GERMAN MEDICAL ORGANIZATION
Before 1933
Two years after the reconstitution of the German Reich, in 1871, the German Medical Association (Deutscher Aerztevereinsbund) was created, which tied together the older local medical associations. This society existed until it was abolished by the Nazi Government. Its structure was democratic, and its interests included problems of hygiene and public health, and to an increasing extent, socio-medical problems especially in the field of sickness and disability insurance.
Bismarck’s legislation of 1881 established compulsory sickness insurance for workmen. In the course of the ensuing years, the vast bulk of the workmen were insured, and consequently most of the ordinary physician’s patients came to be insured patients. There were lists of physicians authorized to treat insured patients, and it was a matter of vital moment to every practicing physician to be listed. To protect their interest with respect to listing, fees, and other such problems, the German doctors founded a voluntary association for the defense of their economic interests known as the Hartmann Bund.
Questions of professional ethics, medical malpractice, etc., were handled in Germany in two distinct sets of medical boards or “Courts.” An entirely unofficial and voluntary system was established by the German Medical Association. The other, which was endowed with semi-official status, was called the Reich Chamber of Physicians. These chambers were elected by vote of the members and were supported by an assessment.
In addition to these organizations, there existed in Germany purely professional societies of doctors, where papers concerning scientific and practical problems were read and discussed, and which established connections with similar societies abroad. The German Government agencies which supervised the certification and licensing of physicians as well as their professional activities were the Ministry of Education and the Reich Health Office (Reichsgesundheitsamt) in the Ministry of the Interior. The latter supervised medical practice and licensing through the channels of the Ministries of the Interior of the various German states, although licensing was a federal function rather than a state function.
Medical education and training were rather standardized but good. The students spent 5 or 6 years at one of several of the medical universities; they took a final examination covering their clinical studies and then spent a year at an authorized hospital under supervision. Thereafter the interns were licensed and permitted to establish a practice. After two more years they became eligible to treat insurance patients, and, after submitting a thesis, could obtain the degree of doctor from a university.
Immediate Impact of Nazism on German Medicine
In the years immediately preceding the Third Reich, physicians’ organizations devoted to Party politics sprang up. One of these was the National Socialist Physicians’ Society, founded in 1929, in which Conti played a leading role. There was a rival association of Social Democratic Physicians, and a Socialist Society of Physicians. These societies proposed candidates for election to the Physicians’ Chambers, and thus the National Socialist Physicians’ Society and the Socialist associations came to compete with each other.
The notorious “boycott day” in Berlin, 1 April 1933, was a day of disgrace for German medicine. Members of the National Socialist Physicians’ Society, who knew the membership lists of the Socialist societies and the lists of Jewish physicians, broke into the apartments of their Socialist and Jewish colleagues in the early morning hours, pulled them out of their beds, beat them and brought them to the exhibition area near the Berlin Lehrter Station. There, all of them, including men up to 70 years old, were forced to run around the garden, as in a hippodrome, and they were shot at with pistols or beaten with sticks. There they had to stay for several days without sufficient food, and then were handed over to the SA which carried part of them to the cellars at the Hedemannstrasse jail for further tortures.
Thereafter, the members of the Socialist Society of Physicians were barred from all insurance practice because of “Communist and subversive activities.” In the subsequent listings of physicians issued by the insurance companies, the Jewish physicians were included in a separate list headed “Enemies of the State or Jews.” Soon, the insurance companies, even private ones, were no longer permitted to pay fees to the Jewish physicians. Immediately thereafter, Jewish physicians were excluded from all professional and scientific societies. At first, those who were war veterans were nominally allowed to carry on their insurance practice, but patients who kept going to them were threatened and exposed to all kinds of unpleasantness on the part of the insurance officials.