Networks for diabetes care: an obvious need.

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