“We lose about 8,000 general practitioners a year,” laments Luc Duquesnel.
“Access to care is getting worse”, alert Thursday on franceinfo doctor Luc Duquesnel, general practitioner in Mayenne and president of the general practitioners of the Confederation of French medical unions. A study by the Dress, unveiled Thursday, May 25 by France Bleu, indicates that 78% of liberal general practitioners consider that there are not enough of them in their territory. This is eleven points more than in 2019. “I’ve been practicing for 35 years and retirement means nothing to me. I want to continue working but these are the worst working conditions of my life”warns Doctor Luc Duquesnel when he is to meet the Minister of Health during the day.
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franceinfo: Nearly 80% of general practitioners believe that there are not enough of them in their territory. Are you surprised by this number?
Luc Duquesnel: There is no surprise, since we are losing about 8,000 general practitioners a year and this will continue, at least, until 2030. And all this, while the population is growing and aging, so there is more demand for care and follow-up from patients with chronic pathologies. Concerning my territory, I am in the Pays de la Loire region where medical demography is the weakest.
“At the national level, it’s about 89 general practitioners per 100,000 inhabitants. In my territory of 43,000 inhabitants, we have a medical density of 34 general practitioners per 100,000 inhabitants.”
Luc Duquesnel, President of the General Practitioners of the Confederation of French Medical Unionsat franceinfo
For example, which is caricatural, in 2006, we did 17 guards a year because we were 21, we will go on January 1, 2024 to 37 guards. These are working conditions that are increasingly difficult. General medicine, and in particular the profession of attending physician, that is to say ensuring the follow-up of patient care, is no longer attractive. We also see it among interns in general medicine who today choose to change their medical specialty.
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Still according to Dress, two thirds of general practitioners also indicate that they refuse new patients. Is it something you experience on a daily basis?
Every day ! While the national average for independent physicians is between 1,000 and 1,070 patients per attending physician in their patient base, in our territories, we are between 1,500 and 3,000. Today, in fact, our secretaries spend more time to say no to requests for care. Because saying yes means that the patients for whom we are the attending physician, we will not be able to take care of them. At some point, it affects the quality of care.
“We’re having a real tsunami when we hired an advanced practice nurse, when we hired medical assistants.”
Luc Duquesnelat franceinfo
And everything that is implemented globally means that access to care is probably not getting worse as quickly as it could get worse, but it is getting worse.
Have you ever thought about quitting?
I wonder yes. I’ve been practicing for 35 years and retirement means nothing to me. I want to continue working but these are the worst working conditions of my life. So I wonder.
What should be done?
When a medical convention leads to offering general practitioners a tip of 1.50 euros for the revaluation of their consultation, which is often long, from 30 to 45 minutes for our elderly, polypathological patients, it is humiliating and contemptuous. This automatically leads doctors to question their profession. What is the view of this government, the Health Insurance on the work we do on a daily basis?
You have an appointment, with other representatives of the world of health, with Minister François Braun, after the assassination of a nurse at the CHU de Reims. What are you going to ask?
This type of meeting, I would say, is a bit of a must. We are going to say the same thing again as what we have been saying for ten or fifteen years. It is true that the problem of access to care creates tensions with respect to certain patients. We can also understand anger, so without coming to physical aggression. I am also a regulating doctor, that is to say the night of the weekends for the center 15. Every month, it happens to me to have death threats because people are not satisfied with the answers brought to them at their request for care. We are also in a society where it means wanting everything, right away. And that is not possible. Firstly because it is not justified, but also because both in the hospital and in the city, thirty years of policies carried out by the various governments have brought us to the situation where we are today.
Hospital beds are being closed, emergency services are closing. This creates a climate of violence. Every month I get at least one death threat over the phone with a recorded conversation.”
Luc Duquesnelat franceinfo
But I’m not going to file a complaint because that means I’m going to cut off one hour of consultation to go and file a complaint. It is also allowing doctors, when they are in danger, to be able to report it. And then, it’s not just health professionals, there are firefighters, there are police officers, law enforcement. Overall, we are also in a society that is becoming more and more violent.