Access to care: what is this “shock therapy” demanded by Que Choisir from the public authorities?

“More than ever, regulation of the installation of doctors” by the public authorities “is an emergency in France”writes the consumer association in a study published on Monday.

“Because there is a shortage of doctors, we must rationalize the offer by prioritizing the most under-resourced areas”indicates the association.

In its study, Que Choisir recalls that “the supply of liberal medicine, already sluggish, will deteriorate: by 2030, the density of liberal doctors will drop by 5%”.

This degradation of the liberal medical offer will contribute to clog a little more the emergencies of the hospitals, already bloodless, warns the association.

Indeed, according to an econometric study carried out by him, “a 1% decrease in the density of private doctors in a department increases the activity of its emergencies by up to 0.6% in the short term, and up to 0.9% in the long term”.

The departments already understaffed in liberal doctors will be the most affected, since they are generally those where the average age of practitioners is the highest, notes the association.

In the possible remedies, Que Choisir supports various proposals recently defended by the public authorities but rejected by the unions of liberal doctors.

The association judges for example “interesting” the “territorial commitment contract”rejected by doctors during recent negotiations with the National Health Insurance Fund.

This contract provides for a higher consultation rate, in exchange for efforts to increase the medical offer: commit to a minimum number of patients, employ a medical assistant, work on Saturday mornings…

Que Choisir also declares itself in favor of direct patient access to nurses in advanced practice (IPA), physiotherapists or speech therapists. This direct access is at the heart of a bill currently under consideration in Parliament, but much criticized by doctors’ unions.

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Que Choisir makes other proposals that are less criticized by practitioners, such as increasing the number of medical students, and granting a “decent pay” for their work in hospitals.

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