Despite advances in technology Germans favor the personal touch over telemedicine | Science| In-depth reporting on science and technology | DW | 13.12.2013
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Despite advances in technology Germans favor the personal touch over telemedicine

As telemedicine revolutionizes medical care around the world, Germans are happier paying a visit to the doctor. And those who could benefit from the technology will have to wait.

By international standards, Germans have plenty of doctors: 3.84 for every 1,000 patients. In the US, the number is 2.46. But such statistics shed little light on how doctors are distributed throughout a country.

"In some rural regions, we have a situation where a consultation might require a day's travel for the patient," says Wolfgang Loos, chairman of the German Society for Telemedicine. "It's time for solutions."

One of the solutions, he says, is that a doctor could consult patients via live video streams to the patient's home.

And this idea of digital medicine has taken root - up to a point.

In the field of stroke prevention and care, for example, small hospitals and care clinics are networked and can consult specialists through video conferencing whenever they have questions.

Patients with chronic heart issues can access a different form of telemedicine: some measuring instruments are connected to centralized medical networks, and if a patient's value suddenly worsens, a nearby doctor is alerted.

A woman holds a small electronic device in front of her face

Telemedicine devices can wirelessly alert doctors to a patient's problems

Still, telemedicine faces a number of particularly German hurdles.

Person-to-person contact

Doctors in Germany are not allowed to diagnose a patient remotely without having dealt with that patient before, at least once in person. This is stipulated in the "prohibition of remote treatment" - a German code of conduct for doctors.

In Switzerland, remote diagnoses are less regulated than in Germany. For example, the Basel-based Medgate company can advise patients over the phone and in some cases can even prescribe medicine.

Beyond code of conduct restrictions, though, patients in Germany are accustomed to - and expect - a direct line of personal contact with their general practitioner and specialist.

It's for this reason that Franz Bartmann, chairman of the telematics committee of the German Medical Association, believes the concept of telemedicine strikes a nerve with the average German. He cites Scandinavia, where the process works differently.

"If you're sick in Sweden, you have a telephone number and can speak with a nurse. She decides which level of care you'll be brought into - the doctor comes in at the end of it."

A doctor touches a woman's arm

Feeling better: Germans still prefer the personal touch

There are also technical barriers that inhibit telemedicine in Germany. In many regions, high-speed Internet access is lagging, making video conferencing or the transmission of large patient data files nearly impossible. The areas lacking broadband access are often the same rural regions, say its advocates, which would benefit most from telemedicine.

Global medicine

Beyond Germany's borders, telemedicine is taking hold.

Wolfgang Loos of the German Society for Telemedicine speaks of the cooperation between a hospital in northwest Frankfurt and a clinic in Brunei in Southeast Asia. Around the clock, German specialists can connect with their colleagues in Asia via videoconferencing.

Another example is a telemedicine project in Vietnam by a German government-owned development bank.

"The idea is that different hospitals in rural regions are networked to a central hospital in Hanoi," says Loos.

But Bartmann says telemedicine does have its limits.

While he's in favor of relaxing the German prohibition of remote treatment, and sees huge potential in the field of telemedicine, he maintains that "direct contact between doctor and patient is indispensible."

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