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Bertrand de Rochambeau (Gynecologist, president of SYNGOF)
In a new survey published this Thursday, the UFC Que Choisir denounces the extent of excess fees practiced by specialist doctors in France. More than half of them would use it. Doctissimo asked Dr Bertrand de Rochambeau, president of the Union of French Obstetricians and Gynecologists, to react to this data.
Exceeding fees charged by specialist doctors is an increasingly widespread practice, if we are to believe the “alarming figures” from the consumer association UFC Que Choisir. In 2022, the symbolic bar of 50% is crossed, with 52.2% of liberal specialists using this practice compared to 45.8% five years earlier.
Who are the specialists most concerned?
According to the survey carried out by UFC Que Choisir which studies eight different specialties:
- Gynecologists are the most likely to overcharge fees, with 71.4% of specialists concerned. They set the consultation at 50.60 euros on average, with a basic consultation at 30 euros and therefore an average excess of 20.60 euros.
- Ophtamologists represent the second specialty that most requires its patients to put their hands in their wallets: 66.7% of eye specialists exceed the basic rate of Health Insurance, with an average excess of 13. 60 euros.
- Finally, on the third step of the podium are anesthetists, almost 60% of whom have a consultation which exceeds the basic rate of Social Security, by 10.90 euros on average.
Territorial inequalities persist
If “the soaring price of care” is denounced by the consumer association, it recalls that profound “territorial inequalities” also remain. The UFC Que Choisir believes, for example, that a consultation can be “up to 2.5 times more expensive from one department to another“.
Generally speaking, Paris, Ile-de-France, the southern regions of France and some departments in large metropolises, such as Bas-Rhin or Rhône, have the highest prices.
UFC Que Choisir calls for a ban on installation in sector 2 for new doctors
To combat this move away from conventional rates practiced by more and more doctors, Que Choisir pleads for a “closure of access to sector 2 (free fee) for new arrivals”.
A measure to which Dr Bertrand de Rochambeau, president of the union of French gynecologists-obstetricians and co-president of Avenir spé le Bloc, the first union of specialist doctors in France, is totally opposed. “We are totally opposed to this measure which goes against the freedom of choice of practitioners.“. According to him, if the prices for consultations increase, “it is because of the added value that the doctor brings to his patient, with his years of study, possible operations or childbirth what he can do to her… If we ask patients, it is not our prices that concern them but rather the low reimbursement offered by Health Insurance“.
No new agreement between Health Insurance and gynecologists since 2021
For him, gynecologists are not necessarily “the bad students” singled out by the consumer association. “There are still, according to Social Security, 69% of procedures performed in gynecology which are at the enforceable rate. Moreover, the obstetrician gynecologists pay 40,000 euros of insurance in connection with their risky activity, in particular childbirth, when these are reimbursed up to 334 euros by Health Insurance” he further specifies. So many reasons which, according to him, allow “understand their need to increase their fees”.
What could limit the increase in excess fees, according to Dr de Rochambeau, is a new signing of an agreement between private gynecologists and Health Insurance. “This is what was done in 2016 for 5 years: Health Insurance increased its reimbursement base and we limited our excesses, so that the remaining costs for patients are improved. This agreement ended in 2021, negotiations resumed at the beginning of 2023 but failed and since then, nothing has changed” deplores the specialist.
But for the UFC-Que Choisir association, there is no guarantee that a revaluation of the enforceable prices for consultations by Health Insurance will not be followed by an increase in the fees of practitioners who are already in excess. The association insists on “the need to reduce the differences between basic prices and the prices charged, which patients pay out of their pocket, either directly or through an increase in the contribution to their supplementary insurance“.