3G rule at the doctor: No treatment without a test?

As of: 10/6/2021 4:47 a.m.

Several medical practices only want to treat vaccinated, convalescent or tested people. The doctors justify this with the “house right”. But is that also allowed?

A laminated A4 sheet hangs on the entrance door to Johannes Bauer and Bruno Schwarz’s orthopedic practice in Friedberg, Swabia. “Access and medical treatment only according to 3G regulation” is to be read on it. “The main reason is to protect patients who cannot be vaccinated against corona,” explains orthopedist Bauer. Pregnant women, children and people with impaired immune systems should also be protected in this way. “And a secondary aspect is that of course we don’t want to endanger the practice.” If you cannot prove a negative PCR or rapid test, you can still do it in practice.

The practice in Friedberg is exemplary for a nationwide development. It is still unclear how many practices only treat according to 3G. Certainly a minority – but there are not isolated cases. Search engines can find dozens of practices that require 3G for patients within an hour. And everyone who could be reached has a health insurance certificate.

This is how patients think about 3G at the doctor’s

The three patients who sit in the Friedberg orthopedic surgeon’s office think the 3G rule is good. The two statutory health insurance doctors also emphasize that the reactions are almost entirely positive. Only one patient has complained so far.

We meet the woman in front of the building. “Under certain circumstances, such a 3G rule in doctor’s offices is fatal,” she criticizes. “For example, what if I want to go to the family doctor with stomach ache, but first have to make an appointment for a test at the pharmacy?” She asks. “And then it turns out that I have a ruptured appendix. I think a visit to the doctor is part of basic care and must not be subject to a 3G reservation.”

Orthopedist Schwarz cannot understand that: “Our children, who are the losers of the pandemic, have to be tested three times a week. I don’t understand what problem it should be to be tested once.”

“Whoever chooses the profession has a higher risk”

A few kilometers further, Alexander Niederle bends over his patient’s open mouth. The dentist is exposed to a comparatively high risk of infection, as patients naturally have to take off their mask for treatment. In addition, there is the spray mist that is created by the water cooling during drilling and generates a lot of aerosols through which coronaviruses are transported. Nevertheless, the statutory health insurance physician rejects a 3G rule in medical practices. “As far as the risk of infection is concerned, the job is one of the most dangerous. But whoever chooses the job has to live with it and must also be aware that there is simply a higher occupational risk. That was the statement made by the Association of Statutory Health Insurance Dentists last year.”

Orthopedist Bauer sees it differently. “It’s not about risk in general. It’s about avoidable risk.” But dentist Niederle has other concerns, especially legal ones. “If someone comes with pain at short notice, it is relatively clear that I am not allowed to send someone like that away, even if they are not my own patient. This also applies if they do not want to take a test.”

Clear statement from the National Association of Statutory Health Insurance Physicians

The Bavarian Association of Statutory Health Insurance Dentists (KZVB) has a similar view: “Doctors help everyone. There is no discrimination based on skin color, gender or vaccination status,” says KZVB President Christian Berger. If a statutory health insurance physician rejects a patient with reference to 3G, the physician could in extreme cases be prosecuted for failure to provide assistance, Berger continued. The view of the National Association of Statutory Health Insurance Physicians, responsible for general practitioners and specialists, is even clearer: “Doctors cannot make treatment dependent on compliance with the 3G rule,” it says in writing.

If you ask in 3G practices, you don’t want to know anything about a treatment requirement. “Our bosses want a 3G rule in their rooms. That is our house right,” says the doctor’s assistant in a Munich practice on the phone. When asked whether there is a chance of treatment without 3G evidence, the answer is “currently not”. You get the same answer elsewhere.

“Certain Dilemma”

“There is a certain legal dilemma,” admits orthopedist Bauer, who treats according to the 3G rule in his practice. “But the view of the Association of Statutory Health Insurance Physicians is not a legal situation.” Bauer and his colleague Schwarz see a need for political clarification.

The Bavarian Ministry of Health obviously does not see him. In Bavaria, the Infection Protection Act provides that a 3G rule applies from an incidence of 35 in closed indoor spaces. But that does not apply to medical practices. Therefore, the ministry also makes it clear that it is fundamentally not possible to only allow access to the doctor’s practice according to the 3G rule.

Legal back door

However, there is a legally flawless back door: practices are allowed to treat unvaccinated and untested people during specially set up office hours, writes the National Association of Statutory Health Insurance Physicians. That could be at the end of the consultation hour, for example, when there are no other patients in the waiting room, says the KZVB.

The orthopedic surgeons in Friedberg, Swabia, want to keep the 3G rule for the time being. Even if the debate is gaining momentum. Possibly as soon as next week when the tests become chargeable.

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