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The actual development in Europe and especially the decisions of the European Court of Justice in view of the free migration of patients within the European Union give rise to the supposition that pressure will increase to harmonize the health care systems in the near future.

There are different tendencies to have either a national health service or else to have ultra liberal economical solutions whereby private insurances will undertake an exclusion policy following purely financial considerations. Especially the last alternative is not only ineffective but is also insonsistent with the desires and social traditions of the European polulation. The effects resulting thereof also contradict in many aspects the principles of medical ethics. The free choice of the physician, competence and independance of the physician are on the other hand the prerequisite for the confidential relationship between physicians and patients.

"As much liberality as possible, as much state as necessary " to get or to maintain a fair free access to medical care this is the motto of physicians in free practice.

The responsable actors within the future European social system

1. of a liberal professional organization of medical care are of the opinion that the liberal professions stand out for their economical freedom and high personal responsibility being indispensable for a modern European society

2. decide to stand up together for the improvement of the health care systems considering the social achievements in Europe as well as the maintenance medicine to which everyone has access guaranteeing the quality of care

3. will elaborate a charta based on the principles mentioned above as a guideline for the different member countries defending a liberally organized medical care.

Paris, October 1999



European doctors of EANA define the liberal medical practice as:

Professional independence Clinical autonomy based on knowledge and experience

Independence from undue political, financial or other constraints

Direct responsibility for the patient

Patient is free to choose their doctor

Safeguarding of the doctor/patient relationship.

Other fundamental elements of the liberal practice are:

Medical services personally rendered by the doctor

Freedom to enter contractual arrangements

Economic independence

Freedom to determine services and prices

Freedom to undertake entrepreneurial risk

Responsibility of data in eHealth

Responsibility of quality assurance and liability

Responsibility to maintain professional competence (CME/CPD)

In order to guarantee optimum patient orientated healthcare provided by doctors in free/independent/liberal practice in Europe, it is necessary to guarantee professional development, especially continuous medical education (CME/CPD).

Brussels, June 10th/11th 2009



E.A.N.A. supports the right of all European physicians to establish their own independent medical practice.

In several European countries we have seen an increasing trend of individual medical practices being compacted into larger groups or bought by large medical corporations or health insurers.

The reason beyond sheer financial interest is often that, with health care reform, new operational regulations are implemented, which in some cases make it impossible for small entrepreneurs to exist.

E.A.N.A. emphasizes the importance of a EU-wide policy to assure that individual practice, on which all our healthcare systems are founded, remains supported in Europe, and specially that regulatory measures do not prevent individual practices from establishing themselves.

Drafted during the E.A.N.A. spring meeting in Gibraltar, May 2011.

Adopted in June, 2011.