The Finnish Medical Association was founded on 28 February 1910. The aim of the
Association from the outset was to unite the medical community to protect its interests,
to develop health-care services in Finland, and to foster ethical principles and
collegiality. Today, the Finnish Medical Association is known as a powerful professional
organization and influential health-political body. In its 90th year, the
Association wishes to emphasize the importance of medical ethics by publishing a new book
on the subject (Lääkärin etiikka - Medical Ethics), which will be distributed to all
members. In the year in which the Association was founded, 1910, there were just over 500
physicians in Finland. There were many problems associated with the status and livelihood
of the profession: fees were outdated or rates were not fixed. Physicians could be
arbitrarily given notice. There was no social security.
The words that lead to the foundation of the Finnish Medical Association were uttered
at a meeting of the Medical Society of Finland (Finska Läkaresällskapet). Dr. Alfred
Theodor Ehrström suggested that physicians should come together in an Association to
enhance the financial and social status of physicians. The suggestion was adopted
unanimously, and Professor Max Oker-Blom, who was subsequently elected first President of
the Association, supplemented it with a wish that the Association should become the heart
and conscience of the medical profession. There was a great need for the foundation of such an Association. This is demonstrated
by the fact that 95% of the medical community immediately joined. The percentage has
remained roughly the same for 90 years. There are few other professions most members of
which can be said to belong to a single organization. The Finnish Medical Association has always participated actively in development of the
health-care system. Because of its initiative and wide-ranging expertise the Association
achieved a well-recognized position in this work at an early stage. Central issues in the first decades of the history of the Association were improvement
of the health care of the rural population and enhancement of the position of municipal
physicians. At the time of the foundation of the Association 100 municipal physicians were
responsible for rural health care. Their employment and incomes were often insecure. The
demands of the Association concerning establishment of posts of municipal physicians in
all municipalities were implemented only in the 1940s. At the beginning of the 20th century there were few hospitals in the
country. Many were in poor condition. Much of the rural population had no access to
hospital care. Many children, in particular, died from lack of treatment. In the 1920s and
the 1930s, experts of the Association made plans for improvement of the hospital-care
system, aiming at provision of essential specialist services and regional equality.
Treatment of tuberculosis, mental illness and veneral disease, among other issues,
presented major challenges. After the
losses suffered during the wars increasing attention was paid to population growth and
improvement of the health of citizens. Physicians realized that treatment of illness was
not enough. Health education and correction of social problems needed increasing emphasis.
The child-welfare system established in the 1940s significantly improved the health of
mothers and children. In the 1950s, the Finnish Medical Association participated in the drafting of hospital
legislation and planning of the central-hospital system. The Association stressed that
hospital treatment and outpatient care should not be administratively separate from each
other. Primary health care was considered important, and the Association suggested that
chairs of general medicine be established in faculties of medicine. In the 1960s, health policy was increasingly criticized for being hospital-oriented.
Hospitals were allocated increasing shares of health-care appropriations and the
workforce. The Association stressed that prevention is the cheapest way to treat health
problems. The Association campaigned against smoking and use of drugs, and promoted
physical exercise and road safety. As a result of the Primary Health Care Act that came
into force at the beginning of the 1970s, health centres were established in
municipalities. Their operation did not meet the objectives of the Association in all
respects. Physicians no longer could control the pace of their work, the esteem they had
enjoyed declined, and their salaries decreased drastically. In recent years, establishment
of the family-doctor system has helped correct these problems to a great extent. The
Finnish Medical Association has been involved in ideation in relation to and
implementation of the system in which each health-centre physician is responsible for care
of the health of a specified population. This has improved the quality of health-centre
services and made the work of physicians more meaningful. The introduction of a general system of insurance against treatment injury in Finland
in the 1980s stemmed from an initiative taken by the Association. Finland was the first
country in the world to pass an Act relating to patient rights, in 1992. The Finnish
Medical Association brought these principles to the knowledge of physicians in all
countries by submitting a declaration concerning patient rights for the approval of the
World Medical Association. Although the Finnish Medical Association looks after the interests of its members
safeguarding the rights of patients is an equally important aim. Through the Association
physicians seek to offer their wide-ranging expertise to the development of the Finnish
health-care system. Working for their patients’ best interests - for the good of the
health of individual patients and of the population as a whole - gives the greatest
satisfaction to physicians. The number of physicians in Finland has increased almost 20-fold since the foundation
of the Association. However, expectations and hopes in relation to health care are also
higher. In the 1910s, there was only one working-age doctor per 7,500 inhabitants.
Competition for posts was often keen. Today, there is one physician for roughly 300
inhabitants, and yet the number of physicians is considered too low. According to the Finnish Medical Association, the number of physicians should
correspond to the demand imposed by health-care services, while ensuring the employment
and livelihood of the profession. Working conditions should be organized in such a way
that on-call duty and the general workload are not excessive.
Finnish health care is among the best in the world, and the quality of medical training
in Finland is well-regarded. Our extensive primary-care system, with maternity and child
health clinics, has served as a model for many other countries. Everyone has a right to
health care. However, lack of resources often means that individuals have to wait for
treatment, and health centres and hospitals are overcrowded. At the 90th anniversary of the foundation of the Association Finland is
enjoying a period of strong economic growth. However, the future of health care is
threatened in many ways. The population is ageing, the baby-boom generation is retiring,
and needs for health care are increasing. The well-educated population is used to demand
high-quality and individualized services. Municipal health care funded by tax revenues is
facing overwhelming challenges. The Finnish Medical Association has looked into the future
and has offered decision-makers a model for solving problems relating to health-care
financing. Medical know-how is increasing rapidly. There are increasingly efficient ways of
detecting, treating and preventing illness. However, the rapid development of medical
technology leads to new ethical problems. To what extent should we interfere with the
natural course of life? How much should individuals know about their personal health risks
and those of future generations? How can we ensure that increasing knowledge will not lead
to discrimination and inequality in society? The work of physicians is changing but its ethical basis remains unchanged. A
physician’s duty is to promote and establish health, and alleviate suffering. The
fundamental principles of physicians embody respect for humanity and continuous striving
to improve the quality of their work and develop their professional skills. They will
remain the cornerstones of the medical profession also in the next millennium. The Finnish Medical Association represents the entire medical community in Finland. Its
membership is roughly 18,000. More than 17,000 of the members are physicians and 1,000 are
medical students. The Association represents the medical community in collective agreement negotiations.
The Association’s aim is that physicians’ salaries should correspond to the high
demands on the profession, the responsibility and the lengthy training required. Excessive
on-call duties need to be reduced. The Association’s view is that primary health-care services should be accessible
to all within reasonable times irrespective of their financial standing. Patients’
must have a right to choose their physician and health-care institution. A solid financial
basis must be ensured for health-care to guarantee continuous development of the services. The Finnish Medical Association works together with university faculties to develop
basic and further training. The number of physicians trained needs to correspond to
demand. The Association provides further training for its members and organizes the
biggest annual training event in the field, the Finnish Medical Convention. The Finnish Medical Association continually encourages physicians to improve the
quality of their work, i.e. patient care. The Association has participated in the
development of quality-assurance criteria suitable for health care, and trains its members
for high-quality work. The Association’s Code of Medical Ethics stresses a physician’s duty to serve
his fellow human beings, to promote health and to alleviate suffering. The Finnish Medical
Association also plays an important international role in that it aims at implementation
of patient rights and other goals of medical ethics throughout the world. According to a follow-up survey relating to images associated with professional
organizations conducted by TOY Research in 1999, the Finnish Medical Association is the
most prestigious professional organization in Finland. The survey covered 32 largest
professional organizations in Finland.History of the Finnish Medical Association
Foundation of the Association
Building health-care services
Advocate for physicians and patients
Facing new challenges
The Finnish Medical Association today
Uniter of the medical community
Trustee of physicians
Influential health-political body
Trainer of physicians
Supervisor of quality
Promoter of ethics and collegiality
The most highly esteemed professional organization
Förbund
The Finnish Medical Association -
Health Care and the Medical Profession in Finland
Association
