A new toolbox to tackle the lack of primary care physicians

It is a box of ideas which could be of interest to the government in a hurry to solve the health system crisis . A group of representatives of health professionals, but also of social partners, users and managers of health insurance, proposes in a report to be published this week to improve the organization of work between the various actors of “health care proximity” by better distributing tasks.

“We find ourselves today, in many territories, in an alarming situation, with sick and elderly people who cannot find doctors to treat them, overwhelmed professionals, prospects of many departures not being replaced in the years to come. “, notes the High Council for the future of health insurance (HCAAM) in an opinion and a report that “Les Echos” were able to consult. This work, first revealed by “Le Figaro”, is based on the observation that “nearly six million patients find themselves without a doctor”.

Sensitive subject

Anxious to propose short-term solutions, to allow “equal access to care” and “to treat more patients with fewer doctors”, the think tank proposes in particular to “relieve practitioners from administrative and coordination tasks” and to “free doctors from activities that do not require their level of expertise”. How ? By encouraging doctors to work closely with assistants and nurses for the same patient population.

The subject is sensitive because nurses ensure that their skills are fully recognized and are committed to being able to practice as a liberal. Anxious not to create tension, the HCAAM speaks of a “joint exercise” between doctors and nurses without deciding on the status and the method of remuneration of the latter. The High Council is also in favor of the idea of ​​broadening the skills of other professionals, such as those of masseurs-physiotherapists and pharmacists to take care of frequent and not very serious health problems (sprains, seasonal allergic conjunctivitis, etc. .).

Attractive working conditions

The HCAAM does not recommend calling into question the freedom of installation of liberal doctors, ardently defended by the unions. The group of experts is indeed concerned not to create inequalities between generations by imposing new obligations on young professionals.

In order to have enough doctors in medical deserts, the consultation body recommends rather “creating favorable conditions” for doctors to work beyond the age of 65, even if it means being salaried. He also pleads for “imagining new mechanisms”.

For example, doctors based in areas well supplied with practitioners could work part of their time in areas that are insufficiently covered. “It could be early in the career or during the exercise, full-time for a short period or part-time for a longer period”.

Departmental level

Above all, the HCAAM recommends defining the list of “services to be provided locally throughout the territory” and building short-term solutions between professionals at the level of each department. The idea would be to build on existing initiatives. However, “in the event of a finding of a deficiency”, a public or private operator could be responsible for organizing care in areas that are poorly endowed with attending physicians.