Finding an appointment with a general practitioner is sometimes difficult, and this access to care will be further restricted in the current decade, due to poor past and current political choices. The health crisis does not help, since GPs must test, explain, vaccinate in addition to their usual activity. At the same time, politicians tremble for their careers at the idea of imposing a return to the mask in closed places in times of high viral circulation, and prefer to survey saturated hospitals to assess the impact of their inaction.
General practitioners are essential for the management of unscheduled care, the monitoring of chronic pathologies, prevention, screening, coordination… Unfortunately, they are also essential for useless, stupid or insulting acts, of which we present here a daily sample , in their simplest reality.
1/ Certificates of absence of sick child. An employee must look after his sick child, and benefits from days of absence for this. As the employer (as well as the school canteen and the crèche) do not trust the statements of the parent, a doctor must write these statements down on paper.
2/ Short work stoppage certificates. An employee must be absent due to a daily medical hazard (fever, flu syndrome, gastroenteritis, menstrual pain, etc.). As the employer does not trust the patient’s statements, a doctor must be consulted quickly so that he writes down on paper what the patient tells him (as with sick children, most of these symptoms do not accompanied by no physical sign)… The pandemic shows us, however, that patients can self-declare a work stoppage (via the website declare.ameli.fr) and that they use this service sparingly. This should also encourage the Minister for Prevention to abolish the waiting periods, the main consequence of which is to avoid work stoppages for viral disease (favoring contamination to confinement) or to delay work stoppages for people with the most modest incomes and often the most exposed to difficult jobs (thus exposing them to long and costly care induced by late treatment).
3/ Medical prescriptions for transport. A patient needs to go to a health professional, and must therefore call an ambulance. As the Health Insurance does not have confidence in these health professionals, they must be provided with a paper to confirm the medical validity of a transport to a care center.
4/ Nursing prescriptions. A home help service has been washing a patient daily for 8 years, a nurse has been following a patient suffering from diabetes every day for 15 years… As the Health Insurance does not have confidence in these professionals either of health, it is necessary to provide him every 6 or 12 months with a paper from a general practitioner to continue this care.
5/ Medical bed prescriptions. A patient benefits from a medical bed provided by a pharmacist or medical equipment specialist. As the Health Insurance does not have confidence in these health professionals, it must be provided with a paper to confirm that the patient must continue to sleep in a bed.
6/ Unjustified sports certificates. A patient wishes to practice a sports activity. As the insurer of the structure, the club or the competition wishes to be insured himself, a doctor must sign a sometimes inept paper to say that a patient is fit to swim 50 meters (difficult to test in consultation) , that a minor in good health can run or that an adult does not present any contraindication to pétanque or chess in competition.
7/ Certificates from private insurers. A patient on prolonged sick leave wishes to benefit from income maintenance or assistance with a loan, thanks to a contract taken out with a private insurer. As this insurer has suddenly lost the confidence in its insured that it granted to it during the monthly direct debits, a general practitioner must reveal to it (illegally) all the patient’s history before returning the money provided for in the contract.
Many other points deserve to be improved. The procedures with the departmental houses for people with disabilities should be simplified, with longer rights. Reimbursement of consultations with dieticians should be a priority for a Minister of Prevention.
Finally, our health system deserves to be simplified: today several branches and several health insurance schemes coexist whereas they would gain in efficiency if they were grouped into a single national scheme. In addition, Health Insurance covers the medical costs of those with the lowest incomes (via complementary health insurance), the longest and most expensive care (via long-term illnesses), or in a crisis situation ( delivery of masks, reimbursement of PCR tests, teleconsultations covered 100% by Health Insurance). Mutuals and insurance companies parasitize this system by intervening for brief, inexpensive care for patients with sufficient income; their niche in health should be limited to provident planning and not to daily care. Patients and doctors would also save time, by limiting the interlocutors.
“We are not intended to be the controllers of employers”
In a context of declining medical demography, it is time to rethink the role of general practitioners. We are not intended to be “controllers” or “insurers” for Health Insurance, for private insurance or for public or private employers. If these different authorities wish to carry out checks, they can hire staff for this purpose and do it: they just stop considering general practitioners as the guarantor of their distrust of their fellow citizens.
This “shock of simplification” would be life-saving; it involves no expenditure of public money and would free up hundreds of thousands of general medicine consultation slots per day in France, at the cost of a few hours of effort for our legislators.
Signatories:
Michaël ROCHOY (62), Jonathan FAVRE (59), Thomas LE BERRE (35), Philippe ROUX (32), Chloé LOYEZ (71), Mathieu CALAFIORE (59), Pierre DE DEMOND d’ARS (92), Nicolas DE CHANAUD (75), Marie-Hermine FASSIER-ROBERT (92), Marie Alice GÉANT (59), Marie BENQUE (75), David COSTA (30), Nicolas BARBET (50), Alexandre MALMARTEL (91), Romain MALFOY (62) , Pauline GIRARD (38), Philippe PARENTY (62), Bérangère BARTRO (47), Jean-Paul CHEMIN (62), Florence HARTHEISER (49), Stéphanie MAZAN (31), Julien REICHEL (44), Caroline CHALVIGNAC (06) , Lauranne COIGNARD (38), Mathilde CARRÉ (62), Guy GORET (62), Sylvain BOUQUET (07), Pierre-André BONNET (84), Arnaud CHABARDES (31), Jacques VADON (84), Charlotte GOOLAERTS (84) , Julie LEGRAND (91), Denis DELEPLANQUE (62), Claire MANIGAULT (83), Alexis BERNAL (84), Vianney FOURNIER (62), Aurélien BEYLOT DAUDIGEOS (40), Antoine ANDRE (62), Olivier TAHON (62), Alexa JAFFRE (84), Louis MERLIN (62), Stéphanie LEPRÊTRE (62), Florian FACON (84), Thibault PUSZKAREK (29), Cami lle LEVQUE (47), Jean-Baptiste BLANC (75), Emilie FRANZIN (32), Jean-Baptiste KERN (38), Charlotte BAILLEUIL (59), Sébastien ENFOUX (84), David CARRON (13), Emilie BOURGES (93 ), Amandine SALANOVA (30), Louis-Philippe BALAMBA (93), Charlotte PARMENT (75), Julie MORRIER (75), Jérôme POMMEL (84), Alexandre SERVAIS (62), Elodie ROQUETTE (974), Emmanuelle PERRIN (74 ), Marion GUITARD (64), Jan BARAN (59), Christian CHILLI (83), Jean-Pierre DELPIERRE (62), Fabien ROUGERIE (67), Jean-Charles MORADEI (83), Stéphane LOISEAU (83), Stéphane KRIEF (91), Suzanne ANDRAOS KHOUEIRY (83), Philippe FOLIO (83), Jenny FORTÉ (84), Marc LEDROIT (62), Frédéric LECLERCQ (62), Perrine WASSERMANN (83), Guillaume NOËL (62), Anne DECOBERT ( 62), Philippe LEOUFFRE (83), Muriel VAMPOUILLE DENERVAUD (62), Fanny ROY (83), Dorothée LAVIELLE (62), Thierry LALLEMAN (62), Stéphane AY (62), Céline BERTHIÉ (33), Mélanie PELLET (38 ), Clément MARCHE (75), Thomas PINTO (93), Amandine LABARTHE (94), Christophe LAMARRE (59), Axel BOREY (39), Frédérique HOFLACK (62à, Céline SERRE (13), Adrien PRIVAT (13), Bénédicte BARBARIN (44), Nathalie COTTREEL (62), Michaël PETTINI (47), Pierre DAVID (02), Bruno ANOUILH (62 ), Sébastien DEMANGE (66), Caroline DI LORENZO-KAS (33), Serge COVACI (67), Marion DUFOSSÉ (33), Raphaël DACHICOURT (59), Thomas MAUNOURY (59), Elise FRAIH (67), Julien GIRAUD ( 33), Romain ALEXANDRE (76), Pierre LOUÉ (76), Aurélie TRICHARD-LAVERGNE (31), Olivier GUERCIA (13), Jimmy GIRARDET (26), Manuel PRODHOMME (53), Nicolas FAGE (33), Aurélie CARRON ( 31), Véronique CHERIAUX (37), Cyril MAZUBERT (64), Clément RENAUDIN (69), Nicolas GIRIER (62), Mathilde CHOUQUET (75, Meltem ENGIN (49), Marjorie THOMAS (62), Julien ROMI (08), Isabelle de RICAUD (33), Camille JOURDAIN (62), Mathieu VAN DESSEL (92), Nicolas LEPRINCE (62), Manon LAMBERT (14), Gaël BERNARD (69), Bernard DUSFOUR (34), Christophe COSTANTINI (33), Nicolas LE BOT (62), Tiffany GRANDPERRIN (13), Thibaut DAUPHY (02), Nima SAGAGHIANI (68), William DELORME (68), Hoël CHARBONNEL (35), Donatien TALON (73), Jonathan HIMPENS (62), Lina CADORET (38), Gaëtan D’AILLIERES (59), Patricia DUBOIS (06), Justine DREHAUDAT (51), Virginie FOURCROY (62), Christophe FOURCROY (62), Laura LEBRETON (13), Capucine JOLY (51), Pascal CHARBONNEL (91), Constance BUTEL (62), Stéphanie MARSAN (92), Lucie CAPPE (44), Fanny ALBU ( 67), Charline HOURLIER (08), Anne-Isabelle ROUSSET (49), Cassandre CARPENTIER (62), Thierry DESPLATS (13), Pierre-Vincent BOURLIER (38), Romain VEZILIER (08), Antoine KIRMANN (56), David JENNAH (95), Clotilde LAMBERT (44), Agnès DHALENNE (62), François PERESSON (82), Clarisse MARIN (44), Marie-Céline GOBERT BAUSSERON (08), Anne BOUCAULT (31), Anne-Lise RAYSSAC (31 ), Nadège PIERRE-LOUIS (95), Jennifer BOYER (40), Lionel MICHEL (13), Lucile BLANC (06), Yannick BATHENAY (76), Camille MATHIEU (17), Anne-Solène DELETRE (17), Marion PUECH (31), Jérôme DUTARTRE (68), Delphine GODARD (72), Grégory VANOUTRYVE (62), Jérôme MAZET (94), Baptis you MEUNIER (38), Cécile DESECHALLIERS (76), Nathalie MOZOL LE CAM (13), Mathieu VERGERET (33), Catherine DELAROZÉE (62), Tifaine WITZ (69), Mahefa MARA (33), Marie-Cécile BEAUDOUIN (80 ), Clémentine LALLEMAN (62), Charline HELINCK (59), Héléène CARRIER (84), Edouard PLÛT (14), Frédérique BOUTOILLE (62), Dominique QUEHEN (62), Emilie COUDERC (77), Maëlle PERRIN-FROIDUROT (05 ), Carole CHAMBOSSE (17), Thomas WAUTERS (29), Cécile ERHEL (82), Fabien LABLANCHE (77), Bryan CHARPENTIER (77), Madeleine LHOTE (83), Sandra CAVET (44), David COLOMBO (82), Valérie MULLER (31), Annabelle BONNET (69), Antoine OSPITAL (64), Ruddy LEGROS (08), Aurélie URENA-DORES (30), Brice DONETTI (54), Julien BURNAY (80) and the inter-union REAGJIR (Grouping Autonomous Young General Practitioners Installed and Substitutes)