Social security charges, rent, car… Why general practitioners say they “can’t get by” with a consultation costing 26.50 euros

After obtaining an increase of 1.50 euros during the last negotiations, the general practitioners’ unions are demanding a further increase in the consultation to 30 or even 50 euros, compared to 26.50 euros currently.

Will general practitioners get the price of the consultation to increase to 30, or even 50 euros, as certain professional unions are demanding? In any case, general practitioners are expecting a lot from the third negotiation session with the Cnam, which is being held on Thursday February 8. Practitioners claim that they cannot get away with a consultation costing 26.50 euros.

A general practitioner earns, on average, 7,500 euros net per month. How can we justify this request for an increase?

In Cergy, in Val d’Oise, Delphine Tortiget has worked in a medical center for 13 years. She continues the consultations, which she charges at the regulatory rate: 26.50 euros for a simple consultation. And it is not there, in particular because of inflation: “That’s not enough to catch up with the level of inflation. It would have to be 30 euros. For example, I earn around 16,000 euros per month, because it has fallen a little. There are social charges, rent, secretaries’ salaries, supplies, replacement, car. That’s about 9,000 euros in charges every month. So yes, that’s 7,000 euros left, except for me I work 49 hours in front of patients and I have about six hours of extra work outside of it.”

7,000 euros per month is a lot. But over 55 hours per week multiplied by four, that gives 32 euros per hour. After ten years of study, she believes that it is not enough. Doctor Tortiget would also like to see an increase in the amount she receives as an attending physician. Because all these bonuses can help attract applicants. This is a big issue when we know that nearly seven million people do not have a regular doctor: “It’s one of the solutions for attracting doctors to practice as treating general practitioners. There are many general practitioners who don’t do it. We already don’t have enough of them, so if we can re-attract them to the profession, for the good of everyone…” In ten years, the number of independent general practitioners has fallen by 11%, there are around 57,000 practicing in the city today.

Some general practitioners have already set their consultation at 50 euros

Some did not wait for the outcome of these negotiations with health insurance. They are defunded, that is to say they are no longer accountable to Social Security and health insurance does not finance them. There are a handful of them, a little over 500 according to the Cnam.

Doctor Arnaud Lerouge, for example, doctor in Cambrai (North). As he has broken down, his patients are not reimbursed at all. So obviously, fewer of them come to his office every day: “I went from 40 patients to around 25 to 30 patients. Which means that at the end, I have a slightly increased turnover, which will make it possible to pay for the famous inflation of last year. And to include what the patient does not see: like teachers at school, there is working time outside the presence of the patient. In the evening, like my approved colleagues, I reopen the computer at 11 p.m., to look biology, to send messages to secretaries, to send messages to patients by email. Sometimes at midnight when there is an urgent need to do a biological check again the next day. That’s work that is not absolutely not paid.”

This doctor costs 50 euros for his consultation. He admits that his high price has scared away some of his patients. Those who stay only make an appointment when they really need it: “Indeed, the patients reason a little bit, whereas before I was overwhelmed with work. When it was the flu, everyone was one behind the other; when it was gastro, it was the turn of gastro. There people hydrate at home, perhaps go get some Smecta at the pharmacy. Unless they need sick leave, they live their lives and they realize that the time to take go, they are cured.” Doctor Lerouge adapts his prices. When a patient does not have the means, he lowers his consultation to 30 euros and sometimes it is even free.

Other doctors could see their prices increase

Psychiatrists and pediatricians are even less paid than general practitioners, already at the bottom of the scale among private doctors. To compare, a psychiatrist in the city earns on average 5,800 euros, a pediatrician a little more than 6,000 euros per month while on average specialists are above 9,000 euros per month. Raising the profile of psychiatrists and pediatricians would make it possible to attract young doctors to these specialties which are under pressure.