Medical deserts. Map of areas without general practitioner, paediatrician, ophthalmologist, gynaecologist…
A new brick in the ever-higher wall of medical deserts. UFC Que Choisir publishes an interactive map showing the difficulty of accessing care in France this Tuesday.
About one in four French people live far from a general practitioner. And if we add the financial dimension (with the social security rate or overpayments), the share of healing deserts expands even more, especially when it comes to consulting a specialist.
To compile an inventory of non-practicing areas, the Consumer Society compiled the number of physicians by municipality, focusing on four specialties: general practitioners, ophthalmologists, pediatricians, and gynecologists.
A quarter of the total non-practicing French
In France, about one in four French people (23.5% or 15.3 million people) have difficulty accessing a general practitioner (an area with accessibility between 30% and 60% of the national average). Of those, 2.6% (or 1.7 million people) live in a medical desert, an area where geographic accessibility is at least 60% below the national average, according to the UFC Que Choisir census.
Specialists in big cities, in the south, on the coast…
The distribution of medical professionals is even more unbalanced. “The population of specialist doctors is poorly distributed across the territory,” says Maria Roubtsova, UFC-Que Choisir’s health mission manager. mountain to the detriment of other areas.
The result, according to UFC estimates: 19% of patients (12.3 million people) live in an ophthalmological medical desert. Combining hard-to-reach areas, 38.3% (24.9 million people) of Metropolitan France residents have below-average access to doctors, denounces the consumer association.
In the midst of the child crisis in hospitals, UFC figures also highlight the degraded situation for children: 27.5% of children aged 0-10 live in medical deserts. If we take into account the children of all communities characterized by the difficulty of access to this profession, more than half of the children (52.4%) face difficulties. Finally, nearly a quarter (23.6%) of patients over the age of 15 struggle to see a gynecologist, and a total of 41.6% of them live in a municipality with access difficulties.
Finding a Doctor Safely: Mission Impossible?
Another parameter is added here: cost of care. “Two-thirds of gynecologists and ophthalmologists overcharge. Access to care is also a financial issue: in big cities, one sometimes gets the impression that there is a crowd of doctors here, but if you pay attention to those who sign a contract in the 1st sector, things become more difficult,” Maria Rubtsova explains. Health project manager at UFC-Que Choisir.
For specialists, the difficulty of finding a doctor compensated by the social security tariff adds to the problems. According to the interactive map, more than eight in ten users do not have access to an ophthalmologist less than 45 minutes away under the Social Security rate. Difficulty is also present for pediatricians: almost half of children (46.8%) due to the degree of social security find it difficult to refer to pediatricians, if only serious “medical deserts” are considered, and three quarters (76.3%) adding the category “Difficult access” . On the gynecologist side, 66.8% of patients live in a medical desert, and nearly nine out of ten women (85.8%) have difficulty accessing a doctor with a social security degree.
After this new observation, it’s time to change the health care system, the UFC insists. Calling for a review of the conditions for the placement of liberal doctors, the UFC criticizes Que Choisir: “The incentives that have been regularly reformed have all shown their limits (…) They apply to a few doctors and/or produce only unintended effects”.
Put restrictions on the installation of doctors?
The association calls for more restrictions on doctors. “The installation of liberal doctors should be regulated by the Regional Health Agencies. While other professions, such as nurses or pharmacists, are subject to the rules, doctors are now an exception,” claims Maria Rubtsova.
The UFC is asking for a territorial arrangement for doctors, no longer allowing them to settle in over-supplied areas, except when the situation requires (replacing a retiring doctor or providing a very large area with doctors in sector 1). And asks for an end to toll overcharging: by closing access to sector 2 (free of charge).
The government remains opposed to the restriction on the placement of liberal doctors and is relying on negotiations with doctors to change the situation.