“If this should result in sending interns to areas where there is no one, they will stop medicine“, alerted Saturday September 24 on franceinfo Luc Duquesnel, general practitioner in Mayenne and president of the general practitioners of the Confederation of French medical unions (CSMF), while the government wishes to set up an additional fourth year of internship for students from general medicine by encouraging them to carry it out in medical deserts.
Luc Duquesnel judges the idea “badly presented“.”They must be surrounded by one or two doctors“, he assures. He also calls for “change professional organizations“because the situation”no longer acceptable“.
franceinfo: What do you think of this idea put forward by the Minister of Health?
Luc Duquesnel: A fourth year of internship, among other things for general practitioners, but also for other medical specialties, must be a professionalizing year. This therefore means that we are not going to send these doctors where there have been no doctors for two or three years in the medical deserts. It is a training year. They are always internal. In areas with low medical demography, they will have to be accommodated in medical homes, in multi-professional health homes. This is essential. When I was an intern, if I had been left alone in the countryside, I would have chosen another profession where I would have been a salaried doctor or a hospital doctor. It’s not about endangering them. We need to be surrounded by other colleagues. I would like to remind you that medical deserts are not just rural areas. Paris is a medical desert with general practitioners. So these are also urban areas.
So is this fourth year a good idea?
No. I think it’s misrepresented. And the way some elected officials talk about it, they have the impression that in their village, where there have been no more doctors for three years, we will suddenly have a fourth-year intern who will show up at their house . No, it doesn’t have to be that, very clearly. On the other hand, there are areas where there is a huge shortage of doctors. During this professionalizing year, they must be surrounded by one or two doctors. It is also allowing the territories to organize themselves. But if that should lead to sending interns, who are not yet doctors, to areas where there is no one, they will stop medicine.
What should be done to find a solution to these medical deserts?
Today’s demographic situation is the result of decisions that have been taken for 35 or 40 years by politicians. It is the same people who want coercion today, who have brought us to the situation we are in today. On the other hand, the situation is not acceptable in terms of access to care. These interns, many of them have only worked in the hospital. We have to show them what it is to be an outpatient doctor, liberal medicine. So this fourth year should make it possible to work with other doctors in areas with low medical demography and to discover what liberal practice is. After that, there are plenty of other solutions. It also means working with other health professionals, with advanced practice nurses, hiring medical assistants. We know very well that for the next ten or thirteen years, the number of doctors will continue to decline. So that means modifying our professional organizations to take care of more patients, because the current situation in terms of access to care is no longer acceptable.