Dor several years, the observation has been widely shared of the difficulty of access to care for an increasingly large part of the French population and in a growing number of territories. To describe these difficulties, the term “medical desert” quickly imposed itself in France with the public authorities, the media and the population. Yet, beneath this hard-hitting and catchy formula hides an old and complex issue that is oversimplified. Thus, attention crystallizes on the medical profession and leads to an impoverishment of the debates by opposing the supporters of coercive measures imagined as saving and the defenders of a secular freedom of installation thought as immutable.
Contrary to popular belief, there have never been so many doctors in France. Indeed, the medical density was 318 doctors per 100,000 inhabitants in 2021, whereas it was 119 in 1968 (Department of Research, Studies, Evaluation and Statistics, March 2021). Even if there are disparities in this density between territories, these figures reflect the limits of a purely quantitative approach. Because one of the main components of the problem of access to care, unfortunately little or not taken into account, is the reduction of medical time.
The medical time, devoted to the care and care of patients, is only decreasing. There are several reasons for this, first and foremost the major increase in administrative time, despite the development of digital tools intended to facilitate and simplify procedures.
A deeper evil
It should also be considered that the approach to medical practice of the youngest has changed compared to that of their elders, leaving more room for their personal life. This component is essential, although sometimes overlooked, because there is indeed a change in the societal paradigm from which caregivers are not excluded. Finally, it is clear that a significant number of doctors do not or no longer practice medicine with patients but are still counted with the order of doctors.
Thus, the drop in medical time, which set in many years ago, justifies increasing the number of doctors. This increase was unfortunately not anticipated, whereas already in 2002, the “Demography of health professions” mission proposed to increase the numerus clausus of medical studies to 8,000 in 2007, a figure which was only reached in 2017! The numerus clausus has just been abolished to make way for a numerus apertus as part of a change in access to health studies. But we will have to wait several more years to judge the efficiency of this reform. The effects will only be felt in fifteen or twenty years. Moreover, there is no reason to say today that new doctors will settle in demedicalized areas.
You have 52.16% of this article left to read. The following is for subscribers only.