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Sunday, 1 August 2021

Is healthcare free in Europe?


Medical Care in Europe

Europe's pharmacies can help with minor medical problems.
Pharmacy, Bruges, Belgium
To find a pharmacy in countries with Germanic languages, look for words similar to "apothecary" (such as "apotheek," in Belgium).
By Rick Steves

If you're worried about getting sick while traveling, rest assured: Most of Europe offers high-quality medical care that's as competent as what you'll find at home. The majority of Europe's doctors and pharmacists speak at least some English, so communication generally isn't an issue.

Nearly all European countries have a universal health care system. Though some people refer to it as Europe's "free health care" system, in reality, it's not really free. While each country has its own variation, the common denominator is that everyone pays for health care as a society — intending to minimize the overall expense and spread around the cost and risk so that an unlucky few are not bankrupted by medical costs. This also ensures that those living in poverty can get the care they might not otherwise be able to afford.

Luckily, I've never been seriously injured while traveling in Europe. But I hear countless tales about travelers needing medical treatment. One person told me about how she sprained her ankle during a visit to Denmark. She was X-rayed, bandaged up, and given a pair of crutches to use. The hospital did not ask her to pay a dime — only to return the crutches when she left Denmark. And a staff member of mine, whose infant son received excellent care after a lung infection in France, came home to declare, "Anyone who says socialized medical care is subpar hasn't seen it in action."

While no system is perfect, Europe's universal health care does mean that everyone is taken care of — including foreigners. So if you get sick or injured while traveling, you will receive treatment, no questions asked.


If an accident or life-threatening medical problem occurs on the road, get to a hospital. For serious conditions (stroke, heart attack, bad car accident), summon an ambulance. In most countries, you can call 112, the European Union's universal emergency number for ambulance, fire department, or police. Most countries also have a 911 equivalent that works as well. Or you can ask your hotelier, restaurant host, or whoever's around to call an ambulance (or a taxi for less dire situations).

Be aware that you will likely have to pay out of pocket for any medical treatment, even if your insurance company provides international health care coverage. A visit to the emergency room can be free or cost only a nominal fee, or it can be expensive, depending on where you are and what treatment you need. Make sure you get a copy of your bill so that when you return home, you can file a claim to be reimbursed. If you purchased travel insurance to serve as your primary medical coverage, call the company as soon as possible to report the injury. They can usually work directly with the hospital to get your bills paid.

Minor Ailments

If you get sick on your trip, don't wait it out. Find help to get on the road to recovery as soon as possible. Here are your options if you have a non-emergency situation:


Throughout Europe, people with a health problem go first to the pharmacy, not to their doctor. European pharmacists can diagnose and prescribe remedies for many simple problems, such as sore throats, fevers, stomach issues, sinus problems, insomnia, blisters, rashes, urinary tract infections, or muscle, joint, and back pain. Most cities have at least a few 24-hour pharmacies.

When it comes to medication, expect some differences between the way things are done in Europe and at home. Certain drugs that you need a prescription for in the US are available over the counter in Europe. Some drugs go by different names. And some European medications can be stronger than their counterparts in the US, so follow directions and dosages carefully. Also, topical remedies are common in Europe; if you're suffering from body aches and pains, or any swelling, don't be surprised if a pharmacist prescribes a cream to apply to the problem area. If you need to fill a prescription — even one from home — a pharmacy can generally take care of it promptly. If a pharmacist can't help you, he or she will send you to a doctor or a health clinic.


A trip to a foreign clinic is actually an interesting travel experience. Every few years I end up in a European clinic for one reason or another, and every time I'm impressed by its efficiency and effectiveness.

A clinic is useful if you need to be checked for a non-emergency medical issue, get some tests done, or if your problem is beyond a pharmacist's scope. Clinics in Europe operate just like those in the US: You'll sign in with the receptionist, answer a few questions, then take a seat and wait for a nurse or doctor.

A trip to a clinic may be free or a small fee. Expect to pay this fee up front, whether you're covered through your health insurance company or a special travel policy. Make sure you get a copy of the bill so you can file a claim when you return home.

House Calls

If you're holed up sick in your hotel room and would rather not go out, the hotel receptionist can generally call a doctor who will come to your room and check you out. This option is generally more expensive than dragging yourself to a pharmacy or clinic.

Finding Medical Help

To locate a doctor, clinic, or hospital, ask around at places that are accustomed to dealing with Americans on the road — such as tourist offices and large hotels. Most embassies and consulates maintain lists of physicians and hospitals in major cities (on the US embassy's site, select your location, and look under the US Citizens Services section of that embassy's website for medical services information).

If you're concerned about getting an English-speaking and Western-trained doctor, consider joining IAMAT, the International Association for Medical Assistance to Travelers. You'll get a list of English-speaking doctors in more than 90 member countries who charge affordable, standardized fees for medical visits (membership is free but donation is requested, fee pricing on website, pay provider directly at time of visit, US tel. 716 754 4883).

Is there a shortage of doctors in Germany?


Thousands of doctor vacancies in Germany remained unfilled in 2019

Thousands of doctor vacancies in Germany remained unfilled in 2019

5,9 percent of all general practitioner positions in Germany remained unfilled last year, according to new figures - although the shortage of doctors is not evenly spread across the country. 

Doctors unevenly distributed in Germany

Last year, there were thousands of unfilled vacancies for general practitioners across Germany. Nationwide, a total of 5,9 percent of planned positions could not be allocated. This was revealed in figures published by the federal government, in response to a request from the left-wing MP Sabine Zimmerman. 

The data shows that the greatest shortages were faced in Saarland, where 12,3 percent of all doctor positions remained unfilled in 2019. City-states like Hamburg (0 percent) and Berlin (0,7 percent), on the other hand, were much better supplied with medical staff. 

Shortages were also recorded in Saxony-Anhalt (10,4 percent), Rhineland-Palatinate (9,5 percent), Lower Saxony and Mecklenburg-Vorpommern (8,9 percent each). Overall, in the eastern (new) federal states, 6,4 percent of all general practitioner positions remained vacant, compared to 5,8 percent in the west. 

Number of doctor vacancies in Germany rising

In recent years, there has been a fluctuating rise in the overall number of doctor vacancies in Germany. In 2014, there were 2.213 vacancies, and in 2018, 2.875. But it is difficult to make direct comparisons between different years because the number of doctor positions across the country changes regularly as the federal government updates specifications and regional plans. 

Nonetheless, left-wing politician Zimmermann commented critically on the federal government’s figures: “A shortage of doctors, long distances and long waiting times have long been the norm for many patients,” she said, emphasising that, in rural areas especially, more needed to be done to ensure doctor positions are filled. 

She also called for an end to the coexistence of statutory and private health insurance in Germany, which she blamed for exacerbating the uneven distribution of doctors: “The existing higher remuneration system is also an incentive for doctors to settle in regions with above-average wages and a large number of privately-insured people.”

Does Germany Need doctors?


They’ve come a long way – to be confronted with an even longer licensure process in Germany: Syrian doctors in Germany

Germany, like many other regions around the world, relies on international doctors to supplement its locally trained medical staff and support their health care system. However, Syrian doctors who have immigrated to Germany have reported being confronted with a convoluted and difficult application process to obtain their medical licenses. Professor Julika Loss and colleagues, from the University of Regensburg, interviewed Syrian doctors, who had immigrated to Germany, to report on their experience of the medical license application system. In this blog, Professor Loss tells us more about their study, published this week in BMC Health Services Research

Tens of thousands of Syrian war refugees are currently being trapped between Turkey and Greece or interned in deplorable and dramatic conditions on Greek islands [1]. This drama painfully reminds us that the conflict in Syria continues to be the biggest driver of migration. Since 2015, hundreds of thousands of Syrian migrants have crossed into Europe. Syrians are now the third-largest group of people with a foreign nationality in Germany, and among Syrian immigrants, there are comparatively many well-educated and trained health care professionals, e.g. some 3,000-4,000 medical doctors [2]. Not all of them have fled their country as refugees; many have been granted visas, as Germany is principally welcoming Syrian doctors.

Wire fence
Tens of thousands of Syrian war refugees are currently being trapped between Turkey and Greece.

Why Germany needs Syrian doctors

The reason is simple: In Germany, a relative shortage of physicians has developed over the recent years. A change in working time regulations and a growing demand for part-time jobs, has increased the need for additional doctors. Like many other developed countries, Germany relies on international medical graduates or doctors to supplement its locally trained staff so as to maintain their health care system. Further, as the number of Syrian migrants increases, so does the number of Syrian patients being treated in hospitals and doctors’ offices, resulting in a novel need for Arabic-speaking medical staff. Therefore, Syrian doctors are able to fulfill a double function.

Given this background, it may seem paramount to make the licensure process for Syrian immigrant doctors as straightforward and as swift as possible, actively supporting and advising applicants through the relevant processes. But in fact, the act of obtaining a permanent license to be allowed to practice medicine in Germany is onerous, lengthy, and can bring about many negative experiences. These can include feelings of humiliation, lack of transparency, arbitrariness, and helplessness. This is what many of the 20 Syrian doctors told us in an interview study we performed from 2016-2017.

Syrian doctors in Germany and their stories: the basis of our study

The idea for this study arose when a recently immigrated Syrian dentist, began working with us while waiting for his German dental license to be approved.

He told our team about his experiences with a “bureaucratic”, slow and confusing application procedure to secure his license. We were intrigued by his experiences and wanted to seek out other Syrian health care professionals’ experiences of the system. A qualitative study was designed and we received an overwhelming response to our call for interviewees on a Facebook page for Syrian Doctors in Germany. Within a few days, twenty Syrian health professionals were prepared to share their stories through face-to-face interviews.

Being lost in an opaque and arbitrary bureaucratic process: that’s what it feels like being a Syrian doctor applying for a medical license in Germany

Syrian doctors are highly motivated to apply their skills and expertise in clinical patient care. However, they are confronted with a time-consuming, ever-changing and non-transparent application procedure lasting months, even years.

We found that upon arrival in Germany, Syrian doctors are highly motivated to apply their skills and expertise in clinical patient care. However, they are confronted with a time-consuming, ever-changing and non-transparent application procedure lasting months, even years.

One physician explained: “When I started applying for the temporary license … some rules changed and the authorities were now requiring a C1 course in medical German to obtain the temporary license! After I started the C1 language course, they required the exam for medical terms. When we completed one step, they asked for another step…nothing is stable here.

Interviewees describe a Kafkaesque system where they feel at the mercy of Government employees and reviewers who ask for absurd and impossible accomplishments, refuse to give information and act at random. This is shown in the quote of another interview partner: “There are no clear steps. You can have two [Syrian] doctors who studied at the same university, finished their studies in the same year, – and then one of them can obtain the approbation without any exam, and the other one will need to take another exam. At the end of the day, only one person makes the decision about you. …And of course, we cannot meet this person or talk with them. We don’t even know their name.”

Admin work
Interviewees reported feeling depressed, irritated or even in despair with the medical license application process.

Consequently, the interviewees reported feeling depressed, irritated or even in despair. As informational and practical support from official institutions was scarce, the Syrian doctors relied on personal networks and peers to understand the requirements and find a job.

Where next?

To obtain a balanced view of the licensure process and the interactions involved, future research should explore the perspective of the administrative staff in the German Chamber of Physicians or job centers as well. Naturally, these regulative bodies were not prepared for the large number of migrant doctors applying for a license and were surprised by the abrupt rise in the number of licensure procedures. Journalists have reported that ratifying Syrian diplomas may be difficult because in some cases, fraudulent documents have been provided [3,4]. For the medical profession, in particular, credentials and certificates should be checked thoroughly and carefully. Nevertheless, Germany may learn from other countries such as Canada, Australia, or New Zealand, which have harmonized and simplified assessment procedures for overseas-trained doctors, and implemented specific resources guiding and supporting foreign health professionals in different stages of their application process [5,6].

Welcoming Syrian doctors in Germany is more important than ever – especially as the current COVID-19 pandemic has highlighted the dire need for skilled medical staff in hospitals. While German authorities claim to be making an effort to find as many helping hands as possible to cope with the impending shortage of health care professionals, there are no signs that the accreditation process of foreign doctors – Syrian doctors among them – may be accelerated, or handled in a more pragmatic way [7].


[1] Kingsley P. ‘Better to Drown’: A Greek Refugee Camp’s Epidemic of Misery. New York Times, Oct 2nd, 2018.

[2] Bundesaerztekammer (German Chamber of Physicians). Aerztestatistik zum 31. Dezember 2018, Bundesgebiet gesamt. Bundesaerztekammer, Berlin, Germany 2019. Downloaded from on April 15th, 2020.

[3] Hinz L. Innenministerium warnt – Falsche Zeugnisse und Diplome: Flüchtlinge kommen mit gekauften „Antragspaketen“ [Ministry of the Interior warns – False certificates and diplomas: Refugees come with purchased “application packages“]. FOCUS online, Nov 6th, 2011. Downloaded from on April 15th, 2020.

[4] Eddy MS, Karam. Doctors fleeing Syria for Germany find Refuge, hurdles and delays. In: The New York Times. Sep 8th, 2018.

[5] McLean R, Bennett J. Nationally consistent assessment of international medical graduates. Med J Aust. 2008 Apr 21;188(8):464-8.

[6] Covell CL, Neiterman E, Bourgeault IL. Scoping review about the professional integration of internationally educated health professionals. Human Resources for Health. 2016;14(1):38-. doi: 10.1186/s12960-016-0135-6.

[7] Knight B. Despite coronavirus, foreign doctors struggle to get degrees recognized in Germany. Deutsche Welle March 31 2020. Downloaded from on April 15th, 2020

How much does an MRI scan cost in Germany?


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The patient was treated of erectile dysfunction inHelios Berlin Buch

Here is my feed-back for the visit to Praxis Dr. Kaminski at Dr. Michael Wenders: I have been awaited for that visit as scheduled. I was received in profesional manner, being asked about my medical status. Then, the medical consultation followed in which I received informations about my topic and s...


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