Research article

Review of medical professional organizations in developed countries: problems of decentralized membership registers

  • Received: 17 July 2019 Accepted: 14 October 2019 Published: 22 October 2019
  • This article provides a critical review of international experiences regarding the professional organization of physicians and the registration of doctors in developed countries. The problems faced by professional medical organizations in the EU-15 countries, Japan, the United States and Canada, are examined. Medical professional groups differ in several dimensions, including obligatory registration versus voluntary membership or types of registration (centralized, indirect, or delegated). The centralization-decentralization axis is a key aspect for the analysis. While decentralized systems are better able to adapt to the idiosyncrasy of a particular region, decentralization is identified as a source of potential problems in the organization of medical doctors. Some of these problems (discrepancies in positions on health matters, problems with the reliability of statistical information on medical demography at national level, deficient mechanisms for the control of doctors who have lost their licenses) might have consequences for the quality of the health care system.

    Citation: M Carmen Bautista, Beatriz G Lopez-Valcarcel. Review of medical professional organizations in developed countries: problems of decentralized membership registers[J]. AIMS Public Health, 2019, 6(4): 437-446. doi: 10.3934/publichealth.2019.4.437

    Related Papers:

  • This article provides a critical review of international experiences regarding the professional organization of physicians and the registration of doctors in developed countries. The problems faced by professional medical organizations in the EU-15 countries, Japan, the United States and Canada, are examined. Medical professional groups differ in several dimensions, including obligatory registration versus voluntary membership or types of registration (centralized, indirect, or delegated). The centralization-decentralization axis is a key aspect for the analysis. While decentralized systems are better able to adapt to the idiosyncrasy of a particular region, decentralization is identified as a source of potential problems in the organization of medical doctors. Some of these problems (discrepancies in positions on health matters, problems with the reliability of statistical information on medical demography at national level, deficient mechanisms for the control of doctors who have lost their licenses) might have consequences for the quality of the health care system.


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    Conflict of interest



    The authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

    [1] Yam CHK, Griffiths SM, Liu S, et al. (2016) Medical Regulation. J Med Regul 102: 16–27. doi: 10.30770/2572-1852-102.1.16
    [2] Baron RJ (2015) Professional self-regulation in a changing world: old problems need new approaches. JAMA 313: 1807–1808. doi: 10.1001/jama.2015.4060
    [3] Garoupa N (2006) Regulation of legal and medical professions in the US and Europe: A comparative analysis. Documento de Trabajo 11.
    [4] Davies M (2016) Medical self-regulation: crisis and change, Routledge.
    [5] de Vries H, Sanderson P, Janta B, et al. (2009) International comparison of ten medical regulatory systems.
    [6] Adlington K, Abbasi K, Godlee F (2015) The General Medical Council and doctors' financial interests. BMJ.
    [7] Choudhari KA (2008) The white paper and regulatory reforms: beginning the end of professional self-regulation for doctors. Ulster Med J 77: 4–5.
    [8] Bruce DA (2007) Regulation of doctors. BMJ 334: 436–437. doi: 10.1136/bmj.39135.619410.80
    [9] Merkur S, Mossialos E, Long M, et al. (2008) Physician revalidation in Europe. Clin Med 8: 371–376. doi: 10.7861/clinmedicine.8-4-371
    [10] Borow M, Levi B, Glekin M (2013) Regulatory tasks of national medical associations-international comparison and the Israeli case. Isr J Health Policy Res 2: 8. doi: 10.1186/2045-4015-2-8
    [11] Madara JL, Burkhart J (2015) Professionalism, self-regulation, and motivation: how did health care get this so wrong?. JAMA 313: 1793–1794. doi: 10.1001/jama.2015.4045
    [12] Yam CH, Wong EL, Griffiths SM, et al. (2017) Do the public think medical regulation keep them safe?. Int J Qual Health Care 30: 90–96. doi: 10.1108/IJHCQA-03-2016-0028
    [13] McClelland M, Geldhof J, Morrison F, et al. (2018) Self-regulation, In Handbook of life course health development, Springer, Cham, 275–298.
    [14] Catto G (2003) Improving professional competence-the way ahead?. Int J Qual Health Care 15: 375–376. doi: 10.1093/intqhc/mzg061
    [15] Furnival J, Boaden R, Walshe K (2018) Assessing improvement capability in healthcare organisations: a qualitative study of healthcare regulatory agencies in the UK. Int J Qual Health Care 30: 715–723. doi: 10.1093/intqhc/mzy085
    [16] Risso-Gill I, Legido-Quigley H, Panteli D, et al. (2014) Assessing the role of regulatory bodies in managing health professional issues and errors in Europe. Int J Qual Health Care 26: 348–357. doi: 10.1093/intqhc/mzu036
    [17] Morioka Y, Higuchi N, Kuroyanagi T, et al. (2014) Regulatory Organizations for Physicians' Status and Administrative Sanctions on Physicians:-Examining the Framework of Government Administrative Systems for Physicians in Japan Based on a Questionnaire Survey Conducted on 13 National Medical Association. JMAJ 57: 139.
    [18] Kovacs E, Schmidt AE, Szocska G, et al. (2014) Licensing procedures and registration of medical doctors in the European Union. Clin Med 14: 229–238. doi: 10.7861/clinmedicine.14-3-229
    [19] Audas R, Ross A, Vardy D (2005) The use of provisionally licensed international medical graduates in Canada. CMAJ 173: 1315–1316. doi: 10.1503/cmaj.050675
    [20] Pick RA (2015) Shepherd Or Servant: Centralization And Decentralization In Information Technology Governance. Int J Manage Inf Sys (IJMIS) 19: 61–68.
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