The National Health Insurance Fund asks more than a thousand doctors to limit sick leave so as not to risk financial penalties. Luc Duquesnel calls them on Tuesday on franceinfo to refuse “this setting under objective”.
“Putting this pressure on treating doctors is outrageous, it’s mistreatment of family doctors”, denounced Tuesday June 20 on franceinfo Luc Duquesnel, general practitioner in Mayenne, president of the “generalist” branch of the Confederation of French medical unions (CSMF). Bercy wants to hunt for sick leave of convenience and hopes to recover 10 billion euros in this way.
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The National Health Insurance Fund (Cnam) contacted 6,000 doctors identified as major prescribers of sick leave. Among them, a thousand are particularly targeted. They must commit to limiting sick leave if they do not want to risk financial penalties. Luc Duquesnel calls to refuse “this focus” and encourages them to claim “a prior agreement”. Clearly, the sick leave must be validated by the medical advisor.
franceinfo: Is the government right to hunt for sick leave of convenience?
Luc Duquesnel : If really it is identified frauds which exist with the stoppages of work, very clearly, one cannot agree with such frauds. It is only general practitioners, family doctors who will be checked. 6,000 doctors is 13% of general practitioners since there are currently 46,000 in France. Today, there are fewer and fewer doctors in the field, with more and more patients to take care of. It is very hard today to be a family doctor.
“Finally, the feeling is that we are considered fraudsters. 13% of general practitioners are considered fraudsters by the Cnam.”
Luc Duquesnel, president of the “generalist” branch of the CSMFon franceinfo
Work stoppages have increased by 30% over the past three years. How do you explain it?
There is less and less unemployment, therefore more and more people working. If there are more and more people working with rising wages, it is normal for the number of work stoppages to increase and for the cost of work stoppages to increase. We are not surprised. This is real mistreatment of doctors, family doctors, doctors in the field. The National Health Insurance Fund will contribute to improving access to care. When we see how hard our daily work is. When I stop work, it’s because the appointment with the specialists is in three months and I’m going to extend the employee’s work stoppage.
Have you ever been asked to stop for convenience?
What can happen is someone will fake back pain, but it’s always short-term downtime. Today, we have companies from elsewhere that are identified by the Cnam where the work is increasingly hard, where the turnover of employees is high because the working conditions are very difficult. These are people who present states of anxiety, anxiety-depressive states, who no longer sleep, who come to the office in tears. Normally, the fund is informed of all these stops. If really there are stops that are renewed, she can control the patients. So today, putting this pressure on attending physicians is outrageous, it’s mistreatment of family physicians.
The letters are sent only to doctors who prescribe at least twice as many work stoppages as the others.
It depends on your patient. If you have a patient base which is made up above all of retired patients, the sick leave rate is very low. It is often said that the age of the doctor’s patient base corresponds to the age of the doctor. If you are 40, that means you have a patient base with a large percentage of working people. From there, you are going to have a lot more work stoppages compared to the number of acts you do. There is nothing surprising.
“The fact that the medical advisers will propose a target setting, that is to say that we will tell the doctors: you must reduce your work stoppages by 15%. What does that mean? for patients who are suffering, we will not be able to take work stoppages.”
Luc Duquesnel, president of the “generalist” branch of the CSMFon franceinfo
Doctors are told: refuse this setting under objective, on the other hand ask for a setting under prior agreement. It happened to me a few years ago. When I stop, I warn the patient that my stop will only be effective if it is validated by the medical advisor. None of my judgments were called into question by the medical adviser.