[Waiting list guarantee between medicine and bureaucracy].

The traditional autonomy of the health professions is being eroded by external bureaucratic regulations of health care services, implemented to control costs and secure equitable access to services. This is an international trend. The guaranteed maximum waiting time in Norway is an example of such regulations. Introduced in 1990 and revised in 1997, it regulates the maximum waiting time for hospital admittance for patients who meet certain criteria. The regulation limits physicians' scope for setting priorities according to traditional criteria such as disease severity and admittance on a first come, first served basis. At issue here is whether the waiting time guarantee is compatible with established professional norms for setting priorities. We explored this issue of regulation versus professional norms through a postal survey among 152 physicians and nurses in charge of allocating patients to waiting lists. The results indicate that most respondents do not think that the reform has led to more equitable priorities. Health professionals seem to follow professional norms more than externally imposed rules. Difficulties in interpreting the rules and infringements of the guarantee in respondents' departments led to negative attitudes towards the guarantee. Physicians were more negative than nurses in their attitudes.