The observation is shared at the highest level. “Too much medical time is wasted by an excess of improvidence, casualness, in particular with appointments not honored”said President Emmanuel Macron during his wishes to the world of health, on January 6.
The Order of Physicians and the Academy of Medicine increased the pressure this week, in a rare joint press release, expressing their “deep concern at the serious consequences raised” by this subject.
Nearly 2 hours lost each week
According to several surveys, “6 to 10% of patients do not show up for their appointment, which corresponds to a loss of consultation time of nearly 2 hours per week for the doctor regardless of the discipline and, by extrapolation, nearly 27 million appointments not honored per year”, emphasize both instances.
With the key to “serious repercussions”: access to healthcare hindered for “patients who really need it”increased number of people presenting to already overwhelmed hospital emergency departments…
Last-minute oversights and setbacks are far from explaining everything, believe the order and the academy, for whom “the frequency of duplicate appointments” bears witness to a “discredit for the medical act”turned into “consumer good”.
Charge for unpaid consultations
What to do? The union of liberal doctors UFML has been campaigning for years “for a right to billing for consultations not honored”the title of an online petition which gathered nearly 10,000 signatures under a photo of rabbits.
For this, it would be necessary to modify the public health code, which today provides that the fees cannot be claimed “only on the occasion of acts actually carried out”.
Jérôme Marty, the tempestuous president of the UFML, has calculated that a financial penalty of 5 euros on 20% of missed appointments would yield around 25 million euros per year. A sum that might top up a fund, “managed by the profession”, to finance actions to fight once morest inequalities in access to care, believes the union official.
“Complicated to pay when we have not done any act…”nuance Isabelle Domenech Bonet, deputy treasurer of MG France, the first union of general practitioners, who, on the other hand, calls on the platforms for making appointments to “a little more flexibility”.
Contradictory requests from doctors on Doctolib
Currently on Doctolib, a heavyweight in the sector, the cancellation of a time slot is no longer possible four hours before it. “If people might cancel up to an hour before, we might call other patients to fill in the gaps,” notes this general practitioner in the Allier.
A headache for the platform, which evokes with AFP contradictory requests from doctors, general practitioners being more often asked than specialists for last minute consultations. However, Doctolib is testing a shorter cancellation period with 5,000 general practitioners and pediatricians.
The platform also argues that “several features” already make it possible to limit appointments not honored: reminders, awareness messages, blocking of a recidivist patient by the health professional, waiting lists to fill empty slots…
While calling on the platforms to ensure closer monitoring of appointments, France Assos Santé invites above all to “find the causes” defections.
Given the lengthening delays to see a general practitioner and especially certain specialists, “patients sometimes take several appointments to hope to find one”, remarks Gérard Raymond, president of this organization which brings together a hundred patient associations.
In a country with more than 6 million people – including 650,000 chronically ill – without a doctor, the emergency is not to be “target a population” by sanctions but “to find appropriate solutions”, believes this association leader.
Many voices call for actions to raise awareness of the scourge of “rabbits”. Asked by AFP, Health Insurance confirms that it is working on it, as part of a broader communication campaign on “the good use of the health system”.
