Current developments

Why your gynaecologist has less time.

Why a statutory appointment is getting harder — and what we are doing about it. An open word on waiting times, digitalisation and what 2027 will bring.

Last updated: July 2026 · We keep this page current whenever figures or the legal situation change.

In short

You wait longer for an appointment than you used to. You more often speak to a digital assistant than to a person. You get the impression that it is more about services and less about care.

That impression is not wrong. But the reason lies not in our attitude – it lies in the framework in which statutory healthcare operates today. We explain it here, as plainly and completely as we can, so that you can form your own judgement.

1. Medical work is capped

Statutory health insurers do not pay a practice for every service rendered. They pay up to a certain volume per quarter. Anything beyond that is still provided – but no longer, or only marginally, remunerated.

Salaries, rent, equipment, hygiene, IT security and telematics continue regardless.

2. There are three ways out

Keep working unpaidMany practices do this. It works until it does not — across Germany, practices are closing or failing to find successors. The practice that stood here before us was ultimately carried this way too: on unpaid overtime. What some people miss today was never free. It was paid for — by the people who worked here.
Work fasterMore patients in the same time. We tried. It lowers quality, burns out the team and does not hold. Not an option for us.
Limit capacity honestlyClear quotas, plannable appointments – and yes: waiting times. That is what we chose.
What happens in the consulting room decides what there is time for — that is what this page is about.

3. What this means for you

Appointments are scarcer and must be planned further ahead. We use quotas so that urgent cases take priority.

Digital channels – online booking and our phone assistant – are not a replacement for people. They make sure your request does not disappear into a busy signal when all lines are occupied.

4. Cancer screening: how we allocate it

Cancer screening remains a statutory health insurance benefit. What changes is access – because the capacity for it is capped and therefore scarce. We are open about how we allocate it:

Appointments are given out no more than three months in advance. The contingent is tight.

Requests are made by phone. That way we can assess in conversation how urgent your case is.

Our doctors prioritise by medical urgency: abnormal smears, palpable findings and prior results requiring follow-up come first. This is neither random nor arbitrary – it is the only allocation that is medically defensible.

Whatever remains available afterwards, we release on a rolling basis for phone requests.

→ What you are entitled to as a statutory patient is set out in detail under statutory benefits.

  • “It all used to be included.”
  • “You can't even get an appointment anymore.”
  • “Why should I suddenly pay for this?”
  • “It worked without all this at the previous practice.”
  • “It's all just about money now.”
  • “Three months' wait — for a check-up.”
  • “That's a standard insurance service.”

We hear this. Every day.
This page is our answer — with the figures laid open.

We have many five-star reviews. Recently, also several one-star ones – almost all of them about exactly this: reachability and screening appointments. We read them, and we take them seriously.

Above all they tell us one thing: we explained this badly. It is not about greed and not about a loss of medical ethics – it is about a capacity that no longer stretches to everyone, and about who receives it first. We decided to write that down openly rather than explain it individually on the phone every week. This page is our answer to those reviews.

Screening itself does not change. What changes is the framework in which we may provide it.

5. Why we offer additional services

Because the capped framework is not enough to sustain a practice at this quality. Additional services and membership models fund what statutory remuneration no longer covers: time, staff, equipment.

We say so openly rather than hiding it. If you do not want these offers, you remain our patient all the same.

6. What happens in 2027

On 10 July 2026 the German parliament passed the statutory health savings act; it takes effect on 1 January 2027. The framework will narrow, not widen.

Specifically: services that were previously paid on top – faster appointment scheduling under the Appointment Service and Care Act (TSVG) and the surcharges for the electronic patient record – move under the budget cap. Surcharges for hygiene and for waiting times are cut without replacement.

For gynaecology in Baden-Württemberg, figures from the Association of Statutory Health Insurance Physicians put this at around €17.21 million less – a drop of 5.3% from the current €323.5 million. Of that, €13.1 million alone is the discontinued TSVG remuneration.

This cut is not a regional phenomenon. Nationwide, the National Association of Statutory Health Insurance Physicians expects that, for lack of funding, up to 46 million treatment cases per year can no longer be provided. That is not a figure from the internet but the official estimate of the profession’s own governing body.

Taken together, this produces something now openly named in the debate: medicine according to your insurance status. Those who are privately insured or can pay extra get an appointment sooner; those who cannot wait longer. We consider this development wrong — while saying honestly that a single practice cannot stop it, only cushion it as fairly as possible.

On top of this comes the volume mechanism: the baseline is the service volume of 2025. Whoever works more raises the total volume – and thereby lowers the rate at which each individual service is still paid out. More work is not rewarded; on paper it reduces the payment for everyone.

We will tell you in good time what that means for your care here – before you notice it in the waiting room.

Self check-in instead of waiting-list phone calls: every automated minute flows back into care.

7. And if you cannot go along with this?

Then that is your right, and we do not hold it against you. We will hand over your records promptly and wish you genuinely well.

Please bear just one thing in mind — not as a threat, but as a sober note: in the current situation it is hard to find a new practice with free capacity. A place once given up is usually gone.

We only ask that your decision rests on correct assumptions. The framework described here applies to every practice in Germany. What differs is how openly it is discussed. We chose openly.

Rosgartenstraße 27 from above: this is where we work on the answer to 2027.

8. We are not alone in this

We are in continuous professional exchange with colleagues in the region, with our professional association and with the Association of Statutory Health Insurance Physicians. What we describe here is not a local opinion but the reality currently discussed throughout outpatient gynaecology – usually behind closed doors.

We are among the first practices to speak about it openly and to test viable models for the period after 2027. That is uncomfortable and earns us criticism. We still consider it the more honest path – and we share what we learn with those facing the same questions.

We are on your side. Even when it does not feel that way.
Dr Marion Hansberg-Otte, Medical Director

Questions?

Talk to us. We will answer honestly – even when the answer is uncomfortable.

Get in touch

Last updated: July 2026 DE EN FR IT

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