Two things make German specialist care confusing for newcomers: a word with two unrelated meanings, and a queue that is really two queues.
One word, two meanings
die Überweisung: in medicine, a referral. A slip from one doctor asking another to see you.
It is also the ordinary German word for a bank transfer, which is how most learners meet it first, through the banking vocabulary. The two senses are unrelated and the context always tells them apart, but the first time a receptionist asks whether you have an Überweisung, it can throw you completely.
der Überweisungsschein: the referral slip itself, the piece of paper.
The queue that is two queues
This is what lies behind the long waits.
Germany has statutory health insurance, die gesetzliche Krankenversicherung or GKV, which covers the large majority of people, and private insurance, die private Krankenversicherung or PKV. Doctors are paid differently for the two, and many practices keep separate appointment books.
der Kassenpatient: a statutory patient. der Privatpatient: a private one.
That is why the same practice can offer a private patient a slot next week and a statutory patient one in April. It is neither corruption nor a secret; it is how the payment system is built. Knowing this stops you assuming the receptionist is simply fobbing you off.
The service hardly anyone uses
die Terminservicestelle: the appointment service, reachable on 116117 (eins-eins-sechs, eins-eins-sieben), the same number as the out-of-hours service in the emergency article, and through the 116117 website.
If your referral carries an urgency code, the service has to offer you a specialist appointment within four weeks. You do not get to choose the doctor, and you may have to travel further than usual, but you will get an appointment. If no practice has a free slot, you are offered an outpatient appointment at a hospital instead.
der Dringlichkeitscode: the urgency code, a twelve-character code your referring doctor prints on the referral. This is the part to ask about. Without it, the service will not book you within the four weeks. Ask your GP: Können Sie mir einen Dringlichkeitscode geben? Eye doctors and gynaecologists are the exception: the service books those without any referral.
Most newcomers, and plenty of Germans, have never heard of this service. Of everything in this article, it is the thing most likely to shorten your wait.
The other levers, most useful first
Ask to be put on the cancellation list. Können Sie mich auf die Warteliste für kurzfristige Termine setzen? Appointments are cancelled all the time, and few people ask.
Call at the right time. Many practices release new appointments at a fixed hour on a fixed day. Receptionists will happily answer Wann vergeben Sie neue Termine?, and hardly anyone asks.
Look further afield. A specialist two towns away can have a slot weeks or months earlier than one in your own district.
Say what is actually happening. German practices respond to specifics. Die Beschwerden werden schlimmer gets you further than simply asking for something sooner.
The rest of the vocabulary
der Hausarzt: the GP, the family doctor. die Hausärztin for a woman. There is no formal registration as in some countries, but becoming a regular patient at a practice before you need one is well worth it.
der Facharzt: the specialist. Common ones: der Orthopäde for bones and joints, der Dermatologe or der Hautarzt for skin, der Kardiologe for the heart, der Neurologe, der Gastroenterologe, die Frauenärztin for gynaecology, der HNO-Arzt for ear, nose and throat.
die Praxis: the practice or surgery. die Sprechstunde: consulting hours. die offene Sprechstunde: a walk-in session with no appointment needed. Practices in several specialties, including eye, ENT, skin, gynaecology and orthopaedics, have to offer at least five hours of it a week, which makes it more useful than most people realise.
der Termin: the appointment. die Terminvereinbarung: making one.
die Chipkarte / die Versichertenkarte: your insurance card, needed at every visit.
die Praxisgebühr: a quarterly fee that was abolished at the start of 2013. You may still hear it mentioned, but it no longer exists.
das Rezept: the prescription. The pharmacy vocabulary is in its own article.
die Krankschreibung: the sick note, covered in its own article.
The order to do things in
Find a Hausarzt while you are well. This is the step people skip and then regret.
When you need a specialist, ask the Hausarzt for an Überweisung and, if it is urgent, for a Dringlichkeitscode.
Call the practice you want. If the offer is months away, ask to go on the Warteliste and ask when new appointments are released.
If it is urgent and the wait is long, call 116117 and use the Terminservicestelle.
One change to watch: the government is preparing a reform that would make the Hausarzt the first stop before most specialists. Much of it is still undecided, and until a law is passed, the rules above still apply.
Learning the vocabulary
Save the meaning along with the word. Terminservicestelle is hard to remember as a bare noun and easy to remember as the service that has to find me an appointment when my referral carries an urgency code.
Put the referral slip into Translate whole. It is all abbreviations and boxes, and the diagnosis code on it, an ICD-10 code, tells you what your doctor suspects.
Then let spaced repetition hold it. These thirty words will come up for as long as you live in Germany, so they are worth learning properly rather than looking up every time.
The short version
Find a Hausarzt before you need one. Ask for an Überweisung and a Dringlichkeitscode. Ask for the cancellation list, because almost nobody does.
And when a receptionist asks whether you have an Überweisung, they do not mean a bank transfer.
Holding a referral slip you cannot decode? Put it into Vokabulo. Free to start on iPhone, iPad and in the browser. 🩺
