[Medicine and natural science--time for a change in paradigm].

Whereas in the 18th century medical science was influenced by both religion and the humanities, this changed around the middle of the 19th century as applied science accompanied a rapid development in medicine, especially in the fields of physiology and pathology. Currently the principles of biology, chemistry, and physics form the basis of scientifically-based medicine. This becomes even more evident when looking at the distribution of Nobel laureates for medicine and physiology in the first decade of the new millennium, namely 18 natural scientists compared with only 8 medical practitioners (see www.bnld.eu). In Germany, cooperation between medical practitioners and natural scientists is often hindered by legislation as well as professional claims. Whereas some procedures are restricted to medical practitioners, others, such as diagnostic testing, can be delegated to and performed by natural scientists, although here legal confirmation may be lacking in some cases, for example in genetics. Such discrimination often hinders potential cooperation and can no longer be seen as up to date. Whereas evidence based medicine forms the basis of individual treatment for patients, the introduction of disease management programmes by hospital administrators nullifies any positive effects of evidence-based medicine and reduces the patient to a cost-factor statistic. The aim of present government policy is a cost-effective treatment of diseases, often at the cost of the patient. Medicine is changing from an empirically-based therapy to a rationalised, molecular science. Parity between natural scientists and medical practitioners at all relevant levels is an indispensible prerequisite for a beneficial future healthcare programme. New, as well as existing professions for natural scientists in healthcare must be defined clearly and must have a legal basis, the point of view of the bnld (Berufsvereinigung der Naturwissenschaftler in der Labordiagnostik) for many years.