MAP: Where in France has the best access to healthcare?

According to OECD data, France has 32 doctors for every 10,000 people, slightly below the OECD average of 37.

However, they are not equally distributed - about a third of France is considered to be a 'medical desert', meaning there is a shortage of doctors . It's usually used to mean places that have a shortage of GPs or family doctors, which can make it hard for patients to find a regular doctor to register with.

However it can also be used to mean that areas that have a shortage of certain specialists like dentists.

As of 2023, 4.4 percent of France's population lived more than 45 minutes away from the nearest paediatrician, ophthalmologist, gynaecologist or psychiatrist. 

READ MORE: ANALYSIS: How sick is the French health system?

In terms of health spending, France invests about 12.4 percent of its annual GDP on health care, roughly the same as Germany (12.8 percent).

Nevertheless - France has fewer doctors, nurses and hospital beds than its neighbour to the east.

Life expectancy in France was 82.4 as of 2021, higher than the EU average of 80.1. As for wait times, a study conducted in 2016 showed that over half of people in France (56 percent) reported being able to see a healthcare provider within a day.

So where are these medical deserts?

Based on data from January 2023, the majority of France's medical deserts were located in rural areas, particularly in central parts of the country.

 

The départements of Eure (16.5), Eure-et-Loir (19.4) and Cher (19.7) in central France counted less than 20 medical professionals per 10,000 people. 

In the greater Paris region, the département of Seine-et-Marne (19.6) also had less than 20 healthcare providers for every 10,000 people.

In comparison, the city of Paris came out on top, with over 88 medical professionals per 10,000 people, and the next-best département was Hautes-Alpes in south-eastern France with a density of 50.3 healthcare providers/10,000 people.

France's 'National Order of Doctors' came out with its 2023 report in June, and it noted that "territorial inequalities persist and are widening".

In total, France saw the number of 'active' (working) GPs drop by 500 between January 2023 and January 2022. That being said, there were more specialist doctors overall - an increase of 1,300 professionals.

The National Order of Doctors noted that the decline has been concentrated in central France - which has several sparsely-populated départements with an older-than-average population - with coastal départements keeping the same number of medical professionals or even gaining more coverage.

The vice president of the National Order of Doctors told Le Parisien that départements with the lowest numbers of doctors tend to be those that are "disadvantaged in terms of activities and transport", making them less attractive for young professionals to move to.

What about towns or communes?

To address the issue of medical deserts, regional health authorities in France (the Agence Régionale de Santé, or ARS) are tasked with identifying 'priority zones'. 

In each region, health authorities calculate an 'accessibility indicator' (APL) that considers the transport time to get to the healthcare provider, the number of GPs up to the age of 65 (to show those not of retirement age), the speciality of each practitioner, plus the number of visits made to each practitioner per year.

This indicator allows health authorities to rank areas as either 'zones of vigilance' (ZV), complementary action zones (ZACs), or priority intervention zones' (ZIPs). The latter should receive special support under France's 'National Health Action Plan'.

You can compare regions, départements and communes either by going to your region's ARS website or by consulting the interactive map made by France's Directorate of Research, Studies, Evaluation and Statistics (Drees).

To look at individual regions, start by googling "Zonage médecins" plus the year, your region, and the key word "ARS" (or Agence Régionale de Santé).

The results will vary by region - for example, to look at the priority zones for Bourgogne-Franche-Comté, you can click here. You will see a map showing the ZIPs and ZACs in your region. 

Some regions may not offer a map, but they will list the communes that have a shortage of healthcare providers.

For the Auvergne-Rhone-Alpes region, you can find the list of communes with doctor shortages (by speciality) on the region's health website.

To see all regions, you can use the interactive map on the DREES website. 

DREES map, accessibility to doctors in France

This map shows the accessibility indicator for each commune. You can also interact with the map by choosing the speciality of doctors you want to look at (generalists, nurses, midwives, etc), the year, as well as the age of the healthcare providers. 

If you click 'Tableau' you can also see the breakdown per region at the commune level, using the constraints above.

DREES chart, accessibility to doctors in France

Access to a healthcare providers in medical deserts

There are a few steps you can take to get access to healthcare in areas with doctor shortages.

First, try using the medical app and booking website 'Doctolib'. This will show you upcoming available appointments in your area.

READ MORE: How to use the French medical site Doctolib

If you are struggling to find a GP (médecin traitant), consider trying health centres - some in medical deserts offer special arrangements for people who are unable to find a GP, such as registering you as a patient after a certain number of consultations.

You can also try writing a letter to your local authorities if you are having difficulty registering with a GP or finding a doctor within a reasonable distance.

If you do not mind taking an appointment online, you could also consider 'télémedicine'.

Some communes have also decided to fight medical deserts with roaming medical buses. To find out if one of these is visiting near you, reach out to your local town hall.

In the coming years, the French government would like to set up more mobile clinics, with proposals to add them to train stations.

READ MORE: French health minster: 'We must rebuild our health system to reflect the France of today'