Schleswig-Holstein Medical Association

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The Schleswig-Holstein Medical Association is a corporation under public law (KdöR) established by the Schleswig-Holstein Medical Professions Act of February 29, 1996 (HBKG ). Its members are all doctors who work in Schleswig-Holstein or who have their main residence. It represents the interests of the medical profession and performs individual tasks of the public administration in Schleswig-Holstein in self-administration. They are financed by contributions from their members. The state of Schleswig-Holstein has legal supervision.

tasks

The tasks of the medical association are diverse. Belong to them

  • professional supervision of doctors by issuing professional regulations and monitoring compliance with professional duties
  • the standardization and organization of further training to become a specialist, including qualifications, including the implementation of examinations
  • Establishment and maintenance of a pension scheme for doctors,
  • Participation in a morally and scientifically superior profession,
  • mediation in disputes between doctors and between doctors and third parties,
  • Organization of advanced medical training through advanced training regulations, also by maintaining an academy for medical advanced and advanced training,
  • Preparation of statements on the regulations pertaining to the health system in draft laws and ordinances, including on hospital and university issues as well as problems of outpatient care,
  • Responsibility for the training of Schleswig-Holstein medical specialists (MFA), also by running a training center for inter-company training for MFA,
  • the management of the trust center of the Schleswig-Holstein cancer registry on behalf of the state of Schleswig-Holstein and
  • the provision of a medical emergency on-call service together with the Schleswig-Holstein Association of Statutory Health Insurance Physicians.

Particularly important and not a matter of course for a KdöR is the right of the Medical Association to represent the Schleswig-Holstein medical profession in the perception of their professional interests (representation of interests). This right has its limits when it comes to representing the rights of individual doctors and protecting the economic interests of the medical profession. The Medical Association also has no general political mandate. It charges its members a contribution to cover its costs. Currently (2018) the contribution per member is 0.6% of the income from medical work before taxes.

organs

Chamber assembly of the Schleswig-Holstein Medical Association (2003)

The organs of the Medical Association are the Chamber Assembly and the Board of Directors.

The Chamber Assembly consists of 70 members and is elected for five years. Women and men are to be considered in the formation of the Chamber Assembly according to their share. The more detailed provisions are regulated by an election ordinance of the supervisory authority. The Chamber Assembly decides on all matters of general importance to the Chamber, insofar as they do not only relate to current business. These include, in particular, the main statutes, the professional regulations and the further training regulations for doctors, the statutes on social institutions and the statutes on further training and quality assurance, the budget statute, contribution statute and the fee statute as well as the discharge of the board. The Chamber Assembly elects a board for the duration of its electoral term.

The board consists of the president, the vice-president and up to five other members. He conducts the business of the Chamber, using a management board. The President calls the Chamber Assembly and the Board of Directors and chairs their meetings. He represents the Chamber in and out of court.

Permanent committees elected by the Chamber Assembly are the Finance Committee, the Training Committee, the Professional Code Committee, the Training Committee and the Quality Management Committee. There are also numerous audit committees and other committees.

Facilities

The Medical Association maintains a care facility for all members, a vocational training facility for medical assistants (Section 71, Paragraph 6 of the Vocational Training Act) and an academy for medical training.

The medical association's pension facility provides professional care and offers doctors pension, disability and survivors' benefits. For doctors practicing the medical profession in Schleswig-Holstein, membership is compulsory. The pension institution also pays its beneficiaries child allowances and offers disabled members support with rehabilitation measures . It manages its own special fund and is not liable for the obligations of the medical association. Likewise, the assets of the Medical Association are not liable for the obligations of the pension institution. The contributions of the members and the assets of the pension institution are to be used for a specific purpose .

The Edmund Christiani Seminar (ECS) of the Medical Association is a training facility for medical assistants and carries out compulsory inter-company training as a supplement to training in the training companies. In each training year, all trainees to become medical assistants are instructed in the ECS for at least one week. During this time, training content is practiced that is difficult or impossible to convey in many training companies. In addition to cross-company training, the ECS offers a wide range of advanced and advanced training programs for medical assistants. It has well-equipped medical rooms for the successful implementation of the practical seminars. This includes practice rooms from the fields of medicine, laboratory, X-ray and administration as well as several theory rooms .

The academy for medical training is part of the training department of the Schleswig-Holstein Medical Association. It regularly offers courses and seminars in all areas of medical training. More than 250 advanced and advanced training events with more than 3000 seminar hours take place in the academy every year. Around 6000 participants train here every year. It conducts advanced training events primarily in its own premises in Bad Segeberg, but also outside, and complements the advanced training courses carried out by the regional medical associations. For this purpose, the academy has well-equipped rooms for large, medium and small events.

Schleswig-Holstein Medical Journal

The newsletters for the Schleswig-Holstein medical profession have an eventful history. In April 1866 - two months before the German War  - an edition of the communications for the Association of Schleswig-Holstein Physicians appeared for the first time nationwide for the area of ​​what was then Schleswig-Holstein . The editor was the board of the association, the lead was with Johannes Bockendahl . The "Mitteilungen (NF)", edited by Georg Hoppe-Seyler (1860–1940) since 1892 , was discontinued at the end of 1933 in the 42nd year. From January 1934, the Ärzteblatt for Hamburg and Schleswig-Holstein was published by the Association of Statutory Health Insurance Physicians in Berlin. Professional politics no longer took place either in the Ärzteblatt for Hamburg and Schleswig-Holstein or in the Ärzteblatt for Northern Germany, which appeared as a successor from 1939 . The booklet only had the task of communicating the orders of the Reichsärzteführung and the regional head of the Chamber and KV. In May 1941, the Ärzteblatt for Northern Germany was discontinued. For the next six and a half years there was no medical journal in Schleswig-Holstein.

It was not until 1948 that a bulletin for doctors appeared again with the approval of the military government: The Schleswig-Holsteinisches Ärzteblatt was published jointly by the Medical Association and the Schleswig-Holstein Association of Statutory Health Insurance Physicians . Until 1965, the editors were the managing physician von Kammer and KV Curt Walder (1895-?); His successor was Gerd Iversen (1916-2004). In 1989 the managing directors of the two corporations Bodo Kosanke and Karl-Werner Ratschko took over the editorial support together with the Lübeck ENT doctor Heinz-Peter Sonntag. Occupational and health policy were now the focus of the monthly issues. Notifications from the Chamber and KV have been moved to the irregularly appearing additional publications “Chamber Info aktuell” (Medical Association) and “Northern Lights” (Association of Statutory Health Insurance Physicians). Since 1998 the Schleswig-Holsteinisches Ärzteblatt has been published solely by the Medical Association; KV expanded its newsletter "Nordlicht aktuell" into a publication for contract doctors. Journalist Dirk Schnack has been head of Schleswig-Holsteinisches Ärzteblatt since 2009. The layout has been changed five times since 1948, and in its print version it now reaches more than 16,000 doctors in the “land between the seas”.

history

Medical associations already existed in Schleswig-Holstein in the entire Danish state , e.g. B. in Altona , Kiel , Schleswig and Süderdithmarschen , but none with supraregional importance for the Duchy of Holstein and the Duchy of Schleswig . On June 8, 1865 - after the German-Danish War  - on the occasion of the 3rd Baltic Congress in Kiel, the Association of Schleswig-Holstein Physicians was founded , initially with 142 members. As stated in the letter of invitation, the medical profession should be "compensated for the increased performance expected of them by improving their material performance and honored by the respect they deserve". With other formulations, the goal is still part of the medical professions law applicable to the medical association. The Schleswig-Holstein Medical Association became a focal point of professional medical policy for the province. The annual fee of 6 marks initially levied was increased to 10 marks in 1877. It not only covered the administrative costs, but also made a significant contribution to the costs of the support fund that was soon set up.

When medical chambers for the provinces were established in the Kingdom of Prussia in 1887 , the association was involved in the establishment of the chamber for the province of Schleswig-Holstein . The elections for the Medical Association were largely shaped and influenced by the Schleswig-Holstein Medical Association until its de facto dissolution in 1933 (it still existed until the Reichsärzteordnung came into force). Organized by the German Medical Association until 1931, the German Medical Association became a matter for the medical associations after the Second World War. In 1890 there were 17 regional independent associations, in 1925 there were 22. In 1890 they had between 10 and 20 members. Altona and the three Kiel clubs stood out with a significantly higher number of members. At the top in Kiel was the Association of General Practitioners for Kiel and the Surrounding Area with 80, followed by the Kiel General Medical Association with 47 and the Physiological Association with 29 members.

Provincial Medical Association in Prussia

In 1887 a medical chamber was set up for each Prussian province at the office of the head president . The chambers should deal with all questions and matters of the medical profession and public health care. The perception of the medical professional interests was part of it. The first meeting of the Medical Association for Schleswig-Holstein took place on January 18, 1888 in Schleswig. As in the following decades, the preparation of the election was carried out with the help of the Schleswig-Holstein Medical Association, whose top representatives defined the candidates for the electoral list as a so-called “unified list”. Your first chamber chairman was Julius Wallichs , Altona. Together with Karl Heinrich Christian Bartels , Johannes Bockendahl and Magnus Friedrich Steindorff , he founded the Schleswig-Holstein Medical Association in 1865. He was re-elected five times as chairman of the medical association until 1902. The Prussian law on the medical courts of honor, the distribution right of the chambers and the funds of the medical associations of November 25, 1899 increased the importance of the medical associations. They now became authoritative for the medical profession in Prussia. A code of conduct for the district of the Medical Association for Schleswig-Holstein was adopted on November 10, 1899 and January 26, 1900. In § 1 of the professional regulations of that time, there was already a general clause that is still valid today: "Every doctor is obliged to exercise his profession conscientiously and to maintain the honor and reputation of his class through his behavior in and outside of his profession."

During the time of the Weimar Republic , the Prussian law on medical associations and a medical association committee of December 30, 1926 were passed, with which regulations on medical associations that had been issued up to that point were summarized and amended. Among other things, it was regulated that a welfare institution with legal entitlement could now be resolved (§ 2), but only with the majority of the members of the Chamber Assembly (§ 38, 2) and the approval of the responsible minister (§ 2). The electoral term was extended from three to four years (§ 11). The legal capacity previously only granted to the medical associations' funds was transferred to the medical associations themselves. The medical associations became corporations under public law "without an official function" (§ 3). In the time of National Socialism , the Führer principle replaced the self-administration of the medical profession. In Schleswig-Holstein, at the beginning of May 1933, the little-respected NSDÄB district chairman and gynecologist Hans Köhler from Neumünster was appointed regional representative of the Reich Commissioner without resistance from the Schleswig-Holstein medical profession. At the beginning of April 1935, however, Köhler had to resign from all of his offices due to apparent incompetence, and his successor was the Segeberg surgeon SS-Obersturmbannführer Hans Rinne . The Schleswig-Holstein Chamber of Physicians had lost its previously existing independence and, after the Reichsärzteordnung came into force on April 1, 1936, as a subdivision of the Reichsärztekammer, which was bound by instructions, it also became a legal tool of the National Socialist medical leadership.

The provisional "State Medical Association" in the post-war period

After the collapse of the German Reich from 1933 to 1945 , the Reich Chamber of Physicians and the Association of Statutory Health Insurance Physicians in Germany (KVD) with their provincial subdivisions no longer had a basis for administrative action. However, the subdivisions were indispensable for maintaining a functioning health system. For this reason, in Schleswig-Holstein, with the approval of the British military government, the senior president commissioned the resident doctors Berthold Rodewald (Kiel) and Hans Stubbe (Heide) to take over the business of the medical association on a provisional basis , including the KV tasks . In the chaos of the post-war period in Schleswig-Holstein, which was completely overpopulated with refugees, the occupying power feared the collapse of medical care and the outbreak of epidemics . The admission of a sufficient number of doctors who had come to the country from military service and as refugees to practice with the health insurance fund urgently had to be regulated. Without a formal, legally binding basis, the Reichsärzteordnung (Reichsärzteordnung), which had been freed from National Socialist ideas, was used further. There were no legal bases for professional jurisdiction or specialist certification , and there were no valid election regulations. Rodewald recognized that quick relief was needed. As early as the summer of 1945, a draft law for a medical association law had been drawn up; it found the approval of the state government, but not that of the occupying power. The aim was to follow the Prussian Medical Association Act from 1926.

Despite the difficult traffic conditions and the unsafe postal routes, Rodewald and other active doctors succeeded fairly quickly in re-establishing medical district associations and in finding unencumbered doctors with professional political experience who could be elected as chairmen and confirmed by the military government. These district association chairmen formed the advisory group consisting of 20 chairmen for the “chamber commissioner”, who was soon to be called the president. A kind of parliamentary body was thus formed, which at the time referred to itself as the "State Medical Association". The first preparatory medical association meeting took place on June 30, 1945 in Bad Segeberg. A five-member board was formed at the direction of the military government. The administrative work was done by a managing doctor on behalf of the board, first by Karl Haedenkamp , then by Curt Walder . The tasks to be carried out by the Chamber were extremely difficult and on a scale as never before. Hundreds of thousands of refugees without medical care (1.2 million out of a total population of 2.65 million) were faced with an oversized number of unsupervised doctors (almost 700 versus 350 local doctors). The social hygiene problems, the rapidly increasing sexually transmitted diseases and tuberculosis with desolate accommodation conditions and the unimaginable lack of all necessary materials made the work of the chamber, which had to work under provisional conditions, more difficult.

Everything was overshadowed by the uncertain legal situation of the medical association. The Reichsärztekammer, which had never been officially dissolved, de facto no longer existed because it had ceased its activities as the central Reich institution. The subdivisions in the federal states continued to exist, as in Schleswig-Holstein, and performed their function as functionaries of the Reich Medical Association, which still existed de jure . However, this view was only consolidated through the case law of the Higher Administrative Court of Münster (1951), the 3rd Senate of the Administrative Court of Baden-Württemberg (1952) and other higher courts. Before that, there had also been opposing judgments. Until then, the necessary, but not undisputed, work of the medical associations had no reliable legal basis. In addition, there was the bad mood in the medical profession. She wasn't doing well. The successor organization to the Reich Medical Association was viewed with suspicion. There was strong resistance in the medical profession, including dissatisfaction and bitterness. Decisions made by the Chamber, which were perceived as particularly detrimental, led to personal attacks and denigrations of the Chamber's acting heads. Even more severe were the obstacles created by the sometimes incompetent commissioners of the lower administrative levels appointed by the occupying power .

Schleswig-Holstein Medical Association

At the latest after the entry into force of the Basic Law of the Federal Republic of Germany , a Medical Association Act was overdue. The law passed unanimously by the state parliament on December 7, 1953, entered into force on January 1, 1954, without the Chamber's concerns being taken into account. The law on professional jurisdiction followed on February 22, 1954 and came into force on April 1, 1954. However, from the medical profession's point of view, the long-awaited Medical Association Act had considerable errors. No subdivisions were allowed to be created, the limitation of the medical association's sphere of activity only to doctors who were active as doctors and the lack of authorization for the medical association to create health care facilities with mandatory membership met with considerable criticism. Changes in the interests of the medical profession with the possibility of mandatory medical care for all as well as compulsory membership for all Schleswig-Holstein doctors followed with an amendment in 1959. In the decades that followed, the medical association became an indispensable part of Schleswig-Holstein health policy and administration. Responsibility for the training of medical assistants, the creation of an ethics committee, the establishment of a central advanced training facility for doctors and a training facility for medical assistants, essential involvement in quality assurance in hospitals and an epidemiological , and since 2016 clinical cancer registry, are just a few of the larger projects that can be named.

literature

  • Karl-Werner Ratschko : The Basic Law of the Chamber. Association as a result of the professionalization of the profession. When the Schleswig-Holstein Medical Association Act came into force 60 years ago . Schleswig-Holsteinisches Ärzteblatt, October 2014, pp. 42–49. Digitized

Web links

Remarks

  1. ↑ Schleswig-Holstein was part of the Danish state until 1864 with the duchies of Schleswig and Holstein. At that time Lauenburg did not belong to Denmark, but was ruled by the Danish royal family in personal union. The duchies of Schleswig and Holstein became a Prussian province in 1867 as a result of the German-Danish and Prussian-Austrian wars . The Duchy of Lauenburg initially remained independent under the Prussian King Wilhelm I and only became a district in Schleswig-Holstein in 1876. As a free imperial city, the Hanseatic city of Lübeck , like the principality of Lübeck to the north of it, neither belonged to the province of Schleswig-Holstein nor to the Kingdom of Prussia . Lübeck was given its own chamber law in 1903, corresponding to its status as a free imperial city , which was also linked to a law on honorary jurisdiction and a new professional code. The principality was part of the Grand Duchy of Oldenburg . In 1912, a state treaty between Prussia and Oldenburg agreed that his doctors would belong to the Schleswig-Holstein Medical Association. Altona and Wandsbek were Holstein districts at that time. Only with the Greater Hamburg Law in 1937 did Lübeck and the Oldenburg Province of Lübeck (as the Eutin district ) become part of Schleswig Holstein. Altona and Wandsbek came to the Hanseatic City of Hamburg at that time. Nordschleswig became Danish in 1920 as a result of a referendum. Apart from a few minor changes in the area, these are still the territorial borders of Schleswig-Holstein today.
  2. ↑ The provincial office of the KVD was incorporated into the state medical association until the Basic Law came into force. Then it became independent (also at state level) as the Association of Statutory Health Insurance Physicians Schleswig-Holstein with its own board of directors and its own assembly of representatives.
  3. ↑ There are thorough investigations regarding the details of the efforts to establish medical chamber laws in the three western occupation zones with the help of a Northwest German Chamber Committee and the working group of the West German Medical Chambers founded on June 14, 1947 in Bad Nauheim (since 1955 Federal Medical Association). Thomas Gerst: Medical professional organization and professional politics in Germany 1945–1955 (Medicine, Society and History, Yearbook of the Institute for the History of Medicine of the Robert Bosch Foundation, edited by Robert Jütte, Supplement 21), Stuttgart 2004.
  4. ↑ Rodewald found particular help from his colleagues Stubbe in Heide, Wassmund in Pansdorf and v. Rohden, Dillner and Kröner in Lübeck.

Individual evidence

  1. ^ Pension facility of the Schleswig-Holstein Medical Association
  2. ↑ Legal basis of the pension institution
  3. ^ Karl-Werner Ratschko: Regional mouthpiece. Schleswig-Holstein medical papers have been around for 150 years. The history of regional class politics can be traced in them .
  4. ^ Julius Wallichs: The Association of Schleswig-Holstein Doctors 1865–1890 , Kiel 1890, p. 2 f.
  5. ↑ Legal basis of the Schleswig-Holstein Medical Association
  6. ^ Wallichs, p. 14.
  7. ↑ Julius Wallichs, Wilhelm Henop: Professional organization and associations of doctors in Schleswig-Holstein along with laws, ordinances, contracts, etc. that are important for doctors . Altona 1906, p. 22.
  8. ↑ William Henop: The association Schleswig-Holstein shear doctors 1865-1925. A review and its development , Altona 1925, p. 12. Cf. Paul Graf: Zur Kammerwahl . Communications for the Schleswig-Holstein Medical Association, 40th year (1931), issue 2, p. 48 f.
  9. ^ Wallichs, Julius Peter Wilhelm (zeno.org)
  10. ↑ Münchner Medizinische Wochenschrift, No. 17 of April 28, 1903, p. 744
  11. ↑ Henop, p. 17.
  12. ↑ cf. Wallichs / Henop, p. 48
  13. ↑ Law on the Medical Associations and a Medical Association Committee of December 30, printed in communications for the Association of Schleswig-Holstein doctors, vol. 40 (1934), pp. 51–64.
  14. ↑ K.-W. Ratschko: The Path of the Medical Association and KV in Schleswig-Holstein from 1934 to 1936 (2010)
  15. ↑ B. Rodewald: Freedom, law and order for the medical profession. The medical associations in the post-war period , Schleswig-Holst. ÄBl., Volume 19 (September 1966) p. 307 a. Inadvertently, the page numbers were assigned twice in this year in August and September, which is why the month is mentioned here and the September page number is marked with an added "a".
  16. ↑ B. Rodewald: The State Medical Association of Schleswig-Holstein 1945-1947 . Schleswig-Holst. Ärzteblatt 5th year (1948), p. 4
  17. ↑ Rodewald, State Medical Association, pp. 5, 20.
  18. ↑ Rodewald, State Medical Association, p. 35 f
  19. ↑ a b freedom, p. 308 a.
  20. ↑ Ernst Atzbach: Basic questions of medical chamber legislation and professional jurisdiction and their relationship to the Basic Law with special consideration of the historical development of professional law , Dissertation Marburg, Marburg 1960, p. 20 f.
  21. ^ Notices from the State Medical Association : Legal status of the Medical Associations and Associations of Statutory Health Insurance Physicians , Schleswig-Holst. ÄBl. 5th year (1952), p. 306.