Wide-ranging options for medical treatment in Berlin
Patients who come to Berlin seeking treatment for a medical condition will find the entire spectrum of medical expertise in every medical department here. In the city’s 90 or so hospitals, specialists in all areas work together on an interdisciplinary basis. In addition, there are roughly 9,200 doctors in outpatient practices specializing in specific fields or rare sub-disciplines. They can provide the exact help needed by patients with rare or highly complex conditions.
This page provides basic information about those areas of medical treatment most commonly required by patients. The selection lists indicate those hospitals and medical practices which specialize in the medical department in question.
Medical departments overview
Obesity, an accumulation of excess body fat, can have a variety of causes. Eating too much of the wrong things can often play a part, as can a lack of exercise. Obesity can also result from a metabolic disorder, e.g. a malfunction of the thyroid gland. If a person is seriously overweight, they run a high risk of contracting further diseases, including cardiovascular problems, high blood pressure, diabetes, arteriosclerosis and degenerative spinal diseases.
Normally, the first step towards treating obesity is to make lasting changes to the patient’s diet. A comprehensive dietary plan is compiled, as is an exercise regime that involves increased energy expenditure to lower body fat. In addition, psychotherapy may support the patient in implementing these lifestyle changes.
If these treatment methods prove unsuccessful, surgery may be an option – typical procedures include gastric band, gastric sleeve or gastric bypass surgery. These reduce the size of the stomach so that it no longer holds as much food. Other procedures, such as biliopancreatic diversion, bring about weight loss as a result of malabsorption. Any kind of weight loss surgery requires long-term and regular monitoring of patients. After significant weight loss, many patients choose to undergo plastic surgery to tighten their skin. The most common procedures involve tightening the abdominal wall or the skin of the upper arms and thighs.
We now know that reducing stress, eating a healthy diet and taking sufficient exercise can help prevent many cardiovascular diseases. Nonetheless, the number of such diseases is rising worldwide, including diseases of the arterial, venous and lymphatic systems. Arterial circulatory disorders such as those caused by arteriosclerosis may be life-threatening if they obstruct the flow of blood to the heart or brain. In such cases a cardiologist must intervene by fitting a bypass or stent.
Patients with a congenital heart defect or serious heart disease require cardiac surgery, which in some cases may be very extensive. Highly-specialized surgeons can perform a wide range of procedures, from heart valve replacements and the implantation of an artificial heart to a complete heart transplant. Paediatric cardiac surgeons provide care for even the tiniest patients to ensure that they get off to a healthy start in life.
Healthy teeth play an important part in good overall health. All kinds of general complaints such as backache, headache or tinnitus may in many cases be caused by problems with the teeth or chewing apparatus. And the reverse is also true: many diseases (e.g. blood diseases, cancer, infections) involve symptoms in the oral cavity. This is why dentists often collaborate with experts in other disciplines such as orthodontics, osteopathy, neurology and maxillary surgery.
The most common causes of excruciating toothache are exposed necks of the teeth, corroded enamel, caries, gingivitis and periodontitis. Conservative dental treatment aims to diagnose the caries, remove any demineralized and infected parts of the tooth, and reconstruct the tooth using appropriate material. If a tooth cannot be preserved, a crown, bridge or implant can be used to replace it. Aesthetics play an important role in dentistry alongside medical considerations.
To ensure healthy teeth, it is important to learn how to clean one’s teeth properly, starting in early childhood. A diet containing as little sugar as possible is also essential. To maintain good oral health, regular check-ups and professional dental cleaning are very important.
Being the largest organ of the human body, the skin has an extremely wide range of functions. It protects us from the sun’s rays, cold and heat, and prevents pathogens from entering the body. As a sensory organ, skin is also very important because it allows us to touch and feel our surroundings. Serious skin diseases such as skin cancer are caused by external factors or other organic diseases. Because they are so visible, they often pose a considerable problem for those affected.
For dermatology specialists, one of the most important diagnostic tools is to talk in detail about the patient’s medical history. This helps possible reasons for skin changes to be identified and thus allows appropriate treatment to be planned. One common examination is performed using a reflecting microscope that enables the dermatologist to see deep into the layers of the skin. This technique is particularly useful when it comes to the early detection of life-threatening malignant melanomas.
Diabetes mellitus is a metabolic disease associated with a pathologically increased blood sugar level. Forms of the condition include type 1 and type 2 diabetes (the latter also being known as “adult-onset diabetes”), as well as other types such as gestational diabetes. Because of its high prevalence, diabetes is already being described as the “epidemic of the 21st century”.
Typical signs of diabetes are weakness, infections and constant thirst. If left untreated, diabetes can result in dangerous secondary conditions and later consequences such as a heart attack, stroke, retinal or kidney damage or even a condition known as “diabetic foot”. An early diagnosis and permanent treatment are therefore essential for diabetics.
Diabetes management courses train patients how to monitor their condition and take proper care of themselves long-term. They learn how a healthier lifestyle, including for example regular exercise and a balanced diet, can reduce their blood sugar level. They are also taught how to measure their blood sugar themselves, and how to administer drugs such as insulin.
Ear, nose and throat (ENT) medicine treats diseases of the eye, nose, paranasal sinuses, mouth and throat. Diagnostic techniques are used for example to analyse functional disorders connected with smelling, hearing and tasting, to explore problems with balance or to detect tumours in the head and neck region.
Numerous patients from abroad travel to Germany to have a cochlear implant fitted at a specialized clinic. An electrode implanted in the inner ear, in conjunction with professional auditory training, enables deaf and hearing-impaired patients to regain much of their hearing. Some ENT clinics also specialize in rhinoplasty, a form of plastic surgery to correct the size or shape of the nose. Removal of the tonsils and correction of the nasal septum are also common procedures.
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Not all couples wishing to have a baby find themselves able to conceive without medical help. This can often pose a considerable burden on a family, prompting them to seek advice at a specialized fertility clinic.
The first step is to diagnose the possible cause in either the woman or the man. The woman will be asked about the history of her menstrual cycle, and ultrasound or endoscopic procedures are performed to examine the reproductive organs. Men undergo manual and ultrasound examinations and have their semen analysed and their hormone levels checked.
Depending on the diagnosis, a variety of treatment is available. This can involve medication such as hormone therapy, surgery or artificial insemination. Experienced experts are familiar with the entire spectrum of possible causes and know about all the different ways to diagnose and treat infertility. They draw up a suitable treatment plan in discreet and confidential consultation sessions with the families.
Patients with a gastrointestinal inflammation or infection will feel very ill and will generally require quick medical help. The most common complaints include inflammations of the oesophagus, gastric mucosa, stomach and bowel, as well as intestinal infections caused by pathogens or parasites. Unfortunately, cancer is also very common in the gastrointestinal tract. Stomach cancer is often attributable to genetic factors or is brought about by a poor diet, smoking and alcohol. Bowel cancer is the most frequent malignant tumour found in the digestive tract, though it can be treated well if detected at an early stage.
Doctors specializing in internal medicine use a comprehensive range of diagnostic measures so as to be able to correctly assess and treat such diseases. These include gastroscopy and colonoscopy. During the course of these endoscopic examinations it is even possible for the doctor to perform minor surgical procedures such as a biopsy or the removal of polyps.
Regular prophylactic colonoscopies can significantly lower bowel cancer morbidity and mortality. Early detection allows treatment to begin in good time, helping to save lives.
When the arms and legs do not receive a sufficient supply of blood, arteriosclerosis is often to blame – whereby deposits in the blood vessels cause them to harden and narrow. This increases the risk of vascular occlusions throughout the body, which can lead to coronary heart disease, circulatory problems in the brain or a stroke. Vascular surgery is responsible for treating the blood vessels, and encompasses conservative, endovascular and surgical procedures. These may include placing a bypass or surgery to treat an aneurysm.
Vascular and visceral surgeons work in close cooperation in most hospitals nowadays. Visceral surgery is concerned with the surgical treatment of the digestive organs and the liver, spleen and pancreas. In recent years, it has increasingly employed minimally-invasive techniques and laparoscopy. Such keyhole procedures reduce surgical trauma, shorten hospital stays and minimize the need for painkillers. In addition, later complications such as adhesions and incisional hernias are minimized.
Gynaecology is concerned with the female reproductive organs, e.g. the uterus, ovaries and fallopian tubes, as well as with the breasts. A wide range of diagnostic procedures are used to check for gynaecological diseases, including ultrasound, manual and visual examinations, tissue sampling and smear and swab tests. A mammography to examine the breasts is also one of the procedures performed by gynaecologists.
As well as preventive measures, gynaecology also encompasses surgical and conservative treatments, including hormone replacement therapy, contraception and family planning procedures.
Obstetrics is a distinct branch of gynaecology that supports women throughout normal or complicated pregnancy and childbirth. International patients are advised to find a suitable maternity clinic soon after arriving in Germany. Regular check-ups during pregnancy can determine whether a natural birth is possible or whether a caesarean section should be planned. If a woman gives birth in a hospital, midwives are always in attendance alongside the doctors. The midwife is responsible for the care and examinations of mother and baby after birth, answering questions about care, diet and breastfeeding.
Naturopathy as practised in Germany aims to do without chemical pharmaceuticals as far as possible, using natural remedies and therapies to support the body’s powers of self-healing. Methods of treatment are extremely diverse – the patient’s condition and particular illness will determine whether and which naturopathy treatment is appropriate. It is crucial for the patient to play a conscious and active part in the healing process.
Light, fresh air, exercise, rest, diet, breathing and emotions play an especially important role in healing. Classic fields of naturopathy include herbal medicine, hydrotherapy, exercise therapy, nutrition therapy and regulative therapy. In a wider sense, naturopathy also encompasses homoeopathy, traditional Chinese medicine (TCM) and Ayurvedic medicine.
Naturopaths are often doctors who have completed their specialist medical training and then undergo extensive further training to receive an official additional qualification in naturopathy from the German Medical Association. In Germany, one can also become a state-recognized alternative practitioner who does not have to be a licensed doctor but has taken a state examination following several years of training.
Chronic kidney disorders are on the increase nowadays, partly as a result of widespread diseases such as diabetes mellitus and high blood pressure. If left untreated, these conditions can lead to chronic renal insufficiency. In this case, patients will only survive if they are given renal replacement therapy (dialysis or a kidney transplant).
Nephrology is a sub-discipline of internal medicine and is concerned with kidney diseases and hypertension. It covers prevention, diagnostics, all non-surgical treatments and follow-up care. Performance of extracorporeal blood purification techniques (dialysis, apheresis, immunoadsorption) and the care of patients with a kidney transplant also fall within the scope of nephrology.
Because kidney diseases often entail no symptoms or pain at first, their early diagnosis is particularly important. If detected early enough, the loss of renal function can still be prevented or at least delayed, meaning that patients are spared dialysis. This is one reason why specialists always advise patients to have their kidney function regularly assessed by their GP.
Neurological diseases affect the nervous system or the brain. Because symptoms can often be described only by the person affected, a detailed discussion of their medical history is an important part of the diagnostic process. The specialist talks to the patient and his or her family about the history of the disease, how it has developed over time and its intensity. Tests of motor and sensory function and coordination, together with lab results and possibly tissue samples, are used to arrive at an initial diagnosis.
To identify the current state of a disease and to plan treatment, neurologists use electroencephalography (EEG) to measure the electrical activity of the brain, and electromyography to assess muscle function. Highly precise imaging of the vessels that supply the brain with blood is achieved using Doppler and duplex ultrasonography. Imaging techniques such as computer tomography (CT) and magnetic resonance imaging (MRI) complete the exacting process of diagnosing these complex diseases.
This allows specialists to provide effective treatment for patients suffering from strokes, neural conditions such as multiple sclerosis and Parkinson’s, headaches and migraines. As brain research is advancing just as quickly as new drugs are being developed, neurology can offer great hope to those patients concerned.
Neurosurgery is a discipline that deal with diseases, malformations and injuries of the central and peripheral nervous system. The central nervous system (CNS) encompasses the brain and spinal cord, while the peripheral nervous system (PNS) refers to the nerves outside the cranium and spinal cord.
In the past, operations on the cranium and spine often entailed a high level of risk and long recovery times, but nowadays modern imaging methods and keyhole techniques allow surgery to be performed with minimum impact. For the patients concerned, this means less risk, less pain and a quicker recovery process. Minimally-invasive procedures are already being used in tumour surgery, microsurgery on aneurysms and in spinal surgery.
Pain therapy is an important branch of neurosurgery, too. Specialists can also use minimally-invasive methods here to reduce pain arising from a slipped disc, spinal stenosis or carpal tunnel syndrome.
A cancer diagnosis often comes as a shock to patients and their families. Tumours frequently develop slowly and go unnoticed without showing any symptoms, and in many cases are detected by chance. Because cancer can often be treated well in its early stages, regular check-ups are particularly important.
According to the WHO, lung, breast and bowel cancer are the most common types of cancer worldwide. Treatment methods depend on the type and stage of the cancer. Every kind of tumour is different, and the course it takes can differ from person to person, meaning that each patient requires individualized treatment.
Cancer is treated by surgically removing cancerous tissue and/or with radiation and chemotherapy. Hormone therapy is used to block the body’s own hormones and thereby prevent a tumour from spreading. Blood stem cell transplants may also be necessary, for example for leukaemia patients who need healthy bone marrow following chemotherapy or radiation.
Eye diseases may affect the front part of the eye, such as the eyelid, conjunctiva or lens, or the rear section such as the retina or optic nerve. The function of the eye can be impaired by a malformation or refractive error such as an astigmatism. The eye may also be affected by systemic conditions: a rheumatic disease for example can dry out the mucous membranes in the eye, while diabetes can cause retinopathy. When treating diseases of the eye, ophthalmologists thus work closely together with specialists in other fields.
In Germany, the most common type of eye surgery – with over 650,000 procedures being performed each year – is cataract surgery. This involves replacing the lens affected by the cataract with an implant. Other ophthalmological procedures include glaucoma treatment and surgery of the cornea, vitreous body or retina. Surgery as an alternative to corrective lenses is also very popular, such as LASIK, PRK, LASEK and other types of laser surgery.
A healthy locomotor system is essential for our wellbeing as it makes an important contribution to our quality of life. The muscle and joint problems that increasingly come with old age are accompanied by pain and severely restrict us in our everyday lives. Arthrosis, osteoarthritis, back pain and osteoporosis are typical orthopaedic complaints. Orthopaedic specialists also treat fractures following an accident, as well as spinal injuries.
Most patients who travel to Germany for orthopaedic treatment wish to undergo joint replacement surgery and receive an artificial knee or hip.
Before any orthopaedic procedure begins, a comprehensive diagnosis must be carried out, if necessary using X-rays or MRI and CT scans. Wherever possible, preference will be given to conservative treatment so as to avoid surgery. If surgery is the only option, Berlin’s hospitals have the very latest medical equipment at their disposal. A slipped disc for instance can be corrected by performing a minimally-invasive procedure. A follow-up course of rehabilitative therapy allows patients to quickly regain their mobility.
Paediatric medicine covers the same specialist areas as adult medicine while taking into account the fact that the body is still growing and therefore has special requirements. Experts in paediatric cardiology, nephrology and orthopaedics are highly trained specialists with very specific qualifications. All medical examinations and treatments are performed on an interdisciplinary basis so as to guarantee the child’s overall wellbeing.
Families from abroad often travel to Germany to have a child treated for a particular medical condition in a paediatric clinic. The healthcare on offer in their home countries may not always be sufficiently geared to the needs of paediatric patients, or the family in question may hope that additional diagnostic insights will help the right treatment to be found for their sick child. It is essential that the family bring details of the latest diagnoses and information about the course of the disease so far and to make this available to the doctors in Germany. In addition, the doctors will require a description of the child’s developmental stage and current problems.
Numerous paediatric clinics in Germany have been awarded a special quality certificate for their inpatient care. To obtain this certificate, clinics are evaluated according to quality criteria to ensure that they guarantee to provide high-quality and age-appropriate care to children and young people. One of the aspects that improves their score is if parents are actively involved in the recuperation process, for example if one parent is allowed to stay with the child in hospital.
In plastic and aesthetic surgery, organs and tissue undergo procedures that aim to change the shape of the body. Plastic surgeons are called for when complex reconstructive surgery is needed, for example following an accident, burns or other surgery. They also operate on the hands and face or optimize body contours. Because this field requires not only expert medical knowledge but also a great deal of experience and skill, the title “Specialist in Plastic and Aesthetic Surgery” is a separate and legally protected qualification in Germany. It requires a comprehensive course of further medical training.
Patients wishing to change their appearance often have a strong subjective sense of their own suffering. Increasing numbers of younger patients are opting to have corrective nose or breast enlargement surgery, whereas older patients tend more towards corrective facial procedures such as the treatment of wrinkles, eyelid surgery or even a facelift.
Aesthetic surgery also plays an important role in the treatment of obesity. After losing a large amount of weight, patients are often left with saggy skin and therefore decide to have liposuction on the stomach, upper thighs or upper arms.
Respiratory diseases can affect the nose, mouth, throat, windpipe or lungs. The most common respiratory conditions are asthma, chronic obstructive pulmonary disease (COPD), pneumonia and lung cancer. Typical symptoms suffered by patients affected by these diseases are coughing and hoarseness, a sore throat, difficulty breathing or a shortage of breath.
In addition to a full patient history, plus palpation, percussion and auscultation of the chest, a pulmonologist may order further diagnostic procedures such as an ultrasound, X-rays or CT scans. The doctor can assess lung function by means of spirometry, ascertaining the volume of air that is inhaled and exhaled. Lung scintigraphy involves using radioactive rays to image the bloodstreams and air flows. In addition, endoscopic procedures are used to examine the lung, e.g. bronchoscopy or thoracoscopy. Exacting diagnostic procedures, involving a biopsy if necessary, are essential to obtain a precise diagnosis and be able to rapidly treat the pulmonary diseases.
A medical diagnosis aims to analyse a patient’s manifest complaints, subjective concerns and familial dispositions. A professional diagnosis includes a detailed discussion of the patient’s medical history, a comprehensive physical examination, and other equipment-based tests. In many cases the diagnosis is the first step, allowing a treatment plan to be compiled and a hospital stay prepared.
While many diagnostic procedures can be performed on an ambulatory basis, invasive measures require a hospital stay. In some cases, it may make sense for a patient to be admitted as an inpatient so that several analyses can be carried out on consecutive days. To reduce travel and waiting times, many hospitals offer inpatient diagnostic services for the patient’s convenience.
Diagnostics can also be part and parcel of preventive medicine. From the age of 55, for example, German health insurance companies will pay for patients to undergo a colonoscopy and for a general medical check-up every two years. The aim is to detect common conditions such as cardiovascular diseases, renal disorders or diabetes at an early stage. Exercise, a healthy diet and measures designed to reduce stress can also play an important part in combating the causes of some diseases. The attending doctor summarizes the examination findings in an easily comprehensible report and gives the patient specific recommendations and advice.
Psychological disorders are among the most widespread diseases nowadays. According to a WHO study, one in ten people worldwide suffers from depression or anxiety disorders, no small number of them having to undergo inpatient treatment at a psychiatric or psychosomatic clinic. Burnout and dementia are also common psychological diseases.
Only an experienced psychiatric expert or psychotherapist can make a clinical diagnosis. This involves assessing whether the patient is suffering from one particular or indeed several psychological disorders, and how pronounced these are. This is important because the type of therapy can differ considerably depending on the kind and severity of the disease.
Disorders of the cerebral metabolism may play a part in some psychological diseases. In this case, drugs (known as psychotropic drugs) can be used. Psychotherapy is also a scientifically founded method of treating psychological diseases.
Patients coming from abroad need to consider in advance whether it makes sense to undergo therapy in the presence of a trusted interpreter. It is also important to remember that psychotherapy is a lengthy process that can rarely be completed in just a handful of sessions.
After an operation or serious disease, rehabilitation may help the patient concerned to resume a healthy and independent lifestyle. Depending on the particular situation and illness, rehabilitation may include physical therapy, speech therapy, physiotherapy, equipment-based training and many other types of therapy. Specialist rehabilitation doctors accompany the patient on their path back into normal life. This may happen on an inpatient basis in the hospital or in an outpatient clinic.
Among the most common indications for rehabilitation are neurological diseases such as a stroke. Once the condition has been treated in the hospital, early-phase rehabilitation begins, initially stimulating the patient’s motor and sensory functions. Patients may then be taught by an occupational therapist how to dress or wash themselves. During the subsequent phase, patients prepare themselves for everyday life outside the hospital, practising routine processes and gaining in confidence. Besides neurological rehabilitation, a patient may be offered orthopaedic rehabilitation following an operation, cardiological rehabilitation after a heart attack or oncological rehabilitation following cancer therapy.
Rheumatic diseases tend to be very painful and inflammatory conditions. They can affect people of all ages, even children and adolescents. Rheumatoid arthritis is particularly common and involves very painful joints, though soft tissue (muscles, ligaments and tendons) can be affected as well as joints and bones.
Rheumatology is a sub-discipline of internal medicine that is concerned with diagnosing and treating autoimmune disorders, which tend to be chronic. Examples of common rheumatic conditions are rheumatoid arthritis, soft tissue rheumatism, ankylosing spondylitis, joint inflammation due to infection or psoriasis, and systemic lupus erythematosus. Most non-inflammatory rheumatic conditions are symptoms of ageing or wear, or are due to injuries that can be treated by specialists in orthopaedics.
Anti-inflammatory drugs are used to treat rheumatic diseases. Additional relief can be provided by physiotherapy, occupational therapy or physical therapy. For some patients with a rheumatic condition in an advanced stage, surgery is the only option, the affected joint being either stiffened or replaced by an artificial one. A special diet can often have a positive impact on the therapy outcome.
For patients suffering from a severe heart, liver, kidney or lung function disorder, an organ transplant is often their only hope. In Germany alone, several hundred patients are currently waiting for a donor heart. Human organ transplants are subject to a strict transplant law in Germany. It stipulates among other things that a patient must receive a donor organ based on their degree of need and the chances of a successful outcome, and not according to financial criteria. Transplants are performed exclusively in certified transplant centres.
The kidneys and parts of the liver can be transplanted as living organs. Before the transplant is performed, extensive tests are conducted to ensure the compatibility of donor and recipient. New techniques mean that kidney transplants can be carried out even if donor and recipient have different blood groups. The entire process is subject to extremely high requirements. In Germany, living donations are only permissible between close relations or those with close personal ties. To rule out any psychological dependence or possible coercion, extensive psychological tests are carried out in addition to the medical examinations.
Improved surgical techniques and advances in immunotherapy mean that the chances of a successful organ transplant have risen considerably. Follow-up care is an intensive phase lasting roughly four to six weeks, and is the critical stage of treatment. Any patient who receives a donor organ will have to take drugs for the rest of their life to protect against transplant rejection. Regular check-ups will also be necessary for the rest of the patient’s life – at very short intervals at first, and gradually with longer and longer gaps. Before undergoing a transplant, international patients should therefore ensure that they can obtain the necessary after-care and continual check-ups in their home countries.
Urology is the field of medicine dealing with diseases and problems relating to the kidneys, bladder and ureters, and with male health issues. One of the male organs most commonly treated is the prostrate, whose benign enlargement is among the most frequent urological conditions.
The range of treatment available to treat serious urogenital problems extends from medication to surgery. One standard procedure is known as transurethral resection of the prostate, which involves removing tissue using an endoscope. The HoLEP laser technique is also well-established in prostate surgery. It allows tumours to be treated and tissue samples to be taken.
Unfortunately, prostate cancer is a widespread disease all over the world. In Germany it is even the most common form of cancer contracted by men. However, the sooner the cancer is diagnosed, the better the chances are of it being cured, which is why it is so important to visit a urologist for regular check-ups.