These Health Conferences, in Vernouillet, are dedicated to solutions to attract new practitioners who are so rare*. What could you say to these young graduates so that they come to Eurelian territory?
We will not get out of it if there is not a de facto effort in quantity: we must train more people and differently. That is to say, to make them want to.
What does it mean to “make them want”?
Overall, medical studies are hospital-oriented, and most of the time takes place in a university hospital. In fact, we train people relatively well. But during this relatively long period, they are not shown all aspects of the job. However, in life, your desire to exercise a profession is often linked to meetings. If you never meet a doctor from a rural area, a doctor from an EHPAD or a general practitioner living in town, you have no reason to want to look like them, because you don’t know what they look like. It is therefore necessary to make a “revolution”.
It means sending young externs, during their first six years of study, outside the university hospitals. This is the first condition.
The Bâtes medical office is still waiting for new doctors. Archives.
“If the GP doesn’t have a pediatrician, a gynecologist, a cardiologist nearby… He won’t be able to do it”
The president of the Les Républicains group in the Senate, Bruno Retailleau, has passed a law aimed at encouraging medical students at the end of their cycle to work in areas lacking doctors. Do you support him?
This is a proposal that I made during the debate during the last presidential election. But it is not sufficient, because Bruno Retailleau speaks exclusively of the purposes of boarding school. This should be done very early on so that future doctors discover all types of sectors to practice. Otherwise, there is no reason for them to come there spontaneously. In addition, this project must be consolidated and extended to all specialties, not just generalists. If the GP doesn’t have a pediatrician, a gynecologist, a cardiologist nearby…he won’t be able to do it. For Philippe Juvin, “The primary responsibility of the State is to bring clarity to income. When it’s not clear, it’s the maquis and we can do anything.” ©National Assembly 2022.
President of the Council of the Order of Eure-et-Loir, Julien Cottet recently declared: “In fact, general medicine is going through an identity crisis, but no one dares to say so. This profession is no longer popular”.
The bottom line is that young doctors want a different life from their elders. That is to say, a less dense professional life. When a doctor retires, it takes two or three young people to replace him. We will no longer find people who want to work 70 hours a week! It’s true that general medicine, as practiced by professionals of my generation, is less appealing. Young people want to come together and work in a network. As a result, there is a multiplier effect: people go where they are already grouped together.
Creation of medical houses, tax advantages, installation bonus, administrative facilities, etc: the territories compete with offers to attract doctors. Doesn’t this one-upmanship create territorial inequalities?
One of the major subjects relates to the remuneration of doctors, which is poorly constructed. The consultation (25€) is badly paid. And so we add a whole bunch of packages, stuff and stuff. All of this is expensive for the community, and yet the doctors continue to think that they are poorly paid. It’s typical in France: we pay people badly and we create derivatives. Like the rising price of gasoline: instead of lowering it at the pump, we write checks!
What are you asking for?
Initiate a reflection to increase the price of the consultation. In return, cleaning up all these “maquis aid” which, as a result, creates competition between the municipalities. The primary responsibility of the state is to bring clarity to revenues. When it’s not clear, it’s the maquis and we can do anything.
The project to rebuild a new hospital in Dreux is seen as a hope for revitalizing the medical supply. It’s a good sign ?
Anyway, French hospitals are not in good condition; their reconstruction is obvious. The health system should not be hospital-centred, but it should be able to count on good quality hospitals. The idea of opposing liberal medicine with the hospital environment is heresy. One should feed off the other, the patients are the same. The Victor Jousselin hospital must be rebuilt. For Philippe Juvin, “its reconstruction must be part of an ecosystem within the whole city”. Archives.
“A hospital project cannot be a deserted city project, but must be part of an ecosystem”
The expectations of the population are the priority.
You have to define your needs upstream, not those of today, but in 20 years, with the aggravation of chronic diseases, the aging of the population. And you have to wonder about the attractiveness of what is around the hospital. An establishment in a basin where no one comes to work will not attract doctors or nurses. A hospital project cannot be a deserted city project, but must be part of an ecosystem.
The Health Conferences are a point of convergence for the realization of a Local Health Contract which includes several fields (living environment, mental health, prevention, installation…) What would you like to add to it?
You have to create a chain between the various stakeholders and know “who does what?” A local health contract is the ability to get professionals who are not all doctors to work together. The interest is that every medical minute must be used for the practice of medicine. A nurse or a physiotherapist can take over in some cases. Is it useful to go see a doctor for the renewal of a prescription for a very stable illness? Moreover, local contracts are good if they do not create administrative burdens. They already represent 14% of a GP’s time. It’s already too much!
* 57 professionals in the department for a ratio of 100,000 inhabitants, against 318 doctors at the national level and 170 at the regional level, according to Doctor Talal Abdelkader, vice-president of the Agglo (L’Écho Républicain of November 4.)
The Assizes of Health, at the Atelier à spectacle, Wednesday November 9, at 6 p.m., in Vernouillet. Presentation of the Agglo’s territorial health project, in the presence of many professionals from various organizations (the ARS, the Regional Health Observatory, the management of the Dreux hospital, etc.).
Head of emergency department of the Georges-Pompidou European Hospital (Paris) since 2012, Philippe Juvin is mayor of La Garenne-Colombes; MEP from 2009 to 2019 and spokesperson for the French delegation within the group of the European People’s Party. He was elected deputy for the 3rd constituency of Hauts-de-Seine.
His idea taken up by Emmanuel Macron.
In his speech of October 26, on France 2, Emmanuel Macron announced that retired doctors will be able to continue to work without paying new contributions for retirement. “I smile in corner, because it is me which made it vote by the Assembly, against the opinion of the majority”, explains Philippe Juvin. “So much the better that the President of the Republic takes up my idea! A quarter of psychiatrists are retired. When a doctor combines employment and retirement, he pays pension contributions on his fees, but he does not earn additional rights.”