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On May 10, Parliament adopted a law allowing direct access to certain nurses, physiotherapists or speech therapists. Access which will however be limited to certain conditions.
On Wednesday, May 10, Parliament definitively adopted the Rist bill aimed at facilitating access to care and relieving congestion in general practitioners’ offices while 6 million people have no attending physician. This law provides in particular for being able to consult nurses in advanced practice, called IPA, who intervene in chronic diseases, but also physiotherapists and speech therapists, without a prescription and therefore without going through the box of the attending physician.
Only for the professionals mentioned, practicing in nursing homes
However, the ambition to allow direct contact between individuals and physiotherapists or IPAs has been reduced in the face of the dissatisfaction of doctors. Thus, direct access will indeed exist, but will be limited to health personnel working in structures such as multi-professional health centres, in coordination with doctors.
Contrary to what the deputies wanted, carers simply registered in the more flexible framework of the Professional Territorial Health Communities (CPTS), which cover around half of the population, will be excluded from the system. For speech therapists in CPTS, direct access will be possible.
A welcome decision, but which must go further
The reactions of the professionals concerned by the measure, which were rather positive, were quick to emerge on the IPA and physiotherapist side:
“At 1,700, we are not going to revolutionize the health system, but it gives us prospects for greater intervention by nurses in the fields of prevention, screening and health promotion”, underlines Julie Devictor, president of the IPA National Professional Council, on the Infirmirs.com website
For Pascale Mathieu, president of the National Council of the Order of Masseur-Physiotherapists, the decision shows confidence in the profession, but requires more and faster action in the interest of patients.
“Let us very quickly open the contractual negotiations in order to allow the reimbursement of direct access care to avoid a two-speed medicine in a context in tension with too many patients who leave the course of care, for lack of answers adapted to their needs, thus reinforcing inequalities.”
For the UFC-Que Choisir, even if “we should not have too many illusions about the immediate impact “of this law for patients, a dike has jumped in terms of the sharing of skills between the doctor and the other caregivers”.
Other skills are also expanded
Always with the aim of facilitating the journey of patients, the text expands the skills of podiatrists-podiatrists and orthoprosthetists. The latter will now be able to adapt “initial medical prescriptions for plantar orthoses less than three years old”. Opticians can also adapt a prescription for corrective lenses or contact lenses with the written consent of the ophthalmologist.
On the pharmacist side, the text also provides for the possibility of renewing a prescription in the event of a chronic condition or even of administering vaccines. The provision aims to avoid an interruption of treatment when a prescription expires while the patient is without an attending physician.