may be consulted. If there are two options that promise to have the same results, the doctor should use the one that goes along with the least risk. In case of comparable medical methods the registered doctor has to choose the less expensive one.

The doctor is obliged to inform the patient about all risks of the drugs prescribed (e.g. the risk of allergies, long-term harms, interactions, adverse affects on driving capabilities). He is also obliged to inform you about how many of the prescribed drugs you are supposed to take and when you should take them.

Obligation to inform

From a judicial point of view every treatment without information and consent is a forbidden bodily harm. The obligation to inform includes the type, the meaning, the procedure, the effects, possible risks, and healing chances of the respective treatment. During the personal consultation the patient must be given the chance to ask further questions. It is not sufficient to give the patient a form with a short informing text. If the doctor still only offers such a form text, it is important to take care that the patient gets a copy of it with date and time and that the handing out is documented by a receipt.

Information is important so the patient knows what he has to expect during the treatment so he can judge for himself the benefits and the risks of the doctor's operation; thus the patient has a basis for his decision with respect to the necessity of the treatment and of the respective measures. Information is the prerequisite for a valid consent to a treatment. The bodily harm only loses its unlawful status after the patient has consented to an examination or treatment. This consent should always be given in written form, particularly in cases of extensive treatments like operations. The written form enables the doctor to document that he fulfilled his obligation to inform. Therefore the patient should always have a copy of the consent handed out to him. The consent may become null and void if the doctor did not inform the patient about a typical treatment risk.

Obligation to document

The doctor is obliged to document all aspects that are of any importance for the treatment and to keep the documentation. This documentation serves as an account for the doctor about the treatment method as well as for further treating doctors to inform themselves about the way the treatment went. It is also an important source of information for the patient. The documents the doctor is obliged to keep include notes about the course of the illness and the treatment, letters from other doctors involved in the treatment, x-ray imagery, medical results (ECGs, test results) as well as notes about the information of the patient and his consent. In case of an insufficient documentation by the doctor the burden of proof can be shifted to his disadvantage.

The patient is entitled to have access to his medical record at any time as far as they contain objective results and facts, This also includes information about drugs and treatment methods, test results, x-ray imagery, but also the index card the doctor has drawn up or a print-out from the computer of the practice if the record is done electronically. Being entitled to take a look at certain records means for the patient that he at least can get copies of these documents handed out to him though he normally has to pay for these. Excluded from the right to access are: the subjective judgement, personal or emotional remarks and impressions of the doctor about the patient as well as remarks by other persons. The right to access exists regardless of whether the treatment is carried out by a doctor, a dentist, in a hospital or a clinic.

It is often difficult to enforce ones right to access against the doctor or the health insurance company. Therefore the patient should point out to the doctor that he has such rights by law.

Specimen letter for the request of medical records/medical and cost plan/x-ray images

Medical records should always be requested in written form with reply card or, if the records are handed out personally this should be documented by a receipt.

SPECIMEN LETTER (for german clinics):

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Access to medical record

Dear ...

I was being treated by you during the time from ... to ... . I would like to ask you to send me the following medical records as a copy: doctor's letters, doctor's reports, protocols, medical and cost plan, x-ray images. The costs for the copies will be paid by me. Please hand me out the x-ray images in the original.

My right to access is based on law and on court decisions: According to § 810 BGB I am legally entitled to have access to medical records because they are "a document being in the posession of a third party" that has been drawn up in my interest.

I am entitled to have x-ray images handed out to me (decision of the LG Aachen from October 16th 1985, AZ 7 S 90/85).

The German data protection acts clarify whether a person is entitled to have access to the data recorded about him. I ask you to send me within three weeks after the date of this letter the documents together with a declaration by a third person entitled to do so that states the completeness and correctness of the data. Should the documents not be sent to me, I am entitled to let my lawyer file a suit at the responsible court with respect to the right to access to medical records.

The doctor normally loses these legal proceedings and then also has to pay the costs for these proceedings as well as for the lawyers.

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