“Knowing that 11% of French people do not have a attending physician, 18% to 20% depending on the territory, conditioning the increases on, in particular, obligations of permanence and on-call care, does not seem totally absurd to me”, notes the sociologist Frederic Pierru.
“General practitioners are relatively poorly paid in France” And “Liberal specialists are among the best paid in the world”, explained Tuesday, February 14 on franceinfo Frédéric Pierru, sociologist at the CNRS, specialist in health issues. Doctors are called again by the unions to close their practices on Tuesday. They demand an increase in consultation and denounce their working conditions. “The revaluation of the consultation raises the question of the reduction of income inequalities” between physicians, he points out. Health insurance offers GPs a basic consultation at 26.50 euros, against 25 euros today. The government could condition a more substantial increase on doctors who commit themselves against medical deserts. The Union of Liberal Doctors demands, for its part, a consultation at 50 euros: “How to explain such an increase in the income of doctors with patients who are becoming poorer due to wage moderation, inflation, freezing of the index point”, reacted the sociologist.
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franceinfo: Are general practitioners to be pitied in France?
Frederic Pierru: General practitioners are relatively poorly paid in France compared to other European countries. The problem is that we have liberal specialists who are very well paid, who are even among the best paid in the world.
“The revaluation of the consultation raises the question of the reduction of intra-professional income inequalities between the radiologist who can earn 800,000 euros net annually per year, and then the general practitioner who earns 80,000 or 90,000 euros.”
Frédéric Pierru, sociologist at the CNRSat franceinfo
Generally speaking, general medicine has been given very little value in France. There has always been a fairly large pay gap between generalists and specialists. It seems to me that the debate is there, rather than asking social security or taxpayers to finance 100,000 additional euros in income per year and per doctor.
The government could condition larger increases on greater involvement of general practitioners in the fight against medical deserts. Does that seem relevant to you?
Knowing that 11% of French people do not have an attending physician, 18% to 20% depending on the territory, conditioning the increases on, in particular, obligations of permanence and on-call care, obligations of public service, does not seem to me to be totally absurd. and finally frankly imperious. It’s done elsewhere. In France, we are in a dramaturgy which is quite classic during the negotiation of the national convention which binds the liberal doctors to the Health Insurance. Since the beginning of the 20th century, the beginning of social insurance, we have had demonstrations, strikes.
“The specificity of French doctors is that they have taken up the working-class repertoire, which we see very little in other countries.”
Frederic Pierruat franceinfo
How much should consultation be increased?
What is a little embarrassing and what shocks me is to demand a consultation at 50 euros, which makes 100,000 euros more per year and per doctor. I am a civil servant at the CNRS. I’ve been freezing the index point since 2010 and I’ve been suffering from inflation. How to explain such an increase in the income of doctors with patients who are suddenly impoverished, due to wage moderation, inflation, freezing of the index point, etc.? There is something that is quite shocking, especially when we finally say “no conditions, it’s unconditional and it’s for everyone”. If the consultation of general practitioners increases to 50 euros, the consultation of specialists will increase to how much? You will have to pay. Behind it is the taxpayer who will pay. We cannot say on the one hand, ‘we are carrying out a pension reform’. And then, to reduce public deficits, say ‘we are going to pay 100,000 euros more per doctor per year’. We will have to increase the CSG, but the power has said that it will not increase taxes. We are at a political impasse.
The government wants patients to have direct access to physiotherapists, speech therapists and advanced practice nurses without needing to go through a doctor. It’s a good idea ?
At the end of the 19th century, there were not enough doctors, who mainly treated the rich. Doctors had to be trained on a small scale, that is to say in four years. And so, liberal medicine has been built and organized collectively to fight against health officers. One has the impression of reliving with advanced practice nurses this debate which had taken place at the end of the 19th century. It’s fine to finally denounce a new division of labor between carers, pharmacists, etc., but the question is ‘what are we doing for the 11% of French people who do not have of attending physician?’ General medicine has become a bottleneck for access to a number of treatments. Still, something has to be done. In the recommendations or recriminations of current medical mobilizations, I hear very few solutions. I don’t hear anything constructive.