Consumer advice center warns of compulsory digitalization in the healthcare system

At a health center it is almost impossible to get through by phone, the family doctor's receptionist refers to online appointments and the specialist practice is best reached by email. The digital route can often be an option with hurdles, especially for elderly people.

But some younger patients now also lack a direct contact person in their practices - whether for organizational or technical questions. “Appointments that do not work via apps or internet services are decreasing,” says Philipp Wendt, board member of the Hesse Consumer Center in Frankfurt.

Don't exclude those who are most in need

“There are practices that can no longer be reached directly by telephone. This is particularly a problem for older people.” And: “In our opinion, a minimum offer for an analogue life should urgently be maintained.”

That's why the consumer advice center appeals to doctors not to rely solely on these digital offers, but also to keep direct and telephone access open for making appointments. Everything else is not right, says Wendt. “Otherwise people will be excluded, especially those who need help the most.”

Advantages against payment

The consumer advice center also criticizes the fact that users come across so-called “self-pay appointments” in the appointment booking apps. In concrete terms, this can mean: No free appointments are displayed for those with statutory health insurance, but if you pay for them, you can come.

In North Rhine-Westphalia, the consumer advice center has already sued an ophthalmologist in 2024 because of such an offer. A health insurance patient should pay 150 euros - or wait several months. The regional court ruled: This is not permitted. Crucial part of the reasoning: The appointment took place within the consultation hours set aside for those with statutory health insurance. Contracted doctors are obliged to be available for statutory health insurance patients at least 25 hours per week.

The State Medical Association points to a shortage of staff

According to the Hesse State Medical Association, the fact that many practices now rely on virtual assistants instead of direct telephone access is primarily due to a lack of staff. It is becoming increasingly difficult to find medical assistants, explains a spokeswoman, but at the same time she admitted that direct communication with patients is important - whether on the phone or on site at the practice counter. Alternatively, patients could call the medical on-call service on 116 117 or contact the health insurance appointment service.

Data protection advocates criticize digital compulsory measures

Hesse's data protection officer Alexander Roßnagel complained months ago about a growing digital requirement for important things in everyday life, such as doctor's visits. Digital accessibility is often not sufficiently taken into account. With regard to doctors, he said: Especially with specialists, it happens that appointments can only be made digitally using special apps. This would also mean that health data would be transferred to third parties.

Roßnagel demanded that the existing analog access channels must be retained to a limited extent for services that are part of the general public. “Computer islands” could also help, for example in citizens’ offices where support is offered. “Digital assistance officers” could be appointed in retirement homes.

Younger people and other areas of life are also affected

The spokeswoman for the State Medical Association points out that the problem of difficult participation due to increasing digitalization does not only affect medical care. Older people in particular are increasingly dependent on support from their surroundings from relatives and friends in other areas of life. But younger people also sometimes face challenges.

It's clear that it's not just doctor's appointments that are affected. It can also be difficult when parking offline, as parking fees can increasingly only be paid via apps. When shopping, there are often cheaper offers online. And when it comes to buying tickets, whether for concerts, cinemas or the train, you can do it cheaper or faster online.

Meanwhile, the city of Frankfurt wants to allow older people to participate more in everyday digital life. Those with less money can even apply for a subsidy of 250 euros for a smartphone or laptop from October. There are also general training courses.

But how many (older people) are actually offline?

According to the Federal Statistical Office in Wiesbaden, as of 2025, several million people nationwide said they had never been on the Internet. A good three percent of people between the ages of 16 and 74 are so-called offliners - "they had never used the Internet before," explain the statisticians. That corresponds to almost 2.1 million people.

As expected, there were particularly many “offliners” among older people. “The proportion of those who have never used the Internet was highest in the 65 to 74 year old age group: around a tenth (ten percent) were offline in 2025.”