A doctor who speaks your language: video consultations in English, Turkish, Arabic or German

Why language decides safety in medicine

A good medical decision starts with an accurate history: since when have the symptoms existed, how do they feel, what makes them worse or better, which medicines do you take, which allergies do you have, what has occurred in your family. In a foreign language these details become approximations. Patients leave out things they cannot express, nod at explanations they only half understood and are less likely to ask questions. The consequences range from a wrongly taken tablet to a missed warning.

The research here is clear. Diamond and colleagues evaluated 33 studies in the Journal of General Internal Medicine in 2019: when doctor and patient speak the same language, understanding, satisfaction, adherence and, in several studies, clinical outcomes improve, for example blood sugar control in diabetes. Karliner and colleagues show in Health Services Research that professional interpreting reduces errors and brings care close to the level of people without a language barrier, while improvised translation by relatives or children more often leads to omissions and errors. Flores summarises in his review that a lack of interpreting goes hand in hand with more tests, more hospital admissions and poorer pain management.

In short: your own language in the consultation is not a comfort. It is part of the quality of treatment.

The situation in Germany

Around 24 million people in Germany have a migration history according to the microcensus of the Federal Statistical Office. Turkish and Arabic are among the most widely spoken family languages, and English is the working language of hundreds of thousands of international professionals and students. Many speak good German in everyday life and still hit limits when it comes to the body, pain, shame and medical terminology. Others, especially older people and recent arrivals, depend on translation.

Legally, medical information must be understandable; section 630e of the German Civil Code requires that patients can actually grasp the information on diagnosis, treatment and risks. If the practice cannot ensure this in the patient’s language, it must involve someone who speaks it. Statutory health insurers generally do not cover the costs, so in practice relatives step in, often the patient’s own children. Refugees in the asylum procedure can under certain conditions have interpreter costs reimbursed under section 6 of the Asylum Seekers Benefits Act. For everyone else the search remains for a doctor who speaks their language, and that is difficult depending on region and specialty.

How the consultation in your language works at OpenClinic24

1. Choose your language. The website, the questionnaire and your patient account are available in German, English, Turkish and Arabic. You select your language at the top of the page.
2. Describe your concern. You answer questions in your language about your symptoms, pre-existing conditions and medicines. You can upload photos, for example of skin or a medicine package.
3. Account and reservation. You create an account and add a payment card; €10.72 is reserved. German health insurance is not a requirement.
4. Video consultation. A doctor who speaks your language joins you by video as soon as available. You talk in your language about symptoms, diagnosis, treatment and next steps.
5. Documents. Prescription, sick note and invoice are in your account. They are issued in German so that pharmacies, employers and insurers can process them; what they contain, the doctor has explained to you in your language.

What works well by video in your language

The video consultation is suitable for everything that can be assessed in conversation and by looking: colds, cough and sore throat, stomach complaints, cystitis, skin changes based on photos, headaches and migraine, back pain without warning signs, sleep problems, exhaustion and mental strain, contraception, questions of men’s and women’s health, sick notes, private prescriptions for known medicines and the explanation of results and medication plans you have received from other doctors.

The last point in particular is valuable for many: you have a German discharge letter, a laboratory result or a medication plan and want to understand calmly, in your language, what it means and what you should do.

The video consultation is not suitable for emergencies, injuries, high fever in children, pregnancy complications and anything that requires a physical examination, laboratory tests or imaging. Then the doctor tells you clearly, in your language, where to go: emergency department, on-call service on 116 117 or a local practice. This too is a part of care that is often lost in a foreign language.

Where language makes the difference in everyday life

Three situations show what this is about. A woman who can describe her symptoms when urinating precisely in Turkish also mentions the discharge she would have left out in German out of shame; the doctor recognises that it is not a bladder infection but a vaginal infection and prescribes the right medicine instead of an unnecessary antibiotic. A man who can explain in Arabic that he only takes his blood pressure medicine when he has a headache receives the explanation why daily intake is decisive, and understands it. An older patient with a German discharge letter after a hospital stay learns in his language which of the five new tablets are for what and which he should stop after two weeks. In all three cases it is not about politeness but about errors that are avoided.

Culture, shame and trust

Language is more than vocabulary. Those who speak their mother tongue can more easily talk about topics laden with shame, such as sexual health, mental strain or gynaecological complaints. The doctors at OpenClinic24 know the cultural contexts in which symptoms are described and ask without judging. If you prefer a female or male doctor, you can say so; we take the wish into account as far as availability allows.

Confidentiality applies without restriction: doctors are bound by medical secrecy, your data are processed encrypted within the European Union, and no one except you and the treating doctor has access to the conversation.

What you can prepare

Have ready before the consultation: your medicines or photos of the packages, previous results or doctors’ letters as photo or PDF, a list of your questions in your language, your thermometer and, if available, a blood pressure monitor. Ensure a stable internet connection and a quiet place; a smartphone with a camera is enough. If you would like a relative to be present, say so at the start. And do not hesitate to ask if a term is unclear. The doctor will gladly explain it again; that is what the consultation in your language is for.

For relatives who help

Many people book for their parents or help them register. That is welcome: you can help set up the account, upload results and be present at the consultation if the patient wishes. The doctor conducts the conversation with the person concerned, however, in their language, because it is about their health and consent. For you as a relative this means relief: you no longer have to translate what you yourself do not understand, and you do not have to deliver diagnoses that are not your task.