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Patients in France being sent for 'pointless' tests

Dan MacGuill · 12 Apr 2013, 11:45

Published: 12 Apr 2013 10:18 GMT+02:00
Updated: 12 Apr 2013 11:45 GMT+02:00

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Doctors and other medical professionals in France need to be more “sober” in sending patients for medical examinations and scans, according to a report from France’s Academie nationale de medicine (National Academy of Medicine), published this week.

Dr. Jean Dubousset, a Paris-based orthopaedic surgeon and one of the report’s authors, told The Local that despite France’s reputation as having an excellent health service, young doctors were being taught “push-button” medicine.

“They are not taking the time to conduct a physical examination of their patients, or to ask in-depth questions. And they rely too much on the use of computers – I hear from many patients that their doctor actually looks more at the computer screen, than at the patient himself,” said Dubousset.

To make matters worse, the tests patients are being sent for are extremely costly to France's health service.

According to figures quoted in French daily Le Parisien on Friday, blood and urine tests cost a staggering €2.5 billion in 2011, and MRIs and other scans cost €917 million in 2010.

Ultrasounds for pregnant women cost a total of €127 million in 2010, and in 2011, screening for colon cancer cost €97 million in France.

The report comes after two doctors released a controversial book last year that claimed half of the medicines available in France were useless.

When it comes to early detection of cancers and other diseases, Dubousset believes that while for certain groups (individuals with a family history of cancer, for example), screening is very important, for others the results can be vague and lead to unnecessary anxiety among patients.

“Take for example breast cancer. Authorities in France recommend regular mammograms for women between the ages of 50 and 74, but for women younger than 50, mammograms are not particularly useful. This is because at a younger age, there can be many small, benign presences which can cause needless concern,” said Dubousset.

“We’re making patients think they have these illnesses, because of uncertain screening. Then all you’re doing is putting a new disease in the mind of the patient,” he concluded.

The academy’s report, entitled “Improving the relevance of medical strategies” also notes that easy access to regular check-ups, through free national health insurance, does not help doctors to be more efficient or streamlined in their work.

Around 600,000 French women and men undergo a voluntary check-up every year, involving systematic blood and urine tests.

“Nobody gets a prescription unless it’s from a doctor or a dentist, so that underlines the responsibility of the medical profession in these excesses,” said the report.

The report also states that intrusive surgery is being carried out on elderly patients unnecessarily.

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"Fitting a pacemaker for someone suffering from Alzheimer's disease is both a moral and financial aberration," it states.

Doctors, however were critical of the report.

"Perhaps there are some unnecessary exams, but it's complicated. They have to remember that for us the most important thing is the patient," Dr. Christophe Thiollet told The Local.

Jean-Michel Mathieu, a general practioner in the town of Tours told Le Parisien: "These doctors need to get out into the field. We don't work in easy conditions. They don't know why we propose a prescription or an exam to someone. We are thinking only about the interests of the patient."

Dan MacGuill (dan.macguill@thelocal.com)

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