In response, a new system is being proposed to facilitate easier access to specialist appointments, encouraging patients to cancel appointments early to allow for rebooking without incurring fees.

The discussion on implementing cancellation fees is ongoing and is part of coalition negotiations between the Union and SPD parties in Germany.

Gassen has previously criticized the appointment guarantee plan as poorly thought out, arguing it would be ineffective if many appointments remain unattended.

Currently, courts can impose fees for missed appointments that cause financial losses, but such cases are rare and typically only apply in exceptional circumstances.

While Gassen considers a proposed cancellation fee of up to 100 euros excessive, he supports a reduced penalty of 10 to 20 euros, which he believes is more reasonable.

However, the German Trade Union Confederation (DGB) condemned the doctors' proposals as 'absurd', arguing that they unfairly suspect patients of exploiting medical practices and that systemic improvements in healthcare access are necessary.

Andreas Gassen, chairman of the National Association of Statutory Health Insurance Physicians (KBV), reported that between 10 to 20 percent of booked appointments are now missed.

Doctors' associations in Germany are advocating for a penalty fee for patients who miss scheduled medical appointments without notice, as this 'no-show' issue significantly impacts other patients' access to care.

Federal Health Minister Karl Lauterbach criticized the proposed fees, emphasizing that the real issue lies in patients' difficulties in securing timely appointments rather than missing them.

The German Foundation for Patient Protection echoed this sentiment, highlighting that the lack of available appointments is a more pressing concern than the issue of missed appointments.

During ongoing coalition negotiations between the Union and SPD, the health working group discussed the challenges many insured patients face in obtaining specialist appointments.

This proposed system would require patients to first consult their general practitioner, who would refer them to specialists only when necessary, aiming to expedite appointment scheduling and improve healthcare delivery.