Two weeks after arriving in Germany, we had our first check up with our German OB-GYN. I was very lucky in that hubby had a co-worker here in Germany who just had their first child last year. They had already done all the legwork to tell me about the best doctors and hospitals in town and were more than happy to share their info. The doctor they recommended is actually an American who studied in the US and then transitioned to Germany 15 years ago with her husband. She obviously is fluent in English and because of that she is very popular with expats and American military here in Wiesbaden (the base does not have its own OB-GYN so all military use the community services). It was very comforting to have someone who knows the US and the German systems and ideals very well and is able to communicate effectively with us and help guide us through the system.
Let’s talk about the first appointment. Don’t worry there will be no gross details in here. I am simply going to compare my US experience with the German experience. Everyone can safely read on.
We arrive at our first appointment and had to fill out some paperwork. We have private insurance, which is very uncommon in Germany. Almost everyone here has some form of the German universal health care plan. So for private insurance holders the plan is simple. The doctor’s office and the hospital simply bill you directly. You are in charge of paying the bill and then the insurance company reimburses you. The hospital and the doctor’s office do not get involved with attempting to get money from your insurance. Now initially this kind of seems like a bad deal. I don’t want to have to pay and then wait for the insurance company to pay me back and true it is not the most convenient. On the other hand with my experience working in the health care field, this plan is actually brilliant. Our hospitals and doctors offices in the US employ a whole division of workers whose sole job is to attempt to bill and collect money from insurance companies. They have to call these companies frequently and haggle for pricing and approval. They spend hours filing and refilling paperwork in order to get very minimal payment back from insurance providers. Here in Germany they have to employ very few people in their billing department. Someone has to send out the bill to the German Health Plan but the German Health plan always pays the hospital and there is no arguing over what is what. They don’t bill private insurance companies so this saves an enormous amount of time, energy and money. In turn, this keeps the bills low for all parties so medical services are much cheaper here and of the same quality.
Ok paperwork done. We get called back into the Doctor’s office and we walk into this big L shaped room. In the front part of the room is the doctor’s desk where she has us sit and we talk so she can get to know us. Yep we sat down and chatted with the doctor with no rush to get to the point and out the door. After we got to know each other, it was time to get an ultrasound done. The doctor had us just walk around the corner of the room and there was an exam table with an ultrasound machine. The doctor had me hop up and then SHE PERFORMED the ultrasound. In the US, we had to make a special appointment if we were due for an ultrasound and an ultrasound technician or other professional would perform the ultrasound and then the doctor would just read the results. Here the doctor just performed it all and all in one room. Boom! Done! I was also informed that here in Germany and most of Europe they do ultrasounds at almost every appointment. They see no harm in the ultrasound waves and feel seeing and examining the child at each appointment is important.
The next thing she had us do was what she called a “stress test” but it was more of a heart monitor for the baby. They strap it around your belly and then have you sit for 15-20 minutes while they monitor the baby’s movements and heart rate. I had a similar device placed on me while I was in labor in the US with our first child but it was never used before being in active labor. This device can also detect if your starting to have any Braxton Hicks Contractions (practice contractions) or if it seems your body is preparing for labor which is why they do this at every visit during your final trimester here in Germany. Everything looked good! This little girl is a mover. She never sits still in there. I hope that isn’t a warning for our future!
Ok then at the end, the doctor wanted to get some blood work done. Yikes! I was not worried about getting poked with a needle but worried about finding some outpatient lab to go get my lab work done. In the US, I would have to make an additional trip over to the hospital to the outpatient clinic and wait for what seemed like an eternity to get my blood work done. Have no fears! The assistant who checked me in and checked my weight, blood pressure, etc. she is also the lab tech! They drew my blood right there in the clinic and I didn’t have to travel anywhere else. It was amazing!
In the end, my first appointment was about 45-60 minutes. Everything was completed in the office. It was a great experience.
Quick Update: I wrote this blog a bit ago but never got around to posting it. We have been to several appointments now all with the same routine as mentioned above. We have had an ultrasound at every appointment though we do not get a 3D ultrasound but that’s a fair trade. We received our first bill in the mail it was 89 euros (just about $100) per visit. That is the total cost with lab, ultrasound, etc. at a “no insurance” rate since we have private insurance (so our insurance will be reimbursing us of course). In comparison, I just paid my final bills from my last doctor’s appointment in the US. The fiscal year had just restarted so I had to pay toward my deductible, which meant I had to pay $110 for lab fees and $140 for the ultrasound. The actual bill was much higher that was just my portion. Final point: Medical care in the United States is ridiculously expensive for no apparent reason.