The attending physician is at the heart of the health journey. He coordinates all of the patient’s care and directs him to specialists. How to choose your attending physician? How to change it?
In France, it is considered that more than 85% of French people declared a general practitioner, and that in 99% of cases it is a general practitioner. The role of the attending physician is to coordinate all care received by his patient. He is also responsible for referral to specialists if needed. How to announce his attending physician? Which doctors can you consult without going through the attending physician?
Definition: what is a general practitioner?
The attending physician is the one who coordinates all the care received by a patient. He plays a central role in his personalized medical follow-up. As part of the health course, it is likely torefer the patient to specialists and must centralize all the information in his medical file. It is a real benchmark, hence the importance of taking the time to choose it well. Since 2017, the designation of an attending physician has extended to children under 16 although a lack of declaration or non-compliance with the care pathway is not currently penalized by a reduction in reimbursements.
What is the role of a treating physician?
The roles of the attending physician are clearly defined in the medical agreement. He is therefore required to:
- Treat the patient on a daily basis while knowing his medical and family history.
- Ensure prevention personalized patient: follow-up of vaccines, screening examinations, health advice according to their profile, help with quitting smoking, food advice, etc.
- Refer the patient to specialists that he will have previously informed of his state of health;
- Manage the patient’s medical file by centralizing all the information concerning his care and his health.
- Set up a care protocol in case of long-term illness.
The choice of attending physician is free : it can be your family doctor or another practitioner, general practitioner or specialist, contracted or not. It is not subject to no geographical limit in relation to his patient, and can practice in a hospital environment as well as in a practice or health center. Given the important role he plays, it is best to choose a practitioner close to the insured with whom he is comfortable and confident. The choice often falls on the family doctor, although the members of the same family are not required to declare the same general practitioner. Although the attending physician’s statement is nominative, it is established that in the case of a practitioner belonging to a medical office, the patient can consult another doctor in the group without financial penalty in the absence of his referent.
Once the choice has been made, the attending physician’s declaration form can be obtained from the Social Security fund or by downloading it Cerfa 12485 on the Internet. It is then filled in with the chosen doctor and sent to the fund. The declaration can be made online by remote transmission, directly to the doctor’s office and on simple presentation of the vital card.
Can I go to a doctor other than my primary care doctor?
In the absence of the attending physician, the patient may consult another GP without suffering a reduction in reimbursement. All that is required is for the substitute doctor to enter the “MTR” code from the electronic care sheet or tick the box “Replaced Attending Physician” of the paper care sheet. When the patient is away from home (holidays, business trip, etc.), he can consult another doctor without lowering reimbursement. The doctor must then enter the code “MTH” or check the box “Outside habitual residence” of the care sheet.
What specialists can be consulted without going through the attending physician?
With few exceptions, every consultation with a specialist requires a referral letter from attending physician, essential to respect the course of care and benefit from a maximum reimbursement. This is particularly the case for ENT specialists, gastroenterologists, dermatologists, rheumatologists, cardiologists, allergists and radiologists. The few specialists that can be consulted directly (without going through his attending physician) are: gynecologists, ophthalmologists in the event of renewal or screening and follow-up for glaucoma, the psychiatrists or neuropsychiatrists (between 16 and 25 years old) or stomatologists.
The change of attending physician can be done as often as desiredwithout the need for justification and without any condition. All you have to do is send your health insurance fund a new declaration completed and signed by the new attending physician chosen. The former attending physician will not be informed of this change.