Against medical deserts, not everything has been tried. This is what are going to want to demonstrate the head of the government and the minister of Health this Friday, presenting the government plan for access to care. Edouard Philippe and Agnès Buzyn will inaugurate on this occasion the house of health multiprofessional Chalus in the Haute-Vienne in rural areas.
From the field
The predecessor of Agnès Buzyn, Marisol Touraine, had already multiplied the initiatives : specific contracts for practitioners or students moving into area under-equipped, creating a thousand care homes in (Emmanuel Macron has promised to double their numbers during its five-year term), enlargement of the numerus clausus… The new head of State has promised the creation of a health service, in health of three months, so that the students in medicine are prevention in schools or communities.
But this will still not be on the agenda Friday. The government prefers, for the moment, ” sharing experiences “, ” from the ground “ and not on the top of the administration, according to an official source. In line with the draft law of financing social Security for 2018, which creates a fund for the financing of innovative organizations in health.
The access rather than the presence
The focus will be not on the ” presence “ doctors in the deserted areas, but on ” access “, and” increase the medical time available “basis, explains the same source. Grants for the installation have not been a success. In addition, the regions that include medical deserts are more numerous , even if the new zoning which could be unveiled this Friday will isolate the most sensitive areas.
According to the College of physicians, which published its atlas demographic this Thursday, in 45 counties, the population is increasing, but the workforce of doctors decreases. Especially, the number of general practitioners fall again in 2017, to 88.137, 749 less in a year, and 9 % less in ten years. The feminization of the profession (47 % women), their ageing (average age 51 years), and the increase of 10 % in ten years in the proportion of employees also have an impact, because the weekly hours of employment of these categories of population is lower.
Telemedicine and ” fund structure “
To increase the medical time available, the government has several levers. Telemedicine is going to come out of the experimental phase and become a right for all doctors as early as next year. In addition, the “fund structure” that was created during the negotiation previous, in 2016, to organize and modernize the offices, asking to be with. General practitioners spend on average four hours per week to manage the administrative tasks : it is the medical time lost.
The online services are an answer. According to the company Doctolib, a leader in online booking of doctors, the appointment reminder by SMS can save an hour and a half of consultations per week. In addition, by reducing the time of secretariat, the making of an appointment on-line is yet to win an hour and a quarter weekly.