General practice in the German Democratic Republic (1949-1990) : Adiscipline between threat and professionalization.

Abstract

In the 1950s the socialist health policy in East Germany did not follow aclear-cut course with regard to outpatient medical care. Whilst state-run policlinics gradually took the place of doctors in private practice, the required qualifications of physicians working in outpatient care remained unclear. After preparatory lobbying by committed physicians from the outpatient sector, the 1960 Weimar Health Conference finally paved the way for the preservation and professionalization of general practice in East Germany. The article analyzes the formation of general practice as aspecialty in East Germany between 1945 and 1990. We scrutinize the status of general practitioners and their field in the socialist health system as well as the foundation of their medical society. Our paper aims to contribute to abroader history of general practice in Germany. We draw on literature from that time, unpublished archival material, and interviews with contemporary witnesses. After the establishment of standards for specialist training in the early 1960s, general practice was introduced as afield of specialty in 1967. By this, East Germany had acompulsory specialist training in general practice much earlier than West Germany. In 1971, aspecialist society for general practice was founded in East Germany. However, institutionalization at the medical faculties was still lacking. Meanwhile, the nationalization of outpatient care continued. In the years that followed, primary medical care was increasingly provided in policlinics. In 1989, of 40,000 physicians in the GDR, only about 340 were still practicing in their own offices. Within the nationalized GDR health system acommitted group of physicians, under difficult political circumstances, pushed for professionalization of general practice and its recognition as afield of specialty. When general medicine was recognized as aspecialty in 1967, this happened earlier than in other countries and constituted an important milestone.