At midday, in the middle of July, the president of SOS doctor in Cherbourg Christophe Marchenay and his colleague follow up consultations. “The person who called at 7:35 a.m. had an appointment at 12:10 p.m. I started consultations at 8 a.m., for people who had called at 2:30 or 3 a.m..” explains Christophe Marchenay.
But the day of the doctor starts at 4 a.m.through home visits. “I finish at 8 p.m. in the evening, that’s 16 hours in a day, with 1 hour to eatexplains Christophe Marchenay. On average, that makes us 120 to 140 possible procedures over the day, including visits and consultations. We were forced to maintain this pace to keep two lines of activity minimum per day, knowing that it is a minimum that we absolutely want to keep.
Only two doctors present each day, but to allow others to take vacations. “We need it like everyone else, asks the president of SOS Médecins. We may be present for the population, to treat them, if we don’t take a little care of ourselves, we will no longer be able to treat anyone.” It is to be sure of getting a team in better shape at the start of the school year that everyone makes this big planning effort during the summer.
“We are very quickly saturated”
If the days are busy, they are not more so than usual, according to Christophe Marchenay: “It’s like that all the time, whether it’s winter, spring, summer, autumn. For us, it’s our usual rhythm. We are saturated very quickly.” In the list of consultations for the day, patients of all ages who come for very different reasons. “Dermatological problems, gastroenterology problems, rheumatology problems, lists the doctor. It could be lumbago, which will prevent this gentleman from going to work. It is not vital, but the person will not be able to work and if he does not have a work stoppage, he will be bothered by his employer. Another example : “An 81-year-old lady who has a urinary tract infection, and her doctor probably unavailable or unreachable. A 12-year-old girl who has a sore throat, so perhaps a Covid test to be carried out…” The list is long, but all patients have one thing in common: they all come for a “small” daily emergency, which in the jargon is called “unscheduled care”.
“We lack doctors, it’s a fact”
These patients end up going through SOS Médecins for several reasons: “Either because they no longer have a doctor, or because apart from us, there will be no one who can make an appointment for the same morning, or else the emergency room. But these patients do not want not clog the emergencies and above all, some no longer call their doctor because for day care, there is no availability.
The commitment of SOS Médecins does not manage to unclog the emergencies. According to Christophe Marchenay, it is of course not the fault of the patients: “Do people not know how to temporize? At the same time, it’s complicated for someone who has no medical knowledge to temporize their condition and their request for care”. Not the fault of the GPs either, who “their part” according to the doctor.
We may find all the regulations, all the systems in the world, we lack doctors to see people, that’s a fact.
No more home visits since July 1
Four hours of visits in the morning, then consultations all day: this is not the model that we know at SOS Médecins. And for good reason, since July 1, caregivers have stopped daytime home visits, that is to say at times when they are not in theory the only ones able to provide them. “We continue visits on weekends and at night”insists Christophe Marchenay. “We need an upgrade so that we can continue to recruit and attract doctors. The Braun Mission started in June. We have not received any clear answer on the home visit.”
A decision taken reluctantly, because this aspect of the profession is one of the reasons why these doctors chose SOS Médecins. “We like the contact with the patient, being available all the time, recalls Christophe Marchenay. But if we are not given the means, we cannot do it.”