Dr. Ulrich Prehn opens an old file much marked by the passing of time. Written on the back in ink is Juden (Jews). The documents contained in the file are sorted by dividers on which are typed “Ausschaltung der jüdischen Ärzte” (deactivation of Jewish doctors) and “jüdische Krankenbehandler” (a pejorative term used under the Nazi regime to refer to the fact that Jewish doctors were only permitted to treat Jewish patients). “This file is one of the most important records contained in the archives of the Kassenärztliche Vereinigung Deutschlands as the National Association of Statutory Physicians was known under the Nazi regime. It would seem to be from their legal department,” Prehn explains while surveying the countless other files and piles of documents in his office at the new premises of the Center for Research on Antisemitism (ZfA).
Prehn has been working for two years on the third party-funded file indexing and research project on the history of the Kassenärztliche Vereinigung Deutschlands (KVD) between1933 and 1945. The project was set up by former ZfA visiting professor Dr. Samuel Salzborn. “The file contains both decrees for the disenfranchisement of Jewish doctors, either in the form of circulars or printed in the Deutsches Ärzteblatt and regulations about how to deal with Jewish Krankenbehandler ”, says Ulrich Prehn while leafing through the file. “This pejorative term was used by the Nazis to describe Jewish doctors who were now only permitted to treat ‘their own kind’ so as to enable non-Jewish doctors to care exclusively for patients belonging to the German ‘ethnic group’. In the words of a 19-page circular addressed to the medical council by the Reich Health Leader dating from 17 October 1938: ‘It cannot be our goal to fill the waiting rooms of German doctors with Jews.’”
In the first phase of the project, Prehn and student project assistant Sjoma Liederwald sifted through and meticulously listed and indexed more than 600 items from the records of the KVD, which until then had been lying disregarded in the Cologne archive of the National Association of Statutory Health Insurance Physicians (KBV). The KBV is financing the academic reappraisal of its history and has approved funding for Prehn’s project until summer 2021.
The KVD came about as the result of the amalgamation of the regional associations of statutory physicians, which had been established in 1932 by the Hartmannbund (the association of German doctors) to provide outpatient care and settle invoices for medical services between statutory physicians and health insurers. After the Nazi party took over government in 1933, the KVD came under the supervision of the Reich Ministry of Labor and was responsible for maintaining the register of physicians. As the organization responsible for deciding which doctors were permitted to invoice statutory health insurers for their services, it effectively had the power to exclude Jewish statutory physicians as well as those opposed to Nazi ideology. By disenfranchising medical practitioners, the majority of whom were highly qualified, the KVD not only infringed the ethical principle of collegiality but also jeopardized the capacity to provide adequate medical care for insured patients.
The National Association of Statutory Health Insurers is the successor organization to the KVD in the Federal Republic of Germany. This research project represents the first time that the KBV has granted researchers access to KVD files. By doing so, the KBV hopes to be able to cast light on and reappraise its own past.
“Although the available files represent only fragments rather than a complete set of records, they do cover a striking range of topics relevant for research into the periodand enable a number of possibilities for analysis and presentation,” continues Prehn, discussing the completion of the first phase of the project. The holdings contain documentary proof of the voluntary conformity, ideologization and politicization of the KVD in the period up to 1935, procedures for revoking the licenses of Jewish doctors from 1938 on, evidence of its responsibility for the medical care of forced laborers as well as for restrictions regarding their medical care and that of prisoners of war. “Some sources document how Poles could only be treated in hospitals in extreme cases and as exceptions and how there should be separate treatment times and waiting rooms for Germans and ‘workers of foreign races’ in medical practices in countries occupied by Nazi Germany,” explains Prehn.
The historical holdings also include numerous revealing documents relating to the legal succession of the KVD after 1945, primarily dealing with the issue of compensation for Jewish doctors whose license to practice had been revoked. The National Socialist German Doctors’ League and the Reich Medical Association were dissolved as Nazi organizations by the Allies after the end of the Second World War and medical functionaries sought ways to quickly reestablish professional associations. “The files show, however, that the decision to establish these organizations as direct legal successors to the old associations continued to divide opinion until into the 1950s. Clearly, the objective to take over the assets and the ‘Aryanized’ real estate of the KVD was seen as a reason for legal succession,” observes project assistant Sjoma Liederwald. “The question of whether to continue to employ functionaries from the KVD and the Reich Medical Association is also documented in many files dating from the postwar period.”
Scrolling through the countless files of digitalized sources on his PC, Prehn’s thoughts turn to their use beyond academic research. He already has a number of ideas about making the material and his team’s findings available to a wider public. “Possibilities might include an exhibition, an annotated documentation of online sources or developing a module on the history of doctors’ associations under the Nazi regime for the medical ethics component of university programs for medical students.”