VIDEO. Toulouse: they declare “the death of general medicine”, the punch action of the liberals
By Guillaume Laurent
Published on
For the second consecutive day, liberal doctors are on strike this Friday, December 2, 2022 at Toulouse.
At the call of the collective “Doctors for tomorrow”, a hundred general practitioners configured in front of the Pierre-Baudis center in the morning. The day before, they were more than double to mobilize in front of the premises of the Primary Health Insurance Fund.
Two days of closure, “I would never have thought of it”
On strike, most general practitioners in Haute-Garonne had announced the total closure of their offices, as elsewhere in France, on Thursday 1uh and Friday, December 2, 2022. “I have been settled for seven years, it’s the first time that I’ve closed my cabinetI would never have thought to come to this”, testifies, annoyed, the Dr. Gabrielle Hengy, based in Limogne (Lot) and Midi-Pyrénées referent of this collective which was set up in a few weeks on social networks. “Closing a practice, it’s a cry from the heart, she confides. “But we are at a decisive turning point for our profession. The deterioration that has been observed for a long time accelerated two years ago”.
“A patient came to see me from Toulouse on Saturday,” says a Lot doctor
Launched on Facebook by disillusioned professionals, this “apolitical and non-union” collective was initiated by the Dr Christelle Audigier, general practitioner in the Rhône, and brought together in the space of just a few weeks thousands of doctors, in particular in Toulouse and Occitanie. “This collective has already made it possible to really realize how much the problems were shared between the city and the countryside”, breathes Dr Gabrielle Hengy.
“If the movement was formed so quickly, it is because the shortage of doctors is very worrying, in town and in the countryside. When I talk to other doctors, we realize how much it is complicated in Toulouse too. Last Saturday, I was doing walk-in consultations in Limogne, a patient came to see me from Toulouse because he couldn’t find a doctor at home…”
“We enter symbolically into general medicine”
These Thursday and Friday, the general practitioners have therefore declared dead of their profession: “We enter symbolically into general medicine”, explains Dr Hengy. “Yesterday, each GP was able to put a courier in the coffin brought into the office of the leaders of the CPAM and the ARS. We talked about an hour and a half with them, so that they could bring up our concerns and our demands,” she says.
This Friday morning, the doctors put it back in front of Pierre-Baudis, where they also “made a statement on the occasion of the opening of the congress which is being held on the occasion of the CNR (national council for refoundation) of health “.
Resumption of the strike during the holidays?
After these two days of strike, doctors’ surgeries will reopen on Monday, everywhere in France. But the sling is far from over, warn the doctors: “The next negotiations for the social security financing agreement will be held on December 15”. And if the government tried to play the clock by postponing the deadline to 2023, “we demanded that the subject of the consultation at 50 euros, and the other claims, are looked at urgently.
In the absence of a response, Doctors for tomorrow warns: “The strike movement will resume December 26, in the middle of school holidays, and in the middle of the end-of-year celebrations, a period traditionally crowded in their offices. They would remain closed until January 6.
APNs, “low cost doctors” in the sights
Doctors, who are increasingly overwhelmed by administrative tasks, also denounce the ” Two weights, two measures “with the new Advanced Practice Nurses (APNs), to whom the government intends, in its bill, to entrust purely medical missions, and to evolve to general practitioners.
In order to overcome the shortage of health professionals, these APNs could indeed make prescriptions, when they do not have their 9 to 10 years of study, but half. “It’s a new profession that is emerging, low-cost medicine, laments Gabrielle Hengy. “Even the liberal nurses are also opposed to it. We are not against the idea of nurses, pharmacists or physiotherapists doing more prevention”, she says, “but we feel abandoned by the public authorities who transfer some of our missions to them without consultation, and stick to us at the same time always more administrative tasks”.
Even more grotesque, according to them: these IPAs would be paid by a flat rate system of 50 euros, which is much more than private doctors.
An installation obligation that does not pass
In the columns ofNews Lyon, the founder of the movement also denounced the Retailleau bill, aimed at adding a fourth year of training to generalist interns in medical offices in medical deserts. “Many young doctors resist burnout, we deplore too many suicides,” she said. “An obligation to practice in a medical desert is to put them in difficulty. It goes against liberal medicine”.
A doctor from Toulouse: “We want to fight to save our profession”
Based in Toulouse for two years, the Doctor Benedicte Maril exercises, she, in a cabinet composed of five general practitioners. Like many in the agglomeration, it is closed for two days. “We all wanted to close, we all share the same questions about the future of our profession, we all share a certain suffering at work and we want to fight to save our profession”.
“We see our working conditions deteriorating as we go. There will be the medical convention of 2023 with the first drafts of the government which do not go at all in the direction of the caregivers. This was the straw which broke the camel’s back. It was a bit of a trigger for a number of us, so I wanted to get involved in this collective because I love my job and I would like to continue to be able to do it in good conditions.”
Eight years after passing his thesis, this doctor believes that the situation “has gradually deteriorated” in France. For her, “the central point” of the sling, “is that we need a revaluation of the medical act, which offers us to invest in care, in our offices and to create jobs. We want to delegate the administrative tasks which are overwhelming”. Worried about the turn the doctor-patient relationship, the very essence of the profession of a liberal doctor and in particular of a general practitioner”, Bénédicte Maril is hopeful that this “unprecedented” movement for the profession will sound like an electric shock: “I hope that the government and the patients will hear the suffering of the medical profession”.
What are the group’s main demands?
The main demands of the “Doctors for tomorrow” collective are:
– Value the consultation at 50 euros to be able to invest more (premises, employees, equipment) fully reimbursed to the patient
– Stop coercive packages, which do not improve patient care and whose objectives vary during the year.
– Abandon unnecessary certificates and orders
– Promote a transfer of administrative tasks within medical practices rather than a transfer of care
– Support general medicine interns by saying no to a fourth year of internship, which will delay their installation and risks aggravating the vocations crisis.
“Patients need us,” says Dr. Hengy
Although of course, their patients “worry on an individual basis if they are sick”, admits Dr Hengy, “when we see them in our offices and take the time to explain our problems and our demands to them, they understand us and contain us”. And if the absence of a doctor often turns into a headache, the practitioner recalls that “for non-urgent care, they can be provided in the evening by on-call doctors who can be requisitioned. For more serious problems, there are emergencies. Which are already, too, completely saturated.
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