Networks for diabetes care: an obvious need.

In 1958, the French Government issued ordinances that profoundly reformed m edical education and hospital practice. Hospital physicians in the public s ector became full-time state employees and could no longer conduct private practice in town. By creating a prestigious and powerful public hospital se ctor, the 1958 ordinances set the stage for the significant developments th at French academic medicine and medical research have experienced since the n. However, they also created a gap between the hospital and medicine commu nity. In this way, many patients with chronic diseases such as diabetes fol lowed on a routine basis by their family practitioner may need periodic hos pital evaluation and thus discover that their care lacks continuity and the refore:quality. The 1996 ordinances, by instituting experimental integrated care networks, have tried to remedy this structural defect in the French h ealth care system. Such networks seem particularly well-suited for diabetic patients.