And if, to attract doctors, the solution was wage employment? While six million French people live in a medical desert, debates will be held for three months throughout France as part of the health section of the National Council for Refoundation (CNR°). Among the initiatives to be listed, there is that to pay doctors in medical centers to attract them, as is the case in Saint-Rambert-d’Albon, in Drôme.
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Here, four general practitioners have been welcoming their patients since May 2021. A great boon for Patrick, a resident of the area, who now goes to his doctor with a smile. “Not bad, thank you!“, he replies to Doctor Katya Zekri who welcomes him and invites him to settle down. Patrick is indeed much better since he can come here. “As our doctor has retired, I haven’t had a doctor for a year and a half.he explains. Fortunately, the medical house was able to open its doors and recruit doctors. With my wife and children, we were always looking and it was getting more and more complicated.”
The opening of this center has changed “enormously“things for him.”We live better, we feel calmer, especially when we live in the countryside“, he summarizes. Like him, many other patients were looking for a doctor. The demand was very strong, so much so that on the first day of opening of the center, he received 1,500 calls of patients.
Katya Zekri therefore settled in this center after working in the hospital. This is “the employee first“who lured her here to escape the”constraints” of the hospital, “guards, on-call duty“.”I prefer to earn less and come home at night to see my children and my family“, she assures. Same motivation for Dr. Emeline De La Motte, who had just finished her medical studies before settling here, and who “didn’t know at all“Saint-Rambert-d’Albon.”I arrived because there was this medical center being set up. That’s what really attracted me“, she admits.
Here, the doctors are employees of the community of communes, and this is a demand from young people today. They benefit from a secretariat, they have no administration to do, they have fixed hours and days off. Their monthly salary is fixed, it starts between 2,500 euros and 3,000 euros net, then increases with seniority. “We have a Wednesday and a Friday out of two, it allows you to spend some time with your family. I am 33 years old, four children, this is my first installation and I would never have settled otherwise“, explains Emeline De La Motte.
“I arrive in the morning, I put my things down, I see my patients and when I come back in the evening I have done good medicine.”
Emeline De La Motte, general practitionerat franceinfo
“It’s better for the patients, it’s better for me”assures the doctor, who did not necessarily feel ready to settle down on her own and did not necessarily want to: “I couldn’t see myself as a company manager, a mother of four children, a doctor in a region where there is no doctor, without having a secretary, a whole administration around me, an accountant.“
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This solution allows a better balance of doctors and which is good for the patients of the territory. “It was very, very hard, they hadn’t had a doctor for a while, the treatments were catastrophic, there were unbalanced diabetes, unbalanced hypertension, people who hadn’t consulted since five or ten years“, advances doctor Emeline De La Motte. It was therefore necessary “take things in hand“, and now “the patients are doing much better” and “there are fewer requests“. In all, 2,000 patients are followed at the health center. A fifth general practitioner is expected.
Today, there are 350 health centers in France based on this model, financed by town halls, communities of municipalities and departments. In Saint-Rambert-d’Albon, the project required more than four years of work. “It was not easy, as soon as we touch the world of health, we are in a complex universe which is not our heart business“, says Pierre Jouvet, the socialist president of the community of communes Portes de DrômArdèche.We had to learn, work, find out“, he continues. They proposed to the doctors who were in end-of-study internship in the territory to come, universities were also canvassed.
“It was hard, it always is. Today, we have four general practitioners, if we had five, six, seven or ten, we would fill the health center in the same way“, he assures. All this necessarily has a fairly significant cost for the community. “It costs 200,000 euros a year”explains the president of the community.
“It represents 100 euros per patient. It’s a choice, it’s a political investment.”
Pierre Jouvet, president of the Portes de DromArdèche community of municipalitiesat franceinfo
Pierre Jouvet also explains that other projects carried out by local authorities are more expensive: “When we decide to build swimming pools, when we redo a street, it costs a lot more.” “My desire is to have strong local public services“, he concludes. His community of communes hopes not to stop there. By building the health center, it has left the possibility of building, one day perhaps, an extension right next to it.