Medical on-call service: If 116117 is not available

The number 116117 for the medical on-call service promises medical help – around the clock. Complaints about poor accessibility are now piling up. Why is that?

Serdal Sahin and his sister Pinar have long since got used to the fact that they often have to get up at night. At home in Stuttgart, they care for their 82-year-old father, who suffers from Alzheimer’s disease. Care level five, intensive care. They know the care, getting up, for example when a catheter needs to be changed at night. What is new for the siblings, however, is that they sometimes stand there without help at night.

“That surprised me,” says Serdal Sahin. “I called the medical on-call service on 116117 and had to wait 40 minutes for someone to pick up.” His sister adds: “The alternative would have been to call 112, the emergency number, and say: ‘Sorry, I can’t help it, I can’t reach anyone on call.'”

“The number with the elves,” is how the patient service advertises itself, which should be available on 116117. He promises “medical help at night, on weekends and on public holidays”. General practitioners and specialists on call should be mediated under this number, according to the homepage. Provided that the intermediaries can be reached.

Call center instead of rescue control center

But they are often not available – this has been experienced, for example, in the Emmendingen rescue control center in the south-west of Baden-Württemberg. Up until two years ago, they still accepted calls from 116117 here – now these calls have ended up at a call center, says director Roland Schmucker.

Since then, cases like this have increased: “A woman needed palliative painkillers for her father, but she couldn’t get through to 116117 and therefore dialed the emergency number 112. I couldn’t help her and asked her to keep trying the patient service.” After an hour, the woman reported back, she had not been able to get through to the call center. The rescue control center sent an ambulance, although the man was not an acute emergency, and took him to the hospital.

Calls have quadrupled in 2021

One reason for the poor accessibility of the patient service may be that the calls nationwide have more than quadrupled in 2021, to a total of 77 million, as can be read on the homepage. More than 80 percent of these calls were inquiries about Corona. Because 116117 not only helps with medical advice, but also arranges vaccination appointments.

For the Konstanz general practitioner Markus Fix this is absurd. He speaks of the “abuse of an emergency number”: “I can’t overload such an important number with things like making appointments and risk real emergencies not getting through.”

The doctor has been on the road in the emergency service for more than 20 years. Since switching to the call center, he has significantly less to do. He believes this is probably because the patients failed to dial 116117 and then called 112 in an emergency. Then the ambulance comes – for example for a gastrointestinal infection. “On the other hand, patients who cannot reach a doctor can, of course, suffer serious damage,” says Fix. He also considers the change to be irresponsible.

“I don’t have the staff for it”

According to the Association of Statutory Health Insurance Physicians in Stuttgart, innovations such as the switch to a call center never ran smoothly at first. The main problem, however, is finding staff for the telephone service: “Providing a system that can be reached in the same way as the emergency services, within minutes, is not affordable. And I don’t have the staff for it,” says Johannes Fechner from the Association of Statutory Health Insurance Physicians in Baden-Württemberg. Nevertheless, the KV has no choice. The legal mandate is to be available around the clock. Hence the call centers.

In Mannheim and Bruchsal, there are already more than 100 employees working for the state of Baden-Württemberg. They are currently receiving support from Saxony. Another problem for the Konstanz general practitioner Fix: “In Saxony, you don’t know the Konstanz area. I know of a number of cases in which patients were sent to the wrong clinics because of this.”

At the rescue control center in Emmendingen, on the other hand, there is sympathy for the call center employees: “We feel sorry for them too,” said director Schmucker. Many are completely overwhelmed with the situation. “Every caller they have on the phone will first unload their worries and anger properly.” At the moment there are actually only losers – the call centers, the control centers, the doctors. And of course the patients.