87% of the French territory is a medical desert. Almost eight million inhabitants see the deadlines to obtain an appointment, who travel miles for a consultation, or sometimes end up stopping receiving treatment.
To stop this phenomenon, the Government announced Monday, September 1 that the sending of general doctors in reinforcement in medical deserts, up to two days a month, will be operational from “next week.” The “progressive implementation” of this measure also began on Monday.
Announced in spring, this system specifically means that doctors, in practice or retired, may carry out consultations in these territories against additional remuneration, in a logic of “solidarity.” This commitment remains, on the other hand, based on volunteering.
Two days a month against remuneration
The Minister of Health, Yannick Neuder, said Monday only on Monday, in Los Landas, where he is in motion, a voluntary doctor has arrived. Coming from Gironde, you must work two days a month at the city’s health house. In addition, around sixty doctors were offered as volunteers in this department and around 200 in the Nouvelle-Aquitaine region. “We can level so that it can get rid of every day of the week in the various places,” said the minister.
The Government had detailed 151 intercom in the so -called country of “red areas”, mainly in the center and southwest of the coast. Therefore, in total, 2.5 million patients would be affected by these reinforcements.
Therefore, this device will work for the moment on the basis of volunteers against financial homologists. In addition to the money from the consultations made, the doctor who will have reached a red zone will receive a global sum compensation of 200 euros per day. The government said it has ordered the National Health Insurance Fund (CNAM) “for implementation in September.”
Another specificity, volunteer doctors can currently commit themselves to a maximum of two days a month. The goal is to “ask for little doctors to avoid asking many doctors,” said Yannick Neuder.
Up to 30 million consultations per year?
Therefore, these health professionals can “come and give two days of their time in a territory that is particularly in deficit and has been identified,” in the words of the minister. In fact, a map of “red areas” has been established by regional health prefectures and agencies.
“Thanks to the territorial solidarity mechanism, up to 30 million consultations per year can be guaranteed in areas identified as priority,” said the government.
These consultations can be made significantly by “replacements, retired youth or doctors who want to diversify their practices.” Specifically, “they can get involved when approaching the Council of the Order of the Physicians in the area where they wish to participate or the AR in question,” the Ministry said on Monday.
In an interview with Dépêche du Midi, Yannick Neuder has only detailed “each territory is organized with its regional health agency, its prefect, local elected officials and its professionals. This can be done in a health home, a health center, a paramedical firm or municipal premises.” “We will make available a certain number of tools to facilitate the daily life of doctors for these consultations,” he added, without giving more details.
However, he indicated “medical assistants to the structures made by these solidarity medical consultations to guarantee the voluntary fluidity doctor in their days.”
As the minister said, this new device will work for doctors “with a reasonable proximity.” For “greater distance”, the minister cited the “Doctors Solide” association that “transfers a whole week” instead of more than two days due to long distances. All these volunteer doctors can be replaced in their main office.
“We will make an evaluation of this system in three months,” said the Minister of Health, who said he did not know at this stage the number of general doctors who were offered as volunteers to go and exercise two days a month in a medical desert. He also indicated that the system will be “operational in mid -September.”
An extension of the planned system
Therefore, this measure is part of one of the structuring stages of the “covenant to fight the medical deserts.” In this plan presented in spring, the government specifies that “this solidarity mission will be extended, secondarily, to all dense areas, beyond the priority territories and the first appeal.”
Parallel to other measures, such as the new state of “territorial practitioner of outpatient medicine” for doctors at the beginning of their career, this voluntary system to exercise in a medical desert must also be extended to specialized doctors, in addition to generalists. “The ARS will raise administrative brakes in its implementation and facilitate the conditions of reception and exercise with elected officials and local authorities,” according to the Government.
The objective of this launching phase is to demonstrate that doctors are ready to voluntarily organize to activate a territorial solidarity mechanism that strengthens access to care. “We are going to encourage doctors, and then, we will also have to run for the system, find adequate places, medical houses, offices available to accommodate patients,” said the Minister of Health.
The idea of a must
In fact, François Bayrou had mentioned a coercive measure. Finally, the Executive favors the soft method.
For most liberal doctors, especially those under study, because of being imponed where they work. According to them, medical deserts are above all the consequence of the lack of personnel and push young doctors to places they have not chosen will strongly affect the attractiveness of the profession.
Some deputies, led by the socialist Guillaume Garot, had promoted, in spring, stricter measures, imposing limitations in the installation of doctors, but aroused an even more marked opposition of the latter.
The elected officials led by Guillaume Garot had criticized the measures finally chosen by the Government, lamenting their “optional (Y) character, therefore, random”, and evoking a device that “cannot replace the basic responses.”
Not convinced
The new government measure established in this school year of September is far from convincing everyone. First doubt: are we going to have to undress Paul to dress Jacques? Doctors located near a voltage area can already have overloaded agendas. The first government wants to mobilize the “doctors who have time.”
With Ousest-France, the president of the community of Monts D’Arée Community Communes says he is septic. “We were already in the priority intervention zone. There were already facilities to resolve, financial aid, tax exemptions, prepared cabinets. And yet no one came to see us,” said Jean-François Dumonteil.
In addition, “no doctor will accept paying attention to a patient who will not see and whose continuation of his consultation will be the continuation of”, deplored in BFMTV Laure ARRRRT of the Association “Citizens Against Medical Deserts.”
“Liberal proximity medicine is based on the concept of patients, confidence with patients, time monitoring, human relationships,” Dr. Roger Rua, general practitioner in Rueil-Malmaison (Hauts-de-Seine) abounded in the same direction.
“There, we are simply offered supermarket medicine where we will fill holes,” he added.
93% of the French favorable to a “more equitable distribution of doctors”
According to an UFC-Que Choisir report published in June, 73 French departments underwent a drop in their medical density between 2014 and 2023. The 10 less endowed departments in 2014 had an average of 18.6 doctors for 10,000 inhabitants, this figure falls to 16 in 2023.
“For example, in 2023, medical density in Eure or AIN was respectively 15.7 and 15.9 doctors for 10,000 inhabitants (this figure even descends to 8 in Mayotte), against 42.9 in the Rhône, 45.7 in Hauts-Alpes and even 76.8 in Paris,” the organization writes.
In addition, there are also strong disparities depending on doctors’ specialties. Therefore, if the île-de-France is well endowed with specialists, more than a million and a half of Ile-de-France does not have a attended doctor.
According to the Federation of the French Hospital of France and the election of UFC-Que, up to 93% of the French interviewees say they are favorable to a “more equitable distribution of doctors in the territory, even if that means imposing their place of exercise in the first years.”
Source: BFM TV
