Wednesday, June 19, 2019
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Medical assistants: the counterproposal of doctors

Common front among liberal doctors. All major unions, including those representing students, interns and young people, met on Wednesday morning to define together who among them should be entitled to employment assistance from a "medical assistant" . By 2022, 4,000 jobs will have to be created to free the liberal practitioners from the administrative formalities and the reception of the patients, in order to free time of care.

The counter-proposal of the doctors will be presented on February 20th to the Medicare, which must finance the measure, at the third negotiation session of an amendment to their medical convention.

From three to six consultations per hour

Last week, the unions got angry after the second meeting with Nicolas Revel, the director of Medicare. He presented the expected benefits of recruiting a medical assistant. An assistant for three doctors is thus supposed to release 6 hours of medical time per week and per doctor, equivalent to 300 additional patients per year, or 1,128 consultations. An assistant for two would clear 12 hours, 600 more patients. "Gains observed by the doctor: from three to six consultations per hour and per doctor", writes Medicare in its document.

This little sentence set fire to the powder. "It is not by imposing quantified targets and new constraints on general practitioners still in activity that we will improve the care of their patients", threw MG France, while the SML accused Medicare to consider doctors "As" OS "of the care working on the chain with imperatives of pace and performance". These are not "Normative proposals", has backpeduled Medicare in a release, but only "The reflection of organizational experiences observed in firms already structured in this way".

Avoid Stakhanovism

In their common platform, doctors exclude the reference to the number of consultations per hour or year. GPs should only prove that the recruitment of an assistant allows them to increase the number of patients they are referring physicians, especially the chronically ill and the over 70s. But not everyone would be in the same boat. "One-tenth of GPs follow more than 1,500 patients, while the average is 850. This 10%, do not turn them into Stakhanovists by demanding more"says Jean-Paul Ortiz, president of the CSMF union.

As for specialists, they would commit to increase their patient, but not the number of visits. "It will take a different approach for each specialty," says the doctor. A pediatrician usually sees him more often than an ophthalmologist. " The professionals are ready to negotiate the details and ask for the creation of a monitoring observatory of the measure.

Furthermore, they agree to reserve the aid for a doctor who fits into a "coordinated exercise", provided that this framework remains very flexible. They also want Medicare to help them expand or change their premises to accommodate their medical assistant. And claim a permanent financing. Medicare wants it to be declining over three years.

Solveig Godeluck

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