[Problems due to the presence of a generalist at the emergency service door]

The presence of a general practitioner (GP) at the hospital emergency ward is a first attempt to answer a society phenomenon, challenging the hospital manager, but related to a more complex and extensive problem. New habits, due to various reasons, eventually move an ever growing proportion of patients from the community GP towards the hospital. The relationships between the patient and the practitioner are collapsing down like those between family members especially in towns. How can we resolve such an evolution politically? To have the city GP inside the hospital as it is already the case in big US cities? or, to favor the central role of the community general practitioner in the medical management of the patients, but in opposition to the present course of events? The first solution would be more expensive than the second one.