[The role of general practice within the public health care system]

A comparison of general medicine in a de jure (Germany) and de facto (Netherlands, Great Britain) existing structured primary care model describes the present state as well as the pro and contra of the strengthening of the general practitioner (GP) within the primary health care system. For the patient, the better continuity and comprehensiveness of care has to be emphasized. For the patients, who choose to inscribe on a list of a GP, a reduction of health insurance fees is proposed for the German out-patient care system. Another option would be to reimburse a specialist's service with 80% when he has been consulted directly but with 100% after referral from a GP. The patient care must be strengthened by a modification of the fee system and the task description of a GP has to be defined and delineated from specialist medicine.