Send independent doctors to parts of France with shortage, says report

Independent doctors should be trained and sent to areas of France with a shortage, a new report urges.

Consumer association UFC-Que Choisir has attacked what it called the “dogma of freedom” of where to practise.

It said if current trends continue, the density of independent doctors would “drop by 5%” by 2030, putting more pressure on already-overstretched emergency departments in hospitals.

“More than ever, regulation of where doctors work is an emergency in France,” said the study, published by UFC-Que Choisir. “Because there is a lack of doctors, we must rationalise the offer by prioritising the most under-served zones.”

Read also: How does France’s doctor shortage compare to other countries?

The consumer group called for “shock therapy” to improve France’s health service, adding that “the oversaturation of hospital emergency departments isn’t users’ fault”.

It said that “a drop of 1% in the availability of GPs in a department increases the activity of emergency departments by 0.6% in the long-term, and by 0.9% in the short-term”. Nationwide, it said that a 1% drop in the availability of GPs would lead to 100,000 extra A&E visits.

To tackle this, it called for:

• The coordination of hospital medicine and independent community medicine, which, it said, “still too often operate in silos”.

• Increased training capacity for doctors, to meet the needs of the population within 10 years.

• Training to prioritise the specialities and regions that have the most demand for medical services.

It added that the French departments already lacking in GPs would be most affected by oversaturation, especially as doctors in these areas tend to be older and closer to retirement age, it said.

For example, it said:

• Eure-et-Loir has 48.5 GPs per 100,000 residents, average age 56.3

• Finistère has 108.2 GPs per 100,000 residents, but the average age is 45.9

Read also: Eight facts to understand France’s issue of ‘medical deserts’

UFC-Que Choisir also called the €19.61 FPU (Forfait Patient Urgences) – the fee that users must pay if they show up to A&E and are not hospitalised – “unacceptable” as it means that “it falls to users to evaluate their own health”.

It said that this fee is based on the idea that these users could consult a GP rather than go to A&E. However, it said that “this idea is unfounded”.

The number of medical students currently being admitted to the second year of medicine in France is at levels just above those seen in 1970, despite the population rising by 25% since then, the study added, and called for training that would address this.

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