Starting January 1, 2025, dentists in France will encounter new regulations aimed at reducing geographical disparities in dental care through a bonus-malus system. This initiative incentivizes practitioners to work in underserved ‘red zones,’ offering up to €50,000 for a five-year commitment. While many welcome the changes, some dental students argue it restricts their professional freedom. This regulatory framework mirrors existing systems for other healthcare professions, signaling a broader shift in France’s healthcare policies.
A New Era for Dental Practices in France
In a significant shift within the healthcare landscape, starting January 1, 2025, dentists in France will face new regulations regarding their practice locations. The Health Insurance has collaborated with the leading unions in the field, namely Dentists of France (CDF) and the Federation of Liberal Dentists’ Unions (FSDL), to implement a bonus-malus system aimed at addressing geographical disparities in dental care.
Incentives for Practicing in Critical Areas
This initiative is designed to encourage dentists to serve in areas classified as critical or ‘red zones.’ Dentists who commit to practicing in these underserved regions for a minimum of five years will be eligible for a substantial bonus of €50,000, significantly higher than the current installation aid. According to Cartosanté, a statistical tool from the Ministry of Health, there are over 22,600 zones identified as ‘very under-equipped,’ primarily in rural locales where the ratio of dentists to residents can be alarmingly low. Regions such as Creuse, Allier, and Orne are among those struggling with access to dental care.
In contrast, there are 73 ‘non-priority’ areas—typically urban centers like Paris and Strasbourg—where dentists can establish practices, but their patients won’t receive Health Insurance reimbursements. Although participation in this new system is optional, the financial incentives are compelling. An important exception allows dentists to replace retiring practitioners, ensuring continuity of care in these communities.
Those already practicing or specializing in areas like oral health and orthodontics are not subject to these new regulations and can maintain their existing agreements. Furthermore, personal circumstances may lead to exceptions for some individuals on a case-by-case basis. However, health centers employing practitioners will also face restrictions regarding their establishment and expansion.
Mixed Reactions from the Dental Community
As the implementation date approaches, reactions from the dental community vary. David Lafond, vice-president of the Regional Council of the Order of Dentists of Grand Est, believes the new measures align with the profession’s understanding and can be smoothly executed, especially given the anticipated turnover of retiring dentists in the area. Julien Cardona, deputy secretary-general of CDF, expresses optimism about the agreement, noting it benefits more practitioners than it penalizes.
In contrast, many dental students and recent graduates view the regulations as restrictive. Ralitsa Androlova, president of the National Union of Dental Surgery Students (UNECD), argues that the new measures undermine the freedom of establishment, a core tenet of pursuing a career in dentistry.
This regulatory approach is not entirely new, as similar systems are already in place for other healthcare professionals, including nurses and pharmacists. A growing number of deputies are advocating for similar measures to be applied to general practitioners, indicating a broader shift in France’s healthcare policy.