ENTherapy in Germany, as used here, means internal medicine (Innere Medizin): everything treated without a surgeon’s scalpel — the heart and blood pressure, lungs, stomach and bowel, kidneys, blood, metabolism, hormones and inflammatory joint disease. The word means different things to different people; this page is about the internist.
Psychotherapy, physiotherapy and rehabilitation are separate fields with their own pages. A patient from abroad with a tangle of complaints usually starts with an internist, not a narrow specialist: tiredness, stomach pain and swinging blood pressure may belong to one illness, and the internist sees the whole picture and decides who else is needed.
What a German Internist does
A German internist is a Facharzt für Innere Medizin: a doctor who has completed specialist training after medical school, passed the medical chamber’s examination, and treats the whole person rather than one organ. The field spans the heart and vessels, lungs, digestion, kidneys, blood, hormones and metabolism, the immune system and joints, infections and tumours, and the coordination of everyone in a patient’s care. A family doctor (Hausarzt) is the first port of call for any health problem at any age; a subspecialist such as a cardiologist trains longer and concentrates on one organ system.
This matters with several illnesses: drugs for different diagnoses act on each other, and someone has to see the whole list. An anti-inflammatory painkiller such as ibuprofen, taken for aching joints, can weaken blood pressure tablets and push the pressure up on its own. In a German hospital the internal medicine department holds that role.
Large hospitals split internal medicine into cardiology, gastroenterology, pulmonology, nephrology, endocrinology, haematology and rheumatology, each a separate internist specialty in Germany. The leading problem decides the department: breathlessness with swollen ankles to cardiology or pulmonology, unexplained anaemia to haematology or gastroenterology. Other fields are covered under treatment in Germany.
Why patients come
Most patients come with what could not be explained or controlled at home: blood pressure that stays high on several drugs, unexplained weight loss or exhaustion, recurring abdominal pain, breathlessness on exertion, or abnormal results — raised liver values, low haemoglobin, a high ESR — that never added up to a diagnosis.
The second common case is a diagnosis whose treatment is not working. The doctor then rechecks the diagnosis itself, how the drugs are really taken and what gets in their way. With blood pressure, that means confirming the tablets are taken as prescribed, measuring the pressure outside the consulting room to rule out the white-coat effect, looking for drugs that blunt the treatment and checking whether another condition is driving it up.
The third case is several chronic conditions at once, where the task is to make treatments agree rather than find something new. A cardiologist joins when the heart is central (heart treatment in Germany), an endocrinologist for diabetes and thyroid disease (endocrinology in Germany), a rheumatologist for inflamed joints (rheumatology in Germany); the internist keeps the overall plan.
How the appointment and the work-up run
The first appointment is a long conversation and an examination, not a list of scans. The internist retakes the history even when discharge letters are on the table: they often lack what changes the diagnosis, such as a drug bought without prescription, a symptom nobody wrote down or an illness in the family.
The work-up usually includes blood and urine tests, an ECG and an abdominal ultrasound, and where needed ambulatory blood pressure or rhythm monitoring, lung function tests, endoscopy, CT or MRI. ECG, ultrasound, ambulatory monitoring and lung function tests are part of the internist’s own training; specialists perform endoscopy and cross-sectional imaging. The list is written after the conversation, so the tests follow the complaints.
The basic work-up usually fits into one or two days, with fasting tests in the morning and results at the end; endoscopy, CT or a specialist opinion stretch it, so leave slack before the flight home. Without complaints, a preventive check-up in Germany fits better; for mainly digestive complaints, see digestive system diagnostics in Germany.
What happens once the results are in
There are three outcomes: the diagnosis is confirmed and the treatment adjusted; the diagnosis changes and treatment starts afresh; or a specialist or a procedure is needed — endoscopic, catheter-based or surgical — and the internist still holds the picture together so that new and old treatment do not clash.
The patient takes away a written report (Arztbrief) with the diagnoses, a medication list by active substance, since brand names differ between countries, and a monitoring plan with dates — the items worth translating, because the doctor and the pharmacist at home work from them. The plan is no formality: the WHO fact sheet on hypertension notes that most people with high blood pressure feel no symptoms, and advises taking medicines as prescribed and keeping appointments.
Frequently asked questions
Is an internist the same as a family doctor?
Not quite. In Germany the family doctor (Hausarzt) is the first port of call for any health problem, and some family doctors are themselves internists. An internist’s training, however, must include work on hospital wards, the emergency department and intensive care, and ends with an examination at the medical chamber.
What does the word Therapeut mean in Germany?
Usually a psychotherapist, a physiotherapist or an occupational therapist: a therapist in the broad sense, not a doctor of internal medicine. To find an internist, look for Internist or Innere Medizin; hospital departments are called Klinik für Innere Medizin or Medizinische Klinik, often with a number.
How much does an internal medicine work-up cost in Germany?
As a guide, a general medical assessment of one to two days costs around €1,650, and a consultation with a doctor on the results starts from €130. The exact sum is set by the hospital’s estimate (Kostenvoranschlag), issued in the patient’s name after the documents are reviewed; payment goes directly to the hospital.
How AlenMed arranges internal medicine treatment in Germany
AlenMed starts with a remote review of discharge papers and test results, then matches department and doctor to the complaint among 86 partner hospitals in 38 cities. We book the date, obtain the hospital’s written estimate, arrange the visa invitation and provide an interpreter at the appointment.
After the visit we translate the report, keep a line open to the doctor and set up a remote consultation when the treatment is revised; a second opinion can be arranged too. Our office is in Munich.
This material is for reference only and is not an offer. Diagnosis and treatment are decided by a doctor in person.