This model is intended to bring physician-centred definitive care to the patient, rather than bringing the patient to the care. As a result, in addition to conventional ambulances, most communities have physicians (called "Notarzt") who respond directly to every life-threatening call to provide care. This system does not recognize emergency medicine as a medical specialty, in the sense that North Americans understand it. In these cases, the 'emergency physician' is most commonly an anesthetist, or sometimes an internist or a surgeon. In most areas of Europe, there appears to be little interest in developing emergency medicine as a specialty, although recent developments in Italy suggest that this attitude may be changing. In this model, long 'at scene' times are common. The physician attempts to provide some or all of the intervention that is necessary in place, with transportation to hospital occurring only for those with a legitimate need of a hospital bed, and urgent transportation to hospital being extremely rare. Many patients will never be transported to hospital. In the French version of this model, even the triage of incoming requests for service is physician-led, with a physician, assisted by others, interviewing the caller and determining what type of response resource, if any, will be sent. The German version of this model uses 'conventional' dispatch processes, with the physician being sent to calls as requested by the EMS dispatcher.