(de-news.net) – The German Association of General Practitioners has cautioned against abolishing telephone-based sick leave certification while at the same time calling for more stringent oversight of online sickness certification, as public debate continues over Germany’s persistently high levels of sick leave. In its assessment, the association maintained that the Federal Government should intervene more decisively with regard to commercial providers of sickness certificates, which it views as prioritizing financial gain over patient care and thereby undermining established medical and professional standards. While traditional general practitioner practices operate within clearly defined regulatory and ethical frameworks, the association argued that the current regulatory environment allows for the rapid commercialization of medically questionable attestations, a development it considers incompatible with responsible healthcare provision.
At the same time, general practitioners issued a clear warning to the governing Christian Democratic–Social Democratic coalition against abolishing the option of telephone-based sick leave certification. According to the association, all available evaluations conducted by statutory health insurance funds consistently demonstrate that telephone certification has not led to increased misuse. On this basis, policymakers were urged to ground their decisions in empirical evidence rather than in conjecture or politically driven narratives. Demands from employer groups to eliminate the practice were described as lacking a solid evidentiary foundation. From the association’s perspective, telephone-based sick leave has proven to be an effective instrument for reducing administrative burdens, easing operational pressure on medical practices, and lowering infection risks by preventing unnecessary visits to physicians’ waiting rooms.
These arguments were reinforced by health policy representatives from both the Social Democratic Party (SPD) and the Green Party, who highlighted that the regulation is particularly valuable during seasonal surges of respiratory illnesses, helps avoid unnecessary physician-patient contact, and ensures low-threshold access to medical care. Within this framing, telephone certification was characterized not as an unrestricted entitlement, but as a narrowly circumscribed, physician-supervised option limited to mild and clearly defined conditions.
Government reviews telephone sick leave certification
Following public remarks by Chancellor Friedrich Merz, who questioned the practice and suggested that telephone-based certification may have contributed to Germany’s high sick leave rates, criticism of the policy intensified. In response, the Federal Health Minister announced a review of the existing rules, citing coalition agreements that commit the government to preventing abuse of sickness certification. While reaffirming support for these commitments, representatives of the SPD cautioned against turning telephone-based certification into a convenient scapegoat. They emphasized that the principal drivers of sick leave are well documented and structural in nature, including recurring respiratory infections, rising psychological stress, musculoskeletal disorders, and demanding working conditions involving significant physical or mental strain.
Furthermore, the chair of the Association of General Practitioners argued that the focus of the debate was misplaced, noting that short-term absences account for a relatively small share of total lost working days when compared with long-term illness. Although sickness certifications exceeding six weeks represent only a minor proportion of all cases, they generate a disproportionately large share of overall absence. From this perspective, it was argued that any meaningful reduction in total sick leave would require reforms aimed at improving efficient and medically appropriate reintegration into employment. Such reforms, the association suggested, should include binding improvements to Germany’s phased return-to-work model, making it mandatory for all employers rather than selectively applied.
Concerns were also raised by disability advocacy organizations, which warned that individuals with disabilities and chronic illnesses risk being marginalized in the current political debate. These groups argued that eliminating telephone-based certification could place an undue burden on people with limited mobility or heightened vulnerability to health risks, thereby exacerbating existing inequalities in access to care.
Taken together, critics of a rollback maintained that telephone-based sick leave certification remains a practical, regulated, and evidence-supported component of outpatient healthcare. They cautioned that abolishing the practice without addressing the underlying structural causes of sick leave would likely lead to increased costs, greater administrative complexity, and elevated infection risks, while failing to achieve any substantive reduction in overall absenteeism.
