“We only speak German”: Language barrier sparks debate in pediatric practice.
In Kirchheim unter Teck, a town near Stuttgart in Baden-Württemberg, a pediatric practice has found itself at the center of a heated debate after posting a sign stating that they only treat patients who speak German. The doctors are defending their decision against accusations of racism and discrimination.
When Ulrich Kuhn and Stefan Gaißer opened their pediatric practice on Alleenring in Kirchheim/Teck (Esslingen district) in 2001, they never imagined that 23 years later, they would need to hang such a sign at their reception: “We only speak German in this practice! If communication is not possible due to a lack of German language skills and no interpreter is personally present, we will have to refuse treatment in the future – except in emergencies.”
Public reaction and social media storm
The sign has caused a stir in the community. Since the local newspaper reported on it, countless people have commented on social media about the actions of Kirchheim’s largest pediatric practice. The spectrum of opinions ranges from harsh criticism such as “This is unacceptable” and “Terrible, absolutely terrible. This is everyday racism in all its glory” to great understanding for the approach: “The doc has my full approval. How is he supposed to make a diagnosis if no German is spoken? Later, someone complains about the wrong diagnosis.”
Doctors defend their position
Dr. Ulrich Kuhn strongly rejects the accusation of racism: “This problem arises precisely because we have always cared for every child regardless of skin color or origin, and of course, we will continue to do so.” However, in recent years, it has increasingly happened “that patients simply come, and neither parents nor children understand what we are saying. This language barrier is a reality.”
He adds that the practice now has to care for many more children than before: “This forces us to make the processes in the practice as efficient as possible.” After all, doctors, including pediatricians, are legally obliged to inform patients about everything. This begins with taking the medical history and asking about pre-existing conditions or allergies. Kuhn emphasizes, “For this, we need to be able to talk to the parents.”
Legal and medical considerations
The doctors argue that they must be able to explain to parents what they need to do after the examination. Kuhn states, “All of this is not possible without understanding each other linguistically. If we don’t ensure this, we’re not just entering a legal gray area, but a deep black one.”
Vaccination is another good example. Kuhn explains, “Every vaccination is a minor bodily injury. Therefore, parents must explicitly consent. It must also be clear that they have understood what is happening.” The fact is that none of the doctors working in the Kirchheim practice has such long-term foreign experience that they can say they speak another language as well as German. “That’s why we point out: We only speak German.”
Addressing discrimination concerns
Kuhn dismisses suggestions about using translation apps: “There’s a huge difference between stumbling through ordering something in a restaurant and having to treat patients in a legally secure manner. I need to know what I’ve said myself. To accuse us of a form of discrimination or even xenophobia is absurd.”
He admits that such a sign is currently the exception in pediatric practices: “Colleagues have the same problem, and they see it the same way we do with legal uncertainty. But they probably haven’t come up with the idea that you could do this – or they’re worried about reactions from the internet.”
Professional association’s stance
The German Professional Association of Pediatricians (BVKJ) is not aware of similar signs elsewhere. Spokesperson Jakob Maske emphasizes that such decisions are made by practice owners themselves and “are not made on the recommendation of the professional association.”
In principle, all pediatricians increasingly have to deal efficiently with resources, i.e., save time as much as possible. Communication with people who do not speak one’s own language is time-consuming. In addition, communication problems and misunderstandings regarding diagnosis and therapy often occur. Maske states, “This can lead to a danger for the child. Therefore, it is generally welcome if foreign-language parents bring an interpreter.”
Positive patient response
Kai Sonntag, spokesperson for the Association of Statutory Health Insurance Physicians in Baden-Württemberg, understands the approach of the Kirchheim doctors: “They are in a situation that is hardly solvable for them: On the one hand, they want to treat patients. On the other hand, they have to inform patients, have to inform them about treatments and therapies. This requires a minimum level of communication. Applications like Google Translator or similar are just suboptimal here and cost a lot of time, which is then not available for other patients.”
Kuhn and Gaißer emphasize that their request has been well received by patients so far: “We have fewer cases where we have communication difficulties – and no one has complained yet.”
Broader context: Shortage of pediatricians
The debate highlights the broader issue of a shortage of pediatricians in Germany. According to the BVKJ, the shortage of pediatricians is increasing year by year, initially noticeable in rural areas but now also in cities. This situation is expected to worsen dramatically in the coming years, with 20 to 25 percent of established doctors retiring in the next five years and few successors available.
The shortage extends to medical staff as well, with many practices unable to hire sufficient medical assistants due to a lack of applicants. This context underscores the challenges faced by pediatric practices in Germany, including the need for efficient communication and resource management.
