title: [What is the role of internal medicine in the collective of a general hospital?].
abstract: General internal medicine tends to decrease in many Belgian hospitals. On the opposite, United States are now clearly engaged in a reform of their health system, with a drastic augmentation of the number of general internists. This reflection recognizes the specificities of general internal medicine: the first contact, the longitudinal follow-up, the comprehensive approach and the coordination with other medical participants. The need for subspecialists would be reduced and the need for primary comprehensive care physicians would be increased. The development of a performent sector of general internal medicine is able to respond to the demand of the patients and also of the general family practitioners. This model has positive impacts for the whole hospital community. We are all weary of discussions of state medicine, of the high cost of medical care, of the adequacy of medical care for the indigent, of the shortage of hospital beds for those who can pay, of the shortage of nurses, and so on. But these are, in part our problems; if their solution is to be to our liking, we must be active in them. The spector of state medicine is continually raised before us. Greater participation, by the federal, state and local governments in matters of health seems inevitable although most of us think it is important to retain in some manner or other the principle of private enterprise. Change of some sort will come; it is evident that unless we ourselves reorganize the practice of medicine, it will be reorganized for us.
authors.forename: A
authors.initials: A
authors.lastname: Efira
mesh_terms: D001530:Belgium; D003191:Comprehensive Health Care; D005194:Family Practice; D006769:Hospitals, General / Q000458:organization & administration*; D006801:Humans; D007388:Internal Medicine / Q000458:organization & administration / Q000639:trends; D007400:Interprofessional Relations; D008511:Medicine; D010817:Physician-Patient Relations; D017149:Private Sector; D012017:Referral and Consultation; D013038:Specialization; D013222:State Medicine; D014481:United States