Accessible medical offices in short supply in Germany

Top quality and – above all – accessible medical care is fundamentally important. After all, this is one aspect of participation explicitly stipulated by the UN Convention on the Rights of Persons with Disabilities. But what does the actual situation in German medical offices look like? And what does accessibility mean exactly in this context?

There are approximately 200,000 physician and therapy offices throughout Germany. Yet more than 80 percent of them are not accessible or accessible with restrictions for people with disabilities. Based on these numbers, at the end of April, the Union parties of Germany ("Unionsfraktion") along with representatives of the medical field, health insurance companies and affected patients discussed ways to improve medical care.

The Commissioner of the CDU/CSU parliamentary group for people with disabilities, Uwe Schummer, summed up the expert discussion as follows: "There was a call to create a minimum number of networked accessible medical practices in every region. All experts ascertain that comprehensive services necessitate a KfW support program (KfW= Reconstruction Credit Institute) – comparable to the already existing program pertaining to age-appropriate renovations of residences," Schummer states in a press release. "In addition, physicians need a federal subsidy program for the accessible new construction or renovation of their medical practices." He adds that this is the only way to guarantee prompt and noticeable improvements for patients. Schummer asked to document developments in a separate progress report of the German Federal Government.

In addition, the experts stated that "the costs for the use of sign language interpreters in hospitals are included in the treatment flat rate per case paid by health insurance companies. In March, the Social Court of Hamburg had reaffirmed that all deaf patients have the right to a sign language interpreter." Schummer emphasized that hospitals need to comply with this provision.

A point that is seemingly often forgotten: accessibility does not only refer to mere structural measures. Its scope is considerably more comprehensive, with every type of disability involving different needs and requirements that accessible medical offices need to address.

Patients, who use wheelchairs not only need accessibility in the form of a ramp, lift or an entrance area at grade floor level. It is also important to have easy to open doors or automatic door openers. What’s more, exam rooms should offer enough room to navigate a wheelchair. Exam tables should be height-adjustable and examination equipment portable, if applicable. Oftentimes, there is also a lack of accessible changing rooms, at the gynecologist’s office, for example, and a lack of accessible toilets. Many people with physical disabilities would also like to see a designated space in the waiting room and parking spots in close proximity.

Deaf people should be given access to on-site communication options – either via a sign language interpreter or written alternatives. Health professionals should also keep in mind that patients with hearing impairments should not be called but picked up from the waiting room for example. Although the medical staff should speak clearly and make eye contact, this should not be done in a loud or exaggerated manner.

Meanwhile, guiding systems are important for visually impaired and blind persons. Especially in larger buildings, instructions in Braille in elevators and stairways and voice output to indicate floor levels in elevators are helpful.

It takes a huge load off the minds of people with autism if they are able to schedule appointments via email or online appointment scheduling software instead of having to use the phone. Ideally, an informative website with images of the office gives them a heads up on what to expect once they get to the office.

Many people also find it helpful if they don’t have to wait in the noisy waiting room and are able to leave in between or move to a quieter waiting area. Optical and acoustical stimulation provided by music, radio, TV or flickering lights, for example, can also make waiting in the waiting area difficult. Incidentally, clear and effective communication before the actual treatment or exam as well as accepting that there might be potential issues when it comes to touch doesn’t just help people with autism but also people who suffer from post-traumatic stress disorder (PTSD). In this case, physicians should also take extra time and care and show respect if people set boundaries and would like to be exclusively treated by women for example.

At any rate, respect and openness towards needs, no reservations whatsoever and a certain willingness to find solutions should actually be the given foundation for all medical treatments.

And by the way, all of these different needs and requirements basically also apply to treatment facilities for speech therapy, occupational therapy, psychotherapy or pharmacies. However, wheelchair user and blogger Ju / Wheelymum knows that "accessibility is not a matter of course and more a matter of luck." Yet accessibility in all of these facilities would also benefit elderly persons and parents with strollers – and not just people with disabilities.