Should patients in Germany face fees for no-show doctors' appointments?

The National Association of Statutory Health Insurance Physicians (KBV) says that in view of the strained financial situation facing many medical practices, patients who fail to turn up for appointments should face tougher penalties. 

KBV Chairman Andreas Gassen said the fee should be paid to doctors offices by the health insurers, and then they can bill the patient. 

"It's not just annoying when patients book appointments at surgeries and simply miss them," the head of the association told German daily newspaper Bild.

He said that doctors' offices can't find another appointment to fill the space. Therefore, "a cancellation fee to be paid by the health insurance companies" is appropriate "if their policyholders make appointments and then fail to attend without an excuse".

READ ALSO: 7 things to know about visiting a doctor in Germany

Fees 'up to €100'

According to the report, some medical practices in Germany are moving to this system and charging patients €40 for unexcused absences. In individual cases involving repeated absences, it can even result in charges up to €100.

Gassen said he understood why medical practices were becoming so frustrated. By not turning up for appointments, the slot is then unavailable to others who may need it.

"Against this background, any demand for quicker access (to doctors), and more available appointments is simply ridiculous," he said, in reference to the German government's plans to improve access to GPs.

READ ALSO: Why it's becoming harder to get a doctor's appointment in Germany

However, there are legal questions in Germany over whether a fee can be imposed. Various court rulings on this topic have different outcomes. 

According to the German Consumer Rights Centre (Verbraucherzentrale), fees from medical practices for patients who miss or cancel a doctor's appointments are only allowed in exceptional cases. But offices do issue them. 

Penalty fees of this kind are established in other countries. In neighbouring Austria, for instance, doctors are legally allowed to demand a fee if patients don't show up. The cost varies but it can't be higher than €200. 

The best thing to do to avoid any kind of penalty is to call the doctor's office and cancel the appointment in plenty of time (at least 24 hours) if you can't make it. 

READ ALSO: Can doctors in Germany charge a fee for cancelled or no-show appointments?

'Open aggression'

As well as the way appointments are handled, the National Association of Statutory Health Insurance Physicians recently voiced concerns about other problems in German medical practices.

"Open aggression and extremely demanding behaviour have increased significantly," Gassen said. "The situation is escalating more and more frequently, not only in emergency rooms, but also among those in private practice."

Gassen called for action here, too. "Clear and swift penalties are needed in such cases," he said. "Otherwise the message won't get through to some people."

Justice Minister Marco Buschmann, of the Free Democrats (FDP) has voiced support to tightening the law to better protect emergency services from hostility and violence.