In the brand new waiting room of the “My Region” health center of Mazamet, Léa patiently waits her turn. Before having an appointment here, she made several phone calls to the ten liberal doctors in this Tarn town of 10,000 inhabitants. “My GP retired some time ago. I called the other doctors, but none were taking new patients. One of my colleagues then spoke to me regarding this centre”, says the young woman before being received for consultation by one of the two practitioners working in this public service establishment opened last November.
Like their liberal colleagues, doctors Martin and Tamar travel to their homes, in remote corners of the Montagne Noire, on call at weekends and on public holidays and regularly provide ongoing care. On the other hand, they “focus on the medical and do not have to manage all that is administrative and time-consuming because they are salaried. For the moment there are two of them, but they should be more in the long term, which will make it possible to compensate for the short-term retirements of several private doctors in the town”, explains Elsa Lignières, the medical assistant of the center managed by THE public interest group “My Health, My Region” created by the regional council of Occitanie.
Already nine centers created and 25,000 patients treated
At a time when Health Insurance is trying to negotiate a better paid consultation rate for liberals who would undertake to sign a “territorial commitment contract” to fight once morest medical deserts, the Occitan community has done its next to the choice of employing doctors to provide care as close as possible to its inhabitants. Like what also exists in Centre-Val-de-Loire and which was adopted last year by the region Auvergne-Rhône-Alpes.
In the Lot, the Hautes-Pyrénées and the Pyrénées-Orientales, nine centers of the same kind have opened their doors in recent months and already employ 46 health professionals, mostly doctors, medical secretaries but also a midwife. Since July 1 and the launch of the first structure of this type in Sainte-Croix-Volvestre, Ariège, more than 25,000 patients have been seen for consultation by these salaried caregivers.
“In Occitania, according to the Regional Health Agency, 80% of the territory is in medical tension and we know that 30% of general practitioners will retire in the next five years. With the opening of these centers, we want to put doctors back where people had not seen them for a long time, ”explains Vincent Bounes, vice-president of the Occitanie Region in charge of Health, also director of Samu of the Haute-Garonne.
While France has been facing a shortage of doctors for several years, the group is doing everything possible to attract practitioners to these sometimes remote areas of the territory. “We offer them comfortable working conditions with contracts of 35 or 39 hours modeled on the grid of hospital practitioners, or around 5,000 euros net per month. They have the possibility of being part-time, and we take care of the spouse, the registration of the children at school, places in the crèche. They have no task to do apart from treating “, continues the elected official whose community invests from 100,000 to more than one million euros in these multidisciplinary centers, “to a balanced budget following two to three years “. He hopes to open 60 by 2028 and hire 200 healthcare professionals.
For the moment, a large number of practitioners who have decided to join the “My health, My region” scheme are young doctors trained in Occitania, who made replacements for most of them and were reluctant to install. Others, in mid-career and often from other regions, “wanted a different living environment”, emphasizes Vincent Bounes. And then there is the use of retirees, often part-time, who continue their activity under another status.
Healthcare professionals who can work as a team
But the competition is tough. Hundreds of rural municipalities are thus looking for a general practitioner ready to set up on their territory and all of them are making golden bridges to practitioners so that they choose them, helped by aid from the Regional Health Agency. Some decide to invest in nursing homes, places where professionals come together and pool part of the costs.
This is what the town of Mazamet initially did by investing in a building in 2020 to create a medical center where liberal general practitioners, but also a psychologist or an occupational therapist, meet.
“It was a first step to create a community, to show them that they did not arrive in a desert, some are afraid of isolation”, insists Olivier Fabre, the mayor of the commune who since the periods of confinement multiplies the countryside to attract new inhabitants looking for large spaces and a different quality of life than that offered by the metropolises. New rural people who, beyond public services, also demand access to care. The town hall had therefore started looking for practitioners.
“But we realized that quite a few doctors with whom we were in contact were interested in a more than liberal employee status. For a municipality like ours, employing doctors was a heavy burden. So when we learned regarding the regional council’s system, we found it relevant and we got involved in the GIP which provides financial and legal security”, continues the elected official who had been in discussion with two doctors for some time. time when he got involved with the Region.
One of them was an emergency doctor in Castres. Géraldine Martin was already employed in Lille. Returning to Mazamet for family reasons, she wanted to continue to practice under this status. “In this region, if you settle as a liberal, you no longer have a life. And that’s not what I was looking for. There I only take care of the medical care of patients, I don’t invoice, it’s the secretariat that takes care of it”, explains this 40-year-old doctor who has less income than his liberal colleagues “but also works a lot less hours”.
At the beginning, she had to make the patients understand that they were not in the presence of a family doctor in the traditional sense of the word. “These are the patients of a structure, they can see one doctor or another. It disturbed them, but there is also a reassuring side for them to always have someone to receive them and a medical response. What the region is putting in place is one of the responses to increase the supply of care, it is one of the means that can make young doctors want to settle down, ”says the GP between two patients. Soon, she should be able to count on the reinforcement of a young colleague whose arrival should take place in the spring. “A great relief”, confides a retiree crossed in front of the entrance to the center, delighted to see “young doctors finally settling in”.
