[Hospital pathway of complex patients in a medical service of a local Hospital].

In the current Swiss medical system, hospital care is provided by both university hospitals and so-called « peripheral » hospitals. While university hospitals offer advanced technology and a wide range of medical specialists, how is care organized within the smaller, less complex structure of a peripheral hospital ? In emergencies, although patients usually go to their local hospital, they should not be exposed to lower quality care. Quality treatment is guaranteed by a well-organized structure, supported by a competent team of general doctors and specialists who have access to advanced technology. This article illustrates the journey of a typical patient presenting several common problems that make his case complex to manage, and also illustrates how the internal medicine department of a peripheral hospital operates.