Organized medicine and physician specialization in Scandinavia and West Germany

An analysis of post-graduate medical training is utilized to explore political relationships between physician organizations, government bureaucrats and the medical professoriate in Scandinavia and West Germany. The 'enchambered' German medical profession differs from its Scandinavian counterparts largely in the number and political influence of private specialists, who have been politically dominant within the compulsory German organizations. Whereas the Scandinavian medical organizations have, under varying degrees of duress, yielded the authority for specialist accreditation to state-appointed committees, the German chambers have been able to maintain control of this process. Some leaders have also cooperated with medical faculties to thwart attempts by general practitioners to establish zones of GP influence in the medical schools. However, in the context of a worsening medical market in the 1980s, their ability to mediate intra-professional conflicts between GPs and specialists, and between junior and senior doctors, may decrease, and their retention of greater self-governing powers in comparison with Scandinavia, may prove a mixed blessing.