Barrier-free doctor's office: What matters most

Currently, only about one in three practices is barrier-free. This means that the right to a free choice of doctor is de facto severely restricted for many people in Germany. But what barriers can hinder a visit to your practice?

What are the barriers in the practice context?

In the practice context, there are many barriers for physically or mentally impaired people and for parents with young children. These can be divided into three categories: access to practice, use of practice space, and communication.

Tip: On the website of the National Association of Statutory Health Insurance Physicians you will find a checklist "Is your practice barrier-free?"

Access to the practice

Already getting to the practice and into the practice building can be difficult for many people. Barriers to accessing the practice can be identified by these features, among others:

• No accessibility by public transport
• No handicapped parking spaces
• Access to the house only possible via stairs
• No accessibility of the bell for wheelchair user:inside
• No automatic door openers
• No wheelchair accessible width of the door
• No elevator or stair lift in the stairwell
• Once in practice, there are often further barriers.

Use of the practice rooms

Once in the practice premises, there are usually other barriers. These barriers make it difficult to use the premises:

• No handicapped accessible WC with emergency button
• No room for a wheelchair or stroller in the registration area, waiting room, and exam rooms
• No wheelchair adequate height of the registration counter
• No anti-slip floor coverings
• Unsuitable, non-height-adjustable examination equipment

Barriers can also exist in terms of communication between practice staff and patients.

Communication

It is not only physical obstacles that make it impossible for many patients to visit the practice. There are often difficulties in communication especially for mentally handicapped, visually or hearing impaired persons as well as persons without knowledge of German. These include, among others:

• No alternative to making an appointment by phone
• Staff without foreign language skills
• No information material in easy language
• No or poorly legible signage

The list of restrictions is long, because barriers can exist almost anywhere. But what is meant by accessibility in medical practices?

This means accessibility in medical practices

Accessibility means that all patients can visit your practice and be treated without having to rely on outside help.

Unfortunately, a completely barrier-free practice is not yet the standard. In many buildings, for example, there is no elevator or possibilities for parking in the immediate vicinity. It is not always possible to upgrade the entire practice accordingly. Nevertheless, more and more physicians are recognizing the fundamental problem and are providing accessibility as far as possible and planning for it when purchasing or building a practice in accordance with the legal regulations.

Duties and regulations

There are currently few regulations on accessibility for existing medical practices. However, since the Appointment Service and Care Act came into force in 2019, the associations of panel doctors must at least provide information online about the accessibility options for people with disabilities.

The situation is different for new buildings or conversions of existing premises.

Legal regulation for new practice buildings and changes of use

If you are currently planning a new practice building, structural accessibility is mandatory. Section 50 of the model building code, which serves as a template for the state building codes, stipulates the following for healthcare facilities in particular: "Structures that are accessible to the public must be barrier-free in the parts that serve general visitor and user traffic.

Exceptions

However, there are restrictions here as well. Exceptions to the legal obligation of accessibility can be the following according to § 50 paragraph 3:

• Difficult terrain
• Installation of an otherwise unnecessary elevator
• Unfavorable existing development
• Disproportionate additional expense

If one or more of these items apply to your project, you may be exempt from the accessibility compliance requirement.

Note: In case of doubt, contact the responsible building authority or a specialized lawyer for an expert assessment at an early stage.

If the financial investment worries you, grants can provide some relief.
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Funding opportunities for your practice remodel

Are you considering remodeling your practice to be accessible to even more people? If so, you may benefit from various grant programs and loans. These calls for proposals may be suitable for you:

• Land Saxony
• KfW loans
• Stiftung Gesundheit Fördergemeinschaft e. V.
• Ministry of Social Affairs, Health and Sport of the State of Mecklenburg-Western Pomerania
• State Office for Social Affairs, Youth and Supply (Rhineland-Palatinate)
• Hessian Ministry for Social Affairs and Integration

Depending on the project, renovations can quickly become a very time-consuming affair. If you want to break down barriers in the short term today, digital tools can help - for example, for anamnesis.

This is how easy the accessible anamnesis with Nelly works

Thanks to Nelly, anamnesis becomes easily accessible. Because you can provide your patients with questionnaires and information sheets digitally in multiple languages and also in easy-to-use language. In addition, Nelly enables you to share information - for example, about accessibility in your practice - with your patients. Here's how:

1. Patients enter all relevant data in the input mask.
2. With one click, many documents and treatment contracts can be signed in a legally compliant manner.
3. All data is automatically available to you in the practice software.

Create a digital workflow in your practice now. We will advise you on your individual case without obligation and free of charge!

Contact Nelly now!

The personal designations used in this article always refer equally to all persons. For the sake of better readability, we do not use the same name twice or in the opposite gender.