German Doctors Warn of 30 Million Extra Visits as Coalition Scraps Phone Sick Notes
Published on 07/09/2026 at 02:45 | Redaktion boerse-global.de
A plan to require a doctor’s certificate from the first day of illness – effectively abolishing the pandemic-era phone-based sick note – could send an estimated 30 million additional patients into German surgeries each year, the country’s leading physicians’ organisation has warned. The Kassenärztliche Bundesvereinigung (KBV) calculates that the added workload would consume roughly 208,000 working days for medical staff.
Regional projections back those figures. The Kassenärztliche Vereinigung Baden-Württemberg expects around three million extra appointments annually in its state alone. An economist at the German Institute for Economic Research (DIW) pointed out that fuller waiting rooms could also raise the infection risk for patients, undermining the very purpose of staying home.
The reform, agreed by Germany’s ruling coalition, aims to tighten sick-leave reporting. But critics question whether a problem large enough to warrant such a step actually exists. Data from the KBV and health insurers show that phone-based sick notes – formally introduced during the pandemic and later extended – account for only 0.8?% to 1.2?% of all medical certificates of incapacity for work. The chairwoman of the AOK health fund said there was “no evidence of abuse” of the remote system and called the plan pure symbolic politics that would not meaningfully reduce absenteeism.
Experts attribute the recent rise in recorded sick days largely to better data collection. The electronic certificate of incapacity for work (eAU), rolled out in 2022, closed statistical gaps. According to specialists, between 40?% and 60?% of the documented increase since that year stems from this technical effect. Internationally, Germany topped the OECD list in 2022 with 24.9 sick days per employee, but comparability is limited. In a standardised EU survey on working-time loss, Germany’s rate of 6.8?% sits in the European middle bracket.
The proposed regulation would not take effect before 2027 at the earliest. Current law under §?5 of the Continued Payment of Wages Act requires a doctor’s note only from the fourth day of sickness, though a 2012 Federal Labour Court ruling already gives employers the right to demand one from day one. The new rules would make that the default.
Labour unions have pushed back. Representatives of ver.di and IG Metall fear that mandatory in-person visits will lead to longer sick leaves, because physicians will be less inclined to issue a single-day certificate. The German Trade Union Confederation (DGB) warns of “presenteeism” – employees coming to work ill just to avoid a trip to the doctor.
The political debate is not settled. Senior SPD figures have called for a scientific evidence base before implementation, while voices inside the Christian Democratic Union (CDU) have urged a complete withdrawal of the plan. A clarification emerged during the discussions: a day-one certificate does not necessarily mean a physical visit. Video consultations, which jumped to around 2.7?million uses in 2024, would remain a permitted alternative.
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