Le parcours de soin : une solution ou une contrainte supplémentaire ?

French legislation had established a health care delivery pathway for patients with chronic disease, which is organized under the responsibility of General Practitioners. A number of regulatory systems prompt appropriate follows-up of this pathway for diabetic patients : guidelines, practical guides, SOPHIA program, CAPI, follows-up modules, medical training, Disease Management programs. These actions have a positive impact on monitoring process, but their impact seems to be modest on clinical inertia, which remains a frequent problem. One of the reasons is that the bio-medical model applied to healthcare may produce poor patient adherence which in turn increases therapeutic clinical inertia. Bio-psycho-social model focus on patient and is probably more adapted to get a reduction of clinical inertia, prompting dialog with patient and multidisciplinary cooperation. Health Personalized Plan is coming from health networks and is currently tested by National Health Authority as a tool to implement this approach.