Smartphone Doctor Appointments Become the Norm: What is the "Mandatory Reporting of Available Slots" Demanded by German Insurers?

Can "Making It Visible" Solve the Issue of "Unable to Book Appointments"?

"Can't get through on the phone," "The earliest appointment is months away," "In the end, I have no choice but to go to the emergency room"—complaints about booking doctor appointments are common in everyday conversations in Germany as well. Amidst this, Stephanie Stoff-Ahnis, Vice President of the GKV-Spitzenverband, the central association of statutory health insurance (GKV), has reignited the debate by calling for a **national "unified booking portal."** heise online

The aim of the proposal is simple: to change the current situation where patients wander through multiple sites or keep making phone calls to find "available slots," and to ensure "visibility of available appointment slots." Additionally, by combining a "digital initial assessment" to determine if a visit is truly necessary and where to go first, the proposal aims to optimize the use of medical resources. pharmazeutische-zeitung.de

Contents of the Proposal: Key Points are "Mandatory Reporting of Available Slots" and "Digital Initial Assessment"

Two points are repeatedly emphasized in reports.

1) Report a certain percentage of available appointment slots to an "independent platform"

Stoff-Ahnis is advocating for a system where free slots (freie Arzttermine) must be reported to an independent platform at a certain percentage in the future. The idea is that patients can book these available slots through insurer apps and other means. pharmazeutische-zeitung.de

2) Enter symptoms → Receive recommended actions with "Digital Initial Assessment" + Electronic Referrals

Another aspect is a digital initial assessment that suggests where to seek care (family doctor, emergency department, emergency hospital, rest, etc.) based on entered symptoms or complaints. If necessary, it would be linked with electronic referrals (digital referral letters) to prioritize based on medical urgency. Politically, this sends a strong message, as it hints at an operation where "private or public insurance" is not questioned during booking. pharmazeutische-zeitung.de

How is it different from the existing "116117"? The issue is "who plays the role of traffic controller."

Many people recall the **patient service "116117"** here. 116117 is a system provided by the German Medical Association (KV/KBV) that handles online and phone consultations and booking (Terminservice) under certain conditions. KBV - Startseite

According to KBV's explanation, the online booking (Terminservice) of 116117 is a free service for statutory insurance members, supporting booking searches, acquisitions, and cancellations, although operations vary by state. Additionally, it utilizes a structured medical initial assessment called SmED (equivalent to medical device class IIb) through phone, web, and app channels. KBV - Startseite

In other words, the framework of "booking × initial assessment" already partially exists within 116117. So why is GKV seeking a new unified portal? taz places the core of the debate on **"who designs the patient's entry (access)" and correcting the booking disparity between private and public insurance.** In an environment where the experience that "choosing private insurance results in quicker slots" is widely shared on private booking platforms, GKV wants to ensure fairness by creating a system that does not ask about insurance type. taz.de

Background: Online Booking Has Increased, But the Issue of "Invisible Slots" Remains

It's not that digitalization hasn't progressed. According to a survey by the digital industry association Bitkom, it is reported that the number of people who have booked a doctor online has increased to **64%**, with usage growing significantly over two years. It is also pointed out that specialized platforms like Doctolib are often used as booking routes. pharmazeutische-zeitung.de

However, even if online booking becomes widespread, it doesn't necessarily mean that patients feel they can "get an appointment."
The reason is simple: there are not enough "available slots", or the slots are scattered across different systems, making them hard to find. GKV's idea of "aggregating a certain percentage of available slots to an independent platform" could be a prescription for this issue. pharmazeutische-zeitung.de

Expected Effects: ① Preventing Patient Confusion ② Reducing Emergency Load ③ Narrowing the "Invisible Gap" by Insurance Type

If the proposal is realized, three major effects are expected.

The first is to prevent patients from becoming "digitally lost" while searching for the earliest slot. The second is to reduce the load on emergency departments by decreasing cases that "should not go to the emergency room" through initial assessment.
APOTHEKE ADHOC
The third is to alleviate the sense of unfairness of "insurance that gets you seen faster" through urgency-based allocation and operation that "does not ask whether it's private or public insurance." taz.de

Criticism and Issues: Will Digital Initial Assessment Become "Dr. Google"? Will the Digitally Disadvantaged Be Left Behind?

Of course, there is strong opposition. Symbolically, Eugen Brysch of the patient protection organization "Deutsche Stiftung Patientenschutz" has harshly criticized the insurers' concept as "overconfidence" and "adventurous" for patients. The reasons are that safe judgments cannot be made based solely on entered symptoms, and that it might exclude people without digital access. heise online

Additionally, the medical side (KBV) has long expressed caution against centralized booking control. In a 2024 KBV statement, it was clearly stated that booking platforms should support patients' free choice of doctors, and **"the free choice of doctors should not be sacrificed for the illusion of central planning and monitoring,"** strongly restraining GKV's concept. KBV - Startseite

There are many issues in the actual system design.

• How to differentiate or integrate with the existing 116117 (Terminservice/SmED) KBV - Startseite

• If medical institutions are required to "report available slots," to what extent and under what conditions should they be provided? pharmazeutische-zeitung.de

• Who will bear the responsibility for initial assessment (medical safety and liability in case of misjudgment)? heise online

• When apps become the norm, how to ensure alternative means such as phone and face-to-face (digital divide) heise online
  
  

Reactions on Social Media: "Seems Convenient" vs. "Isn't 116117 Already There?" vs. "There Are No Slots Anyway"

On social media, this news directly connects to "consumer dissatisfaction," making reactions likely to be divided.

"That sounds convenient. Visualization of bookings is necessary."

From those who have started using online booking, there are voices like **"I currently use Doctolib, but many clinics don't use it. It would be helpful if it could be viewed uniformly."** X (formerly Twitter)

"Symptom input for triage? Isn't that 'Dr. Google'?"

On the other hand, there is strong resistance to the digitalization of initial assessment. Skepticism and sarcasm, such as **"Is it safe to rely on a machine's judgment based on entered symptoms?"** spread easily. Reports where patient protection organizations talk about the dangers by comparing it to "Dr. Google" align well with this, reinforcing anxiety on social media. heise online

"There's already 116117" → "But you still can't get an appointment"

In news shares on Facebook, while there are many comments like **"That's already there, it's 116117," there are also simultaneous "second-stage retorts" like "But you can't get an appointment even with 116117."** Facebook

On Reddit, experiences of "insurance booking services ultimately failing" become a spark

On the overseas forum Reddit, experiences like **"Even using booking support via insurers, I ultimately couldn't get an appointment"** are easily shared (not limited to the unified portal itself). For example, there are posts like "I tried the insurance company's service but couldn't get an appointment by the promised