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Choosing a doctor


KathyC
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As we'll be moving out this spring and my husband has several medical problems, this issue is beginning to loom large. I don't want to make language an issue , which I suppose would narrow it down, and there are about eight doctors in our town to choose from. I'm sure the normal advice would be to ask around but that assumes there's anyone to ask that quickly and that they're thinking with the same mindset. I wonder whether, for example, many French people would consider that a good doctor is one who doles out masses of medication. I don't think that this would be a factor in our choice.

I wonder if anyone would be able to give me any pointers as to how to go about this? In addition, do French GPs usually operate an appointments system? : if you join a group practice (assuming they exist) can you see any doctor in the practice? : is it easy to change if you make a wrong initial choice and do many French GPs welcome patients who are reasonably well informed about their conditions and who expect to be proactive in their treatment?

Any contributions on any of these subjects would be most welcome.[:)]

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We had no problem finding a doc,and no problem if you wish to change-just a bit more paperwork.Appointment system is very good ,usually the same day if necessary.The doctors seem to be pro active themselves in that any blood tests(quite common) or xrays are prescribed immediately,or any other test deemed necessary .We find the system generally very good,but do seem to find a simple treatment results in a large prescription.Have heard that the French use this as a guide to how good the doc is,being on the side of hypochondiasm.System varies from uk in that all is paid at the time,but it depends on your ststus within the health system as to the level reimboursed.Repeat prescriptions seem almost unheard of even with an ongoing condition such as hypothyroidism which only gives 2 monthly prescriptions without another doctors visit.At 21 euros a throw it is pocket money for the doc!

Maude   ps yes you can see any doctor within the registered practise

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Kathy - Since your town has 8 doctors, you can always pick one.... to start with, and then, if you are not too happy with him/her, you can change. It is important to have your "medecin traitant", otherwise any specialist's fees might not be reimbursed in full. However, it is also very easy to change your "medecin traitant", once you know which other doctor you would prefer... this may take some time, chatting to various people in your town etc...

I have found that some of the more popular doctors with their French patients, are the ones who know how to sound sympathetic and have good bedside manner, and basic counselling skills. I had one such doctor, a lovely woman, but she was not such a great diagnostician and I changed after a while, since she had given me medication that was quite unsuitable. However, everyone loved her. I have also had as a GP a couple of (male) doctors who would barely listen to me, and who were very keen to tell me their own life story, anecdotes about other patients, sailing activities etc... This does annoy me no end.

They don't all work on an appointment system. Once I waited over TWO hours in the waiting room, precisely to see the woman doctor who was so popular.

And then there is the dentist that my husband went to. Naturally enough, he wanted to make an appointment as he had broken a tooth. He was told he could not make an appointment: the dentist would RING HIM, when he had an opening.... and sure enough, he rang a couple of weeks later. We thought it was absolutely bizarre, and said so, to no avail!

We have had overall excellent medical care though - in spite of oddities above. Visit to the GP one day, off to the neurologist the next day, and then the neurologist ringing a maxillo-facial surgeon colleague down the road, for another opinion, the said colleague said "Sure, send her along now!" so that in the space of 2 days, the problem was getting sorted out!

It all probably varies from region to region - except the "medecin traitant" obligation, which I was afraid of, (afraid of being tied to a GP I did not trust or like) but it was very easy to change... Good luck.

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I asked a neighbour for a recommendation and we were lucky with the result. He always runs late but always has time for you - so I usually go for an early appointment! I don't really think the method of choosing is any different to how one would do it in the UK - and, as has been said above, you can change if you want to.
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Luckily we did not have these problems of choice. Our commune capital 2km down the hill has 1 doctor, with no receptionist, nurse or computer. No appointment system, just turn up between 08:00 and 12:00 and wait till he is free. Each patient gets as much time as the patient needs/wants.

Best of luck anyway.

John

not

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I do think irrespective of language it depends what you are looking for. One of my ex GPs in the UK was loved by his patients as calm reassuring pleasent. My mother loathed being on his list and much prefered the ex military GP who began the consulatation with 'How Are You?' to which 90 % pf patients said 'Very well thank you' to which he replied 'Then why are you visiting my surgery ?'   She liked him because he did not see any need to be nice and did not waste time on pleasentries.

Thinking about it would probably ask the local pharmacist who they rated. Though you then risk find the  medecin who prescribes most.     

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Thanks everybody for the comments. One thing I left out of my original post was the question of whether French GPs make home visits. Is this the norm, does it never happen or could this be something to ask about when choosing your doctor?

Thanks again.

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Yes, French doctors will make home visits. You pay a bit more, that's the main difference.

If your husband has particular medical needs than he can choose a specialist as his medicin traitant - that will save referrals and waiting, but could make it more difficult if he needs to see somebody about a different problem.

Our doctor operates an appointment system, but you can still easily spend an hour in the waiting room.

I have found that although French GPs are charming and caring, they are a bit behind the times. Ours had never heard of one particular condition I have, and despite me getting the literature from the French importer of the equipment, she still does not understand it, so I have to take advantage of a spell back in the NHS to get the prescription updated, despite a referral system that French bureaucracy would be proud of, and a waiting list of several months.

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[quote user="maude"]

Repeat prescriptions seem almost unheard of even with an ongoing condition such as hypothyroidism which only gives 2 monthly prescriptions without another doctors visit.At 21 euros a throw it is pocket money for the doc!

[/quote]

I would suppose it depends on your condition and your medication but I do get prescriptions à renouveler for up to six months (six x repeat) for my asthma inhalers and high blood pressure tablets. When I was first put on tbe tablets I was given a months supply to make sure they were the right ones for me, then I had a few 3 monthly repeat prescriptions, but now that I am settled with the drugs and they are working effectively I can have a six month repeat prescrition with a 'come back sooner if you have any worries' (I check my blood pressure myself in between too to keep an eye on it). As far as the inhaler is concerned, if it isn't working I get wheezy so I know if there's a problem there!

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[quote user="KathyC"]

... One thing I left out of my original post was the question of whether French GPs make home visits. Is this the norm, does it never happen or could this be something to ask about when choosing your doctor?

Thanks again.

[/quote]

Yes, the cost is currently 30€ instead of the 21€ that you pay at the surgery.

John

not

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[quote user="Iceni"][quote user="KathyC"]

... One thing I left out of my original post was the question of whether French GPs make home visits. Is this the norm, does it never happen or could this be something to ask about when choosing your doctor?

Thanks again.

[/quote]

Yes, the cost is currently 30€ instead of the 21€ that you pay at the surgery.

John

not

[/quote]

Thanks. Is the cost reimbursed as usual or do you may the difference yourself? (I do understand about top ups.)

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If i were you i would check out the doctor's waiting room.   I had to go not so long ago and tried my local doctor.   Into waiting room, 6 surly old men whinging about the chasse, all looking fit as the proverbial.    Being in considerable pain at the time, and having this nagging feeling that the doctor was probably also part of the chasse club and would have an hour long conversation with each, we drove 10 kilometres, to a doctor recommended by woman in petrol station (!) and i walked in to find - oh my god TWENTY FIVE people waiting (although it seems the french often take moral support to the doctor and as it transpired a lot were accompanied, so not all patients).   3 hours later i finally got my time with the doc, who was very good as it happens, albeit his first words were 'i dont speak a word of english' (not that i had asked him to as it happens).    Neither of the above doctors had an appointment system.    I am now searching for one who does, because i simply cannot bear to sit in a waiting room for 3 hours every time i need to see a doctor.   Although technically you have to register with a doctor and send form back, i havent done this yet because, as above, i need to find a nice doctor with an appointment system.   however, this does not seem to have had any effect on reimbursements - dont know why.
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The surgery in the village has 2 doctors (and a locum when they're away), 2 nurses and a physio.

The doctors operate an staggered appointment system: one of them goes out to home visits in the mornings, whilst the other does 'drop in consultations' or appointments; in the afternoons, it's the other way round and so on. They take appointments any day of the week (not Sundays though!), also on a staggered basis, each does 2 mornings and 2 afternoons and both do Saturday mornings. Waiting time without an appointment varies and is certainly longer in winter...
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Many doctors in rural France work entirely alone with no partners, nurses, receptionists and all the other auxiliary people that you get used to under the NHS. Many do not even have computers (though that will have to change soon when they are compelled to join the centralised medical records system, in the unlikely event of this ever coming to fruition). They go out a lot on home visits, often at short notice. So trying to run an appointments system is a near impossibility.

Despite all that, our French doctor, who works on that basis, does offer appointments on some days, on other days she operates the 'just turn up' system that the rural French are used to and seem to like. But even with an appointment it is not uncommon to be waiting for an hour or more to actually be seen, for obvious reasons.

I have read on the forums of people turning up and being seen immediately, with no appointment and no wait. I'm not saying it can't happen, but it's an impossibility with most of the doctors round here.

The number of people waiting is probably an indication of the popularity of the doctor. We went with ours because she was recommended by other people in the village, and when we moved 15 km away we stayed with her, and later nominated her as medicin traitant. She has patients even further away who go to her out of choice. Of course, being popular with the French is not necessarily a measure of competence or being au fait with the latest medical thinking, but it can't be a bad sign.

Incidentally, the home visits are refundable - less the usual 1€ contribution.

And the six months repeat prescriptions seems unusual. Three months worth is much more normal.

.

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This is all really useful, so thank you. I'm particularly pleased about the home visits as my husband has emphysema and has to be very careful about picking up infections. We are fortunate in the UK to have a GP who has more or less fobidden him coming in to the surgery (especially in the winter) as they're such unhealthy places. A couple of hours in a surgery in the cold season could be the death of him!

Will, it was your comment about the latest thinking not being too important to French people that I had in mind when I started this thread. A good bedside manner is all very well but when you have a life threatening condition you really need someone who's spot on. Also being prescribed bag fulls of non essential meds is pretty useless, however much the French love it!

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[quote user="Clair"][quote user="KathyC"]Also being prescribed bag fulls of non essential meds is pretty useless, however much the French love it![/quote]
You don't have to have them if you don't want them... Just tell the pharmacien...
[/quote]

Sorry, I was referring back to my original point, that if I ask French people for a recommendation to a doctor, many will think that a good doctor is one that prescribes a lot of medication. I assumed (perhaps wrongly) a different mindset between the British and the French ideas of what constitutes a good GP. Obviously all this is a generalisation but people's information has given me some useful pointers.

Thanks

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