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As a result of recent demographic developments, there has been an increased demand for high-quality health care. Among the various health professions, caregiving represents the largest professional group, numbering approximately 820,000 caregivers. Despite its size, this group is failing to meet basic conditions in line with international standards that secure adequate care. This failing is primarily due to the special path that Germany took regarding healthcare at the end of the nineteenth century and on which it continues to this day. It manifests itself in a heteronomy to which the professional group is permanently subjected by lobbies and policies that view health care from a perspective whose primary aim is to reduce unemployment. The present lack of organization of caregivers has frustrated their political assertiveness; and not least because of this, many caregivers leave the profession early. The profession itself is grappling with its professional identity. The development of expert standards, research into care, ethical reflections, as well as the struggle for common professional training are positive signs in this ongoing debate and are reflected in the positive feedback received from patients. The interdisciplinary dialogue between caregivers and physicians is in need of improvement. The first signs of progress are evident within the framework of health care ethics committees. This dialogue would certainly benefit both the professional group as well as the patients.

Ureterosigmoidostomies, cystoplasties, and orthotopic (ileo)colonic neobladders necessitate regular endoscopic evaluation from at least the fifth postoperative year. After ileal neobladders, conduits, and catheterizable ileocecal pouches regular routine endoscopy is not imperative.

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