Need a doctor in France? Improve local services

One town in the Dordogne is in desperate need of two doctors to replace one who retired in June 2018 and one who will leave at the end of September.

The town of Eymet has been advertising for more than a year, to no avail. The medical centre would welcome a British doctor who speaks some French, as there is a strong English-speaking community.

Eymet is just one of many places in France suffering from a lack of doctors, the so-called déserts médicaux.

Rural areas often suffer and the most common explanation is that doctors prefer to be in cities near to major hospitals.

Not so, says Dr Yannick Schmitt, president of ReAGJIR, which represents doctors who have just left medical school and have been practising for less than five years. “It is totally false to say that young doctors do not want to set up in rural areas,” he said.

“The real problem is a massive lack of doctors. Numbers have gone down by 1,000 a year for the past 10 years. This situation is likely to continue until 2025.

“Many towns and cities also lack doctors. I work in Lingolsheim, a poor suburb of Strasbourg, and there are not enough of us. In Paris there is a huge problem, mostly because it is too expensive to set up.”

A recent study of 15,300 young doctors by the Conseil National de l’Ordre des Médecins found that the quality of local public services is most important to doctors when they choose a location, more so than financial incentives.

Young doctors want to work in a health centre with other medical professionals.

They do not necessarily want to be near a major teaching hospital but are reassured if there is a small local hospital nearby.

“There needs to be work available for their partner and schools for their children,” said Dr Schmitt.

“One solution is for a couple to settle in a town and a doctor will happily travel over an hour to work – but for three days a week, rather than five.

Changing working methods is possible so that patients do not need to see the doctor to ask for a repeat prescription, for example. Tele-medicine is not the answer; it is only useful when a patient cannot get to the surgery.

“The study also showed that doctors are happy to be self-employed but we would like better social security cover. In the first difficult days, doctors are not covered for having only a few patients and they have no sick pay when they, themselves, are ill.

“Some departments have done a good job in attracting new doctors, notably the very rural Aveyron. They encourage students to do their internships with them and have developed medical centres and support programmes to help doctors settle.

“They now have more doctors opening up surgeries than doctors leaving.”

• Talking to a doctor remotely via a teleconsultation has not been taken up as enthusiastically as the government had hoped after the option launched with state reimbursement last September. The projected number of users in 2019 was 500,000, but the first official figures released show just 200 a week on average in late 2018. Recent improvements to upgrade security have seen an uplift and a survey showed that three out of four doctors believe tele-medicine will be part of their daily life by 2030.