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HEALTH

What to do if you live in one of France’s ‘medical deserts’

Around a third of France has a shortage of doctors, dentists or other medical services, known as 'medical deserts' - here's what the government is doing about this, and what you can do if you are struggling to find healthcare.

What to do if you live in one of France’s ‘medical deserts’
(Photo by Loic VENANCE / AFP)

A medical desert is a geographical zone where healthcare providers and general practitioners are severely lacking compared to the rest of the country – it generally refers to healthcare in the community such as GPs or family doctors, dentists or community nurses, rather than hospitals.

Medical desertification mainly affects rural areas with an ageing population – though they’re also developing in some towns and cities (including some Paris suburbs) as retiring doctors are not replaced and younger medics establish themselves in more dynamic zones, both in terms of economy and activities.

Authorities are proposing solutions to allow patients to find a doctor more easily – more on that later. But, first, what can you do if you are one of the estimated 30.2 percent of the population in France who live in one?

Sadly, not a huge amount – such issues aren’t solved easily. But there are a couple of things.

Write a letter

Firstly, complain. Anyone having difficulty registering with, or even just finding a doctor within reasonable travel distance has the right to ask for help from the health authorities, by writing to the local health insurance office.

READ ALSO Medical deserts: Why one in three French towns do not have enough doctors

This will not immediately solve the problem. But it does, at least, highlight it with the appropriate body responsible for dealing with it. 

You can then, if you feel it necessary and after first reporting your problems finding a GP, write to the health insurance conciliator. The conciliator’s job – as well mediating in any disputes – is to help users with their healthcare needs, including finding a doctor. 

The Ameli website has a form letter here. It also helps you find the address of the conciliator.

Find a GP

The biggest problems with medical deserts is finding a médecin traitant – the GP or family doctor that you are registered with.

READ ALSO How to register with a doctor in France?

However it’s worth knowing that you don’t have to be registered with a doctor in order to get an appointment with them, so if you find a doctor with available appointments you can book one, even if that doctor is unable to register you as a traitant.

The medical app and booking website Doctolib is a good place to start, although it usually has more users in the cities.  

How to use the French medical site Doctolib

Some health centres in medical deserts offer special arrangements for people who are unable to find a médecin traitant, such as registering you as a patient after a certain number of consultations.

Télémedicine

If your area has a shortage of doctors, it’s likely that you will end up having to register with a GP a long way from your home.

Many doctors now offer online consultations – known as télémedicine – which may be a practical alternative to making long journeys to the doctor’s office.

Costs for téléconsultations are covered by Social Security like a traditional doctor’s appointment and allows patients to benefit from remote medical help via a computer, a tablet or a smartphone.

The doctor with whom the patient is in contact can make a diagnosis, prescribe medication or tests. The Ministry of Health points out that téléconsultations are subject to “the same quality and safety requirements as conventional procedures”. 

Other services

If you either can’t find a doctor or your doctor is far away, there are other medical services on offer in France, including SOS Médecins (which includes house calls) and Maisons Médicales de Gardes, which are community health centres that include out-of-hours services.

Find full detail on accessing urgent care HERE.

Remember also that all pharmacies have a trained pharmacist on the premises, who can deal with minor ailments and give medical advice. 

Government action

Nearly six million adults in France are not registered with a GP or family doctor, according to government figures.

In an effort to ease the problem of declining and uneven levels of medical care across France in the short-term, President Emmanuel Macron encouraged retired doctors to continue working.

During a wide-ranging TV interview in October, Macron was questioned about the issue of medical deserts. He said: “All doctors who retire, we will allow them to retire […] but on the first day of their retirement, to continue their activity and to keep all the income that is theirs, without paying new pension contributions.” 

In addition, Emmanuel Macron completed his speech by announcing that he wanted to, “give more responsibilities to our nurses, physiotherapists, pharmacists, all our paramedics, psychologists and others so that many tasks that are done by our doctors can go to them.”

The government’s plan to improve uniformity of medical care in France has four priorities:

  • Strengthening the healthcare offer in the regions to serve patients: increased medical and health care presence
  • Implementing the digital revolution in healthcare to abolish distances
  • Better organisation of health professions to ensure a permanent and continuous healthcare presence
  • National oversight, local governance.

Longer-term solutions include training more doctors, reducing their administrative burden to allow more time for patient care, and working to improve uniformity of care outside larger urban areas.

But one suggested solution – extending the general medicine residency by one year, during which future practitioners would be strongly encouraged to settle in the ‘desert’ areas – prompted medical students to go on strike.

Member comments

  1. If you aren’t registered then you only get back 30% of your costs from the state, compared to 70% if you are registered.

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TRAVEL NEWS

France launches ski safety campaign after rising number of accidents

Injuries and even deaths while skiing in France have seen a sharp rise in recent years - leading the French government to create a new ski safety campaign.

France launches ski safety campaign after rising number of accidents

The early part of the ski season in France was dominated by headlines over the lack of snow in popular mountain resorts – but, now that climatic conditions have started to improve for skiers and there is at least some snow, the winter sports season is in gearing up to hit full swing.

READ ALSO Snow latest: Have France’s ski resorts reopened?

Heading into the winter holiday season – French schools in ‘Zone A’ break up for two weeks on February 4th, followed on February 11th by schools in ‘Zone B’, while schools in Zone C finish for the vacation on February 18th – the government has launched an awareness campaign highlighting skiing good practice and how to avoid accidents.

READ ALSO What can I do if I’ve booked a French skiing holiday and there’s no snow?

The Pratiquer l’hiver campaign has advice, posters and videos highlighting safety on the slopes, in an effort to reduce the number of accidents on France’s mountains – where, every year, between 42,000 and 51,000 people have to be rescued, according to the Système National d’Observation de la Sécurité en Montagne (SNOSM)

The campaign, with information in a number of languages including English, covers:

  • on-piste and off-piste safety advice (signalling, avalanche risks, freestyle areas, snowshoes, ski touring, etc.);
  • Help and instructions for children explained in a fun and educational way (educational games, games of the 7 families to be cut out, safety quizzes, advice sheets for sledding, skiing, prevention clips, etc.);
  • physical preparation (warm up before exercise, prepare your muscles and stretch well, also how to adapt the choice of pistes and the speed to your physical condition);
  • equipment and safety (helmet, goggles, sunscreen, etc.);
  • marking and signalling on the slopes (opening and marking of green, blue, red and black slopes, off-piste).

There are 220 ski resorts in France, the world’s second largest ski area, covering more than 26,500 hectares of land, across 30 departements.

In the 2021/22 ski season, totalling 53.9 million ‘ski days’, according to SNOSM, emergency services made 49,622 interventions in France’s ski areas, and 45,985 victims were treated for injuries.

The results show an increase in the number of interventions by ski safety services – a rise of 13 percent compared to the average of the five years prior to the pandemic – and the number of injured, up 8 percent. 

A few incidents on the slopes made the headlines at the time, including the five-year-old British girl who died after an adult skier crashed into her in the Alpine resort of Flaine, and the French actor Gaspard Ulliel, who died at the age of 37 after an accident while skiing in La Rosière, Savoie.

In total, 12 people died as a result of skiing incidents in France in the 2021/22 ski season. Three died following collisions between skiers, two after hitting an obstacle, and seven as a result of a fall or solo injuries. SNOSM also reported “a significant number of non-traumatic deaths, mostly due to cardiac problems” on France’s ski slopes.

The injuries due to solo falls – which represent 95 percent of all injuries –  on the ski slopes increased 2 percent compared to winter 2018/2019. Collisions between users fell, however (4.8 percent against . 5.6 percent) as did collisions between skiers and other people, and obstacles (0.7 percent compared to 0.85 percent).

The number of fatalities caused by avalanches, however, is at a historic low over the period 2011 to 2021, in part because of a relative lack of snow – leading to a drop in the number of avalanches and fewer people going off-piste, while awareness campaigns are hitting their mark, according to SNOSM.

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