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From this paper based on the opinions of hospital patients, a representative group of Dutch family doctors and of specialists, as well as on the results of an investigation in three practices of the Nijmegen University Department of General Practice, two conclusions can be drawn.
(1) The family doctor can fulfil an important role for his patients in hospital. This role arises from his function as a doctor to the family and is complementary to the technical specialist's work in hospital. The family doctor can therefore bridge the gap between hospital and home and between the patient and his family.
(2) A strict referral and hospital admission policy by the family doctor has important consequences and gives him a key position in health care. He can promote the shift from hospital-centred care to domiciliary-centred care which is now generally considered to be necessary.
It seems likely that such a strict referral system means a better quality of medical care for patients.
This is a priority of the first order, greater than that of perfecting hospital medical care, which will require an ever-increasing effort and cost for a decreasing group of patients.