The competent authority is required to establish a specialized medical service in order to fulfill its public health duties. In Lower Saxony, “public health officers” are defined as all physicians who work in these specialized medical services and have completed specialized training in the field of public health. (In the past, however, the term “public health officer” was typically used to refer to the medical director of the municipal health authorities.)

A key responsibility is to conduct medical examinations and assessments and to issue expert opinions, certificates, and attestations based on these. Many legal provisions expressly require an examination by a public health physician. They are also frequently commissioned even when this is not explicitly required. One reason for this is that public health officers are distinguished by their particular independence as well as their specialized additional expertise in the field of public administration. They work on behalf of other authorities as well as private individuals.

Public health physicians perform other duties as well, such as in the areas of preventive health care, infection control, and environmental hygiene.

Examples of public health officer duties and examinations conducted on behalf of government agencies:

• Pre-employment medical examinations for applicants to the civil service
• Determination of medical fitness to practice certain professions
• Assessment of civil servants’ fitness for duty
• Assessment of the ability of public service employees to work
• Assessments pursuant to the Social Code—Book XII (SGB XII)
• Determination of the medical necessity of therapeutic devices and aids, as well as therapeutic treatments and sanatorium stays, for public service employees
• Assessment of fitness for detention, fitness to stand trial, criminal responsibility, ability to work or earn a living, and legal guardianship for courts
• Determination of a person’s ability to travel, e.g., for courts and immigration authorities
• Determination of medical fitness to operate motor vehicles
• Determination of the need for long-term care in accordance with the Social Code—Book XI (SGB XI)

Examples of public health officer activities and examinations commissioned by private individuals:

• Students: Waiver of tuition fees for health-related reasons
• Students: Determination of inability to take exams for health reasons
• Students: Extension of the deadline for submitting a thesis due to illness / Certification of the need for a health retreat for the tax office
• Certification of the need for a health retreat for the tax office