[Hierarchical structures in European countries]

The current form of organization and structure dates from the beginning of the 20th century, but now developments show a trend toward teamwork, where work, power, and authority are evenly distributed among several persons and carried out correspondingly. According to a survey of 11 out of 16 countries in Europe, large surgical institutions are organized according to the hierarchic principle. In Austria, Belgium, and the Netherlands both types of organization exist, and only in Luxembourg, Ireland, and Great Britain does the cooperative system exist. The latter is also preferred in smaller and medium-sized hospitals, and in private institutions as well. This system appears to better correspond to the requirements of economics and specialization.