Access to healthcare in Occitania: “The worst is yet to come” according to doctors

the essential
The lack of doctors is no longer a problem reserved for rural areas. Projections are not optimistic for the next ten years.

Access to care throughout the territory. This is a subject regularly put back on the table and which is no longer the only problem of rural municipalities. Today, there is a shortage of doctors everywhere, especially general practitioners. “In five years, 30% of doctors based in Occitanie will retire. We are at the dawn of the storm and the worst is to come for the next ten years, especially in the peri-urban areas which will see the massive arrival of inhabitants but not caregivers, “says Dr Jean-Christophe Calmes, president of the liberal doctors within the Regional Union of Health Professionals (URPS Occitanie). The organization has just published a vast survey on the difficulties of access to care in general medicine in Occitania, in connection with the zoning work of the Regional Health Agency (ARS Occitanie).

60% of general practitioners believe they can no longer accept new patients

Beyond the crude statistics (a third of general practitioners in Occitania are over 60 years old; a third of liberal general practitioners practice in dense urban areas, a third in intermediate areas and a third in rural areas), it appears that the number of consultations per inhabitant is falling significantly in 80% of the region and that 60% of general practitioners no longer feel able to accept new patients, regardless of the territory.

“It’s not that we don’t want to treat, it’s that we can’t treat”, summarizes Dr Jean-Christophe Calmes for whom medicine can only meet demand on the sole condition ” that it is reformed and that it works in conjunction with elected officials, representatives of the territories concerned, users and health professionals”. “We need elected officials to help us, particularly on the question of rents and premises. But let’s not move in a disorganized way! It is not enough to make places available for them to fill up with doctors. The attractiveness of the territory is important, especially for the spouses of doctors, for their families. It is also necessary to look into the constitution of a team around the doctor for the delegation of certain tasks”, further analyzes the doctor.

“Do not speak of a medical desert but of a territorial desert”

On the side of the order of the profession, the observation is identical. “I am opposed to the use of the term medical desert. When there is no public service, shops, places of culture, places of care, it is a territorial desert! “says Dr. Jean Thévenot, president of the council of the Order of Physicians for Occitania. Certainly, coercion will not work.

“If we force young doctors to settle in areas where they don’t want to go, they will change specialties or jobs. It is better to arouse desire than to make things compulsory and to develop training grounds during training. Some territories of Aveyron have succeeded in doing this by promoting internships for interns, facilitating their accommodation and working on networking and attractiveness”, continues Jean Thévenot, attentive to the policy initiated by the Occitanie Region. “Opening medical centers with salaried doctors, as the Region does, is one of the solutions. But we have to be careful and ask ourselves the question of the territory in which we install them and see, for example, who will take the excess patients after 6 p.m. ”.

Train as needed

As for the delegation of tasks, Jean Thévenot remains cautious: “Each profession has its skills, there are obvious deficiencies in all specialties but also suffering and ill-being and not only among nurses and caregivers. . It is the whole organization of care that needs to be rethought, the whole of the population that needs to be supported and the academics that need to be mobilized so that they train, not the number of doctors that they can train but the number that corresponds to an estimated need”.

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