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Dr Gérald Kierzek (Medical Director)
While a strike among liberal doctors has been underway since December 26 to highlight the lack of attractiveness of the profession in terms of its remuneration, another figure underlines the lack of access to a general practitioner throughout the territory: the number of practice practitioners has reportedly fallen by 11% since 2012.
In the middle of the winter period conducive to viral epidemics, are you struggling to find room with a general practitioner in a practice around your home? This is probably not just an impression. Not only, some of the liberal doctors are currently following the movement launched by Le collective Doctors for tomorrow which called for practices to be closed from December 26 to January 2, claiming a doubling of the basic consultation rate to create a “attraction shock among young doctors” who prefer to live in the city. But in addition, and above all, the sector has suffered from a continuous defection for many years from practice medicine.
Fewer practitioners in the practice, but more in the hospital
If the movement is not new, the figure reported by The world this December 29 is eloquent: in 10 years, more than 11% of general practitioner offices have disappeared from the counters. According to figures from the Drees (Direction of Research, Studies, Evaluation and Statistics) evaluated every January 1, in fact, for ten years, the number of general practitioners practicing exclusively in private practice has increased from 64,142 in 2012 to 57,033 to 1er January 2022.
This does not necessarily mean that there are 11% fewer doctors: at the same time, the number of general practitioners practicing both in the office and in the hospital has fallen from 4,780 to 8,437. they are therefore less available in practice. In terms of the network of the territory, while the French population continues to age and grow, since 2012, the density of general practitioners has increased from 101.7 to 84.34 doctors practicing exclusively in private practice per 100,000 inhabitants, and from 109.28 to 96.82 doctors per 100,000 inhabitants by integrating general practitioners practicing in private practice and in hospitals.
An organization to find, but to adapt to the territorial reality
General medicine seems to suffer from a “dislike” of students. According to the National Association of Students, which also published a study, students feel “a major loss of attractiveness for general medicine”. Among the students who had opted for it, more than one in two now calls this choice into question. It is also the fault of the measures taken by the government, such as the creation of a fourth year of internship to be carried out in the medical deserts which would make doubt 54% of the students who wanted to settle as a general practitioner in France.
For Dr. Kierzek, medical director of Doctissimo, it seems urgent to review the organization of the practice and adapt it, above all, to the territorial reality:
“The general practitioner isolated in his office no longer seems the relevant model on the patient side and organization of care, just as it no longer seems relevant on the work organization side of doctors. The younger generation does not want to be isolated.”
But betting only on the grouping of caregivers, as Emmanuel Macron mentioned in 2017 in his My Health 2022 objective, cannot solve the problem of medical deserts throughout the territory.
“We must also take into consideration the needs of the territories, and if there is a doctor who practices today in an isolated territory, alone in a village, it is important to allow him to stay.”
In his project, the Head of State had indeed mentioned, 5 years ago. “I want isolated exercise to gradually become marginal, to become the aberration and to be able to disappear by January 2022”. It is clear that today, the lack of practitioners in practice is felt in both isolated and populated areas and that there is still work to be done on a plural organization according to the needs of each territory.