The medical trade union plays a major role in the organisation and management of city medecine. The professional organisations of liberals have been called, in particular, since 1971, to negotiate and conclude medical agreements with the sickness insurance funds, which are renewed within the Union nationale des caisses d’assurance maladie (UNCAM). At the time of the HPST law, which enshrines the general principle of first appeal and provides for a schema for organising care including municipal medecine, two heads of medical trade unions representing them at national level have compared their views on the role of professional organisations in the French liberal medecine system.