Because they felt exploited in hospitals Wanted to improve well-trodden supply paths, “left-wing nuts” opened new health center in 1976 - Berlin balance sheet.
The story of slightly different health care system begins in 1972 with the thesis of the architect Klaus Werner, who was then living in Berlin and who is said to be close to socialist ideas. At that time Werner designed “group practice building”, for the realization of which he was looking for and finding politically like-minded doctors. The internist Friedrich Kater and the general practitioner Konrad Tidow are among the first founders. You manage to pull other medical colleagues under your spell within short time. They all have an extremely critical look at the conditions in the clinics. Here they are “exploited instead of trained”, as Kater realizes in review. From now on, her goal is to make it better “self-determined”.
Faster than the construction of the medical center, which began in 1973 The ideological superstructure is growing, which provides for pooling of medical income, co-determination for all employees, “self-awareness group” as well as the “limitation of the number of patients”, less medical equipment and the avoidance of double examinations. All the money in one pot? Grassroots democracy? “We were politically interested, sometimes lived in shared apartments and sent our children to children's stores. We were interested in the works of Marx and Lenin and had socialist ideas within us, but not socialism à la GDR, ”Kater told Deutsches Ärzteblatt. You had nothing to do with that. Every now and then, however, they also “drove over” because they were very impressed by the polyclinics “over there”, he added.
Opening in the time of the "Cold War"
"Left-wing nuts" and "system changers", as Kater and colleagues were called in the medical press at the time, had one among leading medical officials bad reputation. The political views were very far apart, it was the time of the "Cold War" between East and West. When the health center opened in July 1976, preparations were already under way in the “free part of Berlin” to commemorate the 15th anniversary of the building of the Berlin Wall.
Because they felt exploited in hospitals Wanted to improve well-trodden supply paths, “left-wing nuts” opened new health center in 1976 - Berlin balance sheet.
The story of slightly different health care system begins in 1972 with the thesis of the architect Klaus Werner, who was then living in Berlin and who is said to be close to socialist ideas. At that time Werner designed “group practice building”, for the realization of which he was looking for and finding politically like-minded doctors. The internist Friedrich Kater and the general practitioner Konrad Tidow are among the first founders. You manage to pull other medical colleagues under your spell within short time. They all have an extremely critical look at the conditions in the clinics. Here they are “exploited instead of trained”, as Kater realizes in review. From now on, her goal is to make it better “self-determined”.
Faster than the construction of the medical center, which began in 1973 The ideological superstructure is growing, which provides for pooling of medical income, co-determination for all employees, “self-awareness group” as well as the “limitation of the number of patients”, less medical equipment and the avoidance of double examinations. All the money in one pot? Grassroots democracy? “We were politically interested, sometimes lived in shared apartments and sent our children to children's stores. We were interested in the works of Marx and Lenin and had socialist ideas within us, but not socialism à la GDR, ”Kater told Deutsches Ärzteblatt. You had nothing to do with that. Every now and then, however, they also “drove over” because they were very impressed by the polyclinics “over there”, he added.
Opening in the time of the "Cold War"
"Left-wing nuts" and "system changers", as Kater and colleagues were called in the medical press at the time, had one among leading medical officials bad reputation. The political views were very far apart, it was the time of the "Cold War" between East and West. When the health center opened in July 1976, preparations were already under way in the “free part of Berlin” to commemorate the 15th anniversary of the building of the Berlin Wall.The street battles and burning newspaper cars of the 1968 student riots were not over yet.
The "left-wing project" was not harmed by the stimulating political climate in the western part of Berlin, on the contrary: the founders received support from the then ruling SPD and the German Trade Union Federation, whose economic institute paved the way for them in study pointed out: "The structures of outpatient medical care must be changed by promoting joint practice and promoting modern organizational forms of diagnostics in the form of medical-technical centers (MTZ)."
The rest was political pragmatism. At that time, Gropiusstadt was very young West Berlin housing estate that had been designed with lot in mind, except for the settlement of doctors. According to the architect's surveys, the few residents here had to look after almost twice as many patients as elsewhere in Germany. New doctors were therefore welcome. The Association of Statutory Health Insurance Physicians (KV) denied lack of doctors. But behind this, there was apparently an aversion to the new form of care. "Health centers (are) pampered children of leftist ideologues," said KV boss Gerhard Raudszus in 1979 in the Berliner Ärzteblatt. Two years earlier, headline in the Deutsches Ärzteblatt was: “Gropiusstadt Health Center - for the higher glory of the socialist experiment.”
On the other hand, the health center was popular with Gropiusstadt residents from the start. Even in the start-up phase, it offered seven specialist medical specialties under one roof. The short distances, the cooperative interaction between the doctors and employees in the house, the psychological advice center and the social workers were praised. There was even physiotherapy practice with therapy pool in the house. Everything was financed by the doctors.
On the outside, everything seemed to be going well. But internally, huge tensions built up. It was about the money. By the end of the construction phase, the costs seemed to explode. The result was an extremely high rent. Because this would not have been shouldered by the doctors and, according to Kater's memories, KV initially did not want to help, income from the state lottery was made available and given to the developer. With that the rent could be reduced, at least for now. Because it was clear to the doctors that they would later have to pay “normal” rents.
But of what? Most of the fee came from the KV and was only paid for services that were also financed by the statutory health insurance.The street battles and burning newspaper cars of the 1968 student riots were not over yet.
The "left-wing project" was not harmed by the stimulating political climate in the western part of Berlin, on the contrary: the founders received support from the then ruling SPD and the German Trade Union Federation, whose economic institute paved the way for them in study pointed out: "The structures of outpatient medical care must be changed by promoting joint practice and promoting modern organizational forms of diagnostics in the form of medical-technical centers (MTZ)."
The rest was political pragmatism. At that time, Gropiusstadt was very young West Berlin housing estate that had been designed with lot in mind, except for the settlement of doctors. According to the architect's surveys, the few residents here had to look after almost twice as many patients as elsewhere in Germany. New doctors were therefore welcome. The Association of Statutory Health Insurance Physicians (KV) denied lack of doctors. But behind this, there was apparently an aversion to the new form of care. "Health centers (are) pampered children of leftist ideologues," said KV boss Gerhard Raudszus in 1979 in the Berliner Ärzteblatt. Two years earlier, headline in the Deutsches Ärzteblatt was: “Gropiusstadt Health Center - for the higher glory of the socialist experiment.”
On the other hand, the health center was popular with Gropiusstadt residents from the start. Even in the start-up phase, it offered seven specialist medical specialties under one roof. The short distances, the cooperative interaction between the doctors and employees in the house, the psychological advice center and the social workers were praised. There was even physiotherapy practice with therapy pool in the house. Everything was financed by the doctors.
On the outside, everything seemed to be going well. But internally, huge tensions built up. It was about the money. By the end of the construction phase, the costs seemed to explode. The result was an extremely high rent. Because this would not have been shouldered by the doctors and, according to Kater's memories, KV initially did not want to help, income from the state lottery was made available and given to the developer. With that the rent could be reduced, at least for now. Because it was clear to the doctors that they would later have to pay “normal” rents.
But of what? Most of the fee came from the KV and was only paid for services that were also financed by the statutory health insurance.That was by no means enough for all the other offers that offered medical care tailored to the needs of patients. What had to come came: the fee pool was abolished. Each doctor now had to pay his share of the costs from his practice income. What was left was his pre-tax profit. But there wasn't much left for some practices. A manager was needed. He should run the center economically.
However, this led to employees being laid off who, like the social workers, caused expenses but made no money. No source of funding was found for their services. Their representatives on the governing body insisted on the right of co-determination. There, the doctors who gave the funds voted for savings and therefore also for the layoffs. Out of the stalemate meant: out of total participation.
Another "sacred cow" was slaughtered in this way. The works council formed instead was not even recognized by some of the practices. Ultimately, the joint financing of psychosocial care and even the joint patient file had to be given up. Some disciplines now earned comparatively lot. But there was no longer any talk of income.
Friedrich Kater, the last doctor from the founding phase, left the ship last year. In the meantime, the second generation of doctors with the health center has grown older. It includes the pediatrician Christine Spehr, who has been with her practice for 20 years. She is also the managing director of GmbH supported by doctors. The company acts as tenant towards the owner of the property and as landlord towards colleagues - an elegant and lean solution from an economic point of view. All 30 doctors, psychological psychotherapist and, most recently, dentist know where they stand. There has long been no place for grassroots democratic battles - and apparently no need. The younger doctors, believes "long-serving" employee, had little to do with the ideas from back then. But they appreciated the friendly exchange, the security of having experienced colleagues in the background.
An MVZ like others? No, thinks the managing director
The current practice owners do not really want to have their health center compared with any MVZ. They point out that there are still social and conflict counseling offers, even if this finances the Diakonisches Werk. Many facilities such as the cafeteria have also survived the turmoil of the times and will continue to be run as independent facilities. The cooperation between the doctors works, and there is always enough solidarity for excursions and parties.That was by no means enough for all the other offers that offered medical care tailored to the needs of patients. What had to come came: the fee pool was abolished. Each doctor now had to pay his share of the costs from his practice income. What was left was his pre-tax profit. But there wasn't much left for some practices. A manager was needed. He should run the center economically.
However, this led to employees being laid off who, like the social workers, caused expenses but made no money. No source of funding was found for their services. Their representatives on the governing body insisted on the right of co-determination. There, the doctors who gave the funds voted for savings and therefore also for the layoffs. Out of the stalemate meant: out of total participation.
Another "sacred cow" was slaughtered in this way. The works council formed instead was not even recognized by some of the practices. Ultimately, the joint financing of psychosocial care and even the joint patient file had to be given up. Some disciplines now earned comparatively lot. But there was no longer any talk of income.
Friedrich Kater, the last doctor from the founding phase, left the ship last year. In the meantime, the second generation of doctors with the health center has grown older. It includes the pediatrician Christine Spehr, who has been with her practice for 20 years. She is also the managing director of GmbH supported by doctors. The company acts as tenant towards the owner of the property and as landlord towards colleagues - an elegant and lean solution from an economic point of view. All 30 doctors, psychological psychotherapist and, most recently, dentist know where they stand. There has long been no place for grassroots democratic battles - and apparently no need. The younger doctors, believes "long-serving" employee, had little to do with the ideas from back then. But they appreciated the friendly exchange, the security of having experienced colleagues in the background.
An MVZ like others? No, thinks the managing director
The current practice owners do not really want to have their health center compared with any MVZ. They point out that there are still social and conflict counseling offers, even if this finances the Diakonisches Werk. Many facilities such as the cafeteria have also survived the turmoil of the times and will continue to be run as independent facilities. The cooperation between the doctors works, and there is always enough solidarity for excursions and parties.
What is left? An aging patient base with the center, regular training and interdisciplinary case conferences. Christine Spehr is satisfied: "We know that we are not alone with our problems and we help each other when things get tight for the individual." The fluctuation is minimal, she says: "With us, the generations are slowly growing."
The pediatrician is also proud that the health center is still anchored in Gropiusstadt. There is intensive cooperation with the Neukölln self-help center, regular information events for patients and participation in activities and celebrations in the district. Perhaps that is why Friedrich Kater does not like to speak of the failure of the ideas at the time: “Not everything was lost. Some of the things we practiced still exist today, even if under different circumstances. ”
Reinhold Schlitt
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