Jump to content

shortages of generaliste doctors in rural areas


Patf
 Share

Recommended Posts

Ours is a family practise, but the main doctor is now approaching retirement age. He and his wife also train internes. His father, aged 87, still does one session a week.

I had to go today for a new prescription, got there at 8.30 am and already 4 people waiting (a session sans rendezvous.) Another 4 old men came in in the next 5 minutes. The men seemed to all know eachother and were chatting happily.

At last our doctor came for the first patient. Then his interne came, a young woman, and asked for one of us . Not one of them volunteered. So I jumped up, she was excellent.

I  felt sorry for our usual doctor, no wonder he always looks tired. And for the young woman, people not recognising her skills.

But I can understand the old men wanting to see their old friend again, (and not wanting a young woman poking about in their 'bits' - husband said, why not?)

So what's the solution?

Link to comment
Share on other sites

10 years ago I made friends socially with a retired Médecin, he would have been around 70 then, we lost contact when he moved to another town, I am now with the running club of that town and made another friend who turned out to be his son! Seemingly father got fed up with retirement and has been working afternoons for the last decade in the new town where he has a better class of client, he is talking of retiring again soon but he is in his 80's. I run with the grandson as well, he has cerebral palsy.

 

I was seen by a young female remplaçant médecine a few years ago during the summer, she launched straight in to a rectal examination, if she were full time here she would not want for patients [6]

Link to comment
Share on other sites

I think that the simple answer to Pat's question is to pay Generalistes more.

Our excellent GP hasn't been in the best of health recently and must be in her mid-60's. By my very crude 'back of a fag packet' calculations, she will gross €60k p.a. from her surgery. I assume (because I think that I read it on here) that those are her earnings - she doesn't receive a retainer / salary from the State.

After deducting the cost of her secretary, vehicle and premises, I doubt if she ends up with much more than half that.

Now, I may well have undercalled her earnings, but equally I may have have undercalled her costs. The point I'm making is that we're hardly talking about a well paid profession here.

Having seen quite a bit of hospitals in the last year or two, the ratio of 'directs' to 'indirects' here in France is staggering. At our local hospital, there's a main Accueil, then another one for the department where you have an appointment, and even in one situation, another one for the bod you're going to see!

So ........ halve the number of fonctionnaires, double the GP's consultation fee and you then have a profession that young aspiring doctors are queueing up to get in to.

Link to comment
Share on other sites

There is no shortage of doctors being trained. University medical courses are over subscribed as I understand it.

The thing is young doctors don't want to live or work in rural areas. It is always being highlighted on the news.

Apart from the 'place in the sun's' and other expats, who wants to live in the middle of nowhere ? Which is why I have said countless times, do not move rural if you are thinking of moving to France. Move large town city. Especially if you are no spring chicken.

The problem won't go away.
Link to comment
Share on other sites

Get rid of the concours, Caen starts the first year with about 1500 students. Concour at the end of the first year takes about the first 180 on the list. The rest have to resit the year or change their ideas. There does not seem to be a correlation between the number of doctors required and the number the system "allows" to qualify. I believe the powers that be expected much more "diagnostic à distance" to be in place at this stage ie use of the internet and a web cam!
Link to comment
Share on other sites

[quote user="alittlebitfrench"]There is no shortage of doctors being trained. University medical courses are over subscribed as I understand it.

The thing is young doctors don't want to live or work in rural areas. It is always being highlighted on the news.

Apart from the 'place in the sun's' and other expats, who wants to live in the middle of nowhere ? Which is why I have said countless times, do not move rural if you are thinking of moving to France. Move large town city. Especially if you are no spring chicken.

The problem won't go away.[/quote]

At least you're consistent, even when you are talking about subjects where, despite your arrogance, you know very little about.
Link to comment
Share on other sites

Gardian - I agree that should have more financial support from the state. Their salaries are much lower than those in the UK, mainly because they're self-employed (I think.)

re doctor's training here - I believe that there are a lot more women going into medicine now than in the past. Most women eventually want to marry and have a family, which means that their husbands have to have work, and there aren't many opportunities in the countryside; Unless he's a doctor too.

Link to comment
Share on other sites

The number of students who apply for Medicine every year is far, far greater that those that are allowed to study Medicine. This has been the case for many years. In France, you have the right to go to FAC if you pass the BAC. There is little correlation between ability and the course you apply for. The number of Doctors that are allowed to qualify each year is directly controlled by the Government, since 1971 (have just been through all of this with a friends daughter at Caen)

(Le numerus clausus dans l'admission aux études médicales françaises découle d'une loi de 1971 permettant de fixer directement par arrêté ministériel le nombre d'étudiants pouvant être admis en deuxième année de médecine, d'odontologie, de pharmacie et sages-femmes. De ce fait, il ne s'agit plus de passer un examen mais de réussir un concours pour accéder à un nombre restreint de places à pourvoir : l'étudiant ne se « bat » plus seulement contre lui-même, mais aussi contre les autres pour satisfaire sa réussite.

Of course those that qualify can pick and choose where they go, usually near the coast or in affluent areas. Thus, the swath of "désertification" talked about every week on French TV will continue, due in no short measure to the government directly controlling the available number of Doctors who qualify.

The slight ripple in the water this year is because some Medical FAC's have tried to limit the dross that applies. Egality in France works against this. Imagine if they tried to apply the UK system of actually having relevant qualifications to get a place at FAC. The only area this is applied is Prepa and Grande Ecole.
Link to comment
Share on other sites

Interesting, Lehaut.

But I think there's more to it. The very conservative rural population seems to be resistant to change. And very chauvinistic. They prefer the familiar old faces and routines.

I felt so sorry for the young woman Dr. on Monday, no-one wanted to see her. I don't blame her if she chooses to work in a town.

Maybe young men would be accepted better.

Link to comment
Share on other sites

In the village medical centre there is a locum Doctor who speaks perfect English because she also works as a locum in Camden Town.  She also happens to be from Cameroon.

It is interesting to see the British 'ex-pat' brigade (who left the UK because there are too many immigrants so they say) wrestle with the fact that the Doctor they would like to consult because she speaks English also happens to be African [6]

Link to comment
Share on other sites

Eldest daughter's boyfriend qualified as a doctor last month and is awaiting his internship placement but he is not interested in being a GP and wants to work in a large hospital, his location preferences are Guadeloupe, Martinique or Bordeaux (where he lives now). His reasons for not wanting to be a GP are pay, type of patient and total lack of career progression.
Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
 Share

×
×
  • Create New...