Coming from a short international review reasons for networking of scientific research in Germany are given. Success and challenges of medical competence networks are listed, and it is argued how important it is to bridge networks in health care and medical research networks. Some examples from internal medicine are given. The prominent central role of patients is emphasized. Finally it is stated that Germany so far has not established the prerequisites to implement sustainable collaborative infrastructures. Specifically financial, legal, and political support is missing. In addition, it becomes clear that -- in contrast to the USA -- Germany lacks sufficient medical informatics specialists as well as health managers trained to manage IT or networked research. The planned introduction of a telematics infrastructure for health in Germany is perceived as a big chance for improvement.