2024-04-24 08:07:52
Medical deserts are often discussed from the angle of access to general practitioners, and yet they do not spare specialized medicine. Quite the contrary. The Prime Minister, Gabriel Attal, took up the subject on April 6, promising to experiment with direct access, without going through the attending physician, in thirteen departments. One per region. A surprise measure, which arouses strong reluctance.
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He also highlighted a « bonus » for doctors who will accept “to go on guard duty a little further than their usual perimeter”. Without convincing those concerned, in the midst of renegotiation with Health Insurance of the medical agreement setting their rates and conditions of practice. Since April 4, these talks have been at a standstill, several representative unions, primarily among specialists, having suspended their participation.
Any constraints on installation – red rag among the liberals – having been ruled out so far, most of the solutions to improve access to specialists nevertheless pass through this convention. The levers for “save medical time” are known, whether it involves reinforcing medical assistants or nurses in advanced practice in offices, relying on teleconsultation and tele-expertise tools, or even encouraging the “delegation of tasks », according to the established expression, between doctors and paramedical professionals… This project is well advanced.
“No inventory”
Two other important levers, defended for years by specialist unions, are slow to deploy on the ground. This is the case for specialized care teams, which must bring together specialists from the same discipline or the same pathology, in order to organize care pathways across an area of life. There are a few, in dermatology in Ile-de-France, in cardiology in Nîmes, or in neurology in Carpentras (Vaucluse).
Second lever: so-called “advanced” consultations, i.e. these doctors who see patients 50 km or even 100 km from their usual office once a week for some, once a month for others. This type of operation exists around Reims, Boulogne-sur-Mer (Pas-de-Calais) or in the Basque Country. Without it existing “no inventory” of these measures, arising from local and individual initiatives, regrets Patrick Gasser, president of the Avenir Spé-Le Bloc union. Nor any lasting financial support, he laments.
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