The situation, already critical in certain territories, is expected to worsen in the years to come due to the retirement of many practitioners.
Employees see their occupational physician less and less. This is the final report that the Observatory of French Mutuality draws up on Tuesday. In the private sector, a majority of employees (61%) “have not benefited from a visit with an occupational medicine service during the year“, when 6% have never benefited from it. The situation is even more worrying with regard to the self-employed and business leaders: 2.8 million of them are not medically monitored at work, notes the federation of mutual insurers. And this situation is no coincidence. For Mutualité, the decline of occupational medicine in France can be explained by the “medical demographics crisis“.
France had nearly 4,800 occupational physicians in 2022. According to the National Council of the Order of Physicians, the profession would have suffered a loss of 21% of its practitioners since 2010. And the situation, already critical in certain territories, is expected to worsen due to expected retirements, while the current average age is 55 – compared to 51 for doctors in general. As for state-qualified nurses in occupational health (IDEST), to whom the 2016 reform gave more prerogatives, their number is “insufficient to make up for the lack of doctors“says the Mutual. 1874 occupational health nurses were counted in 2018.
Prevent occupational wear and tear
It’s no secret that France is a bad student when it comes to work accidents. 3.5 fatal accidents at work per 100,000 people in employment were recorded in 2019, i.e. twice the European average. In the midst of a debate on pension reform, while the notions of “Health at work” and of “arduousnessmake the headlines, the French take the subject seriously. According to a Harris Interactive survey carried out in 2023 for the Mutualité Française, 39% of working people consider that work damages their health. In their majority (52%), they consider themselves “ill-informed about various aspects related to occupational health such as physical occupational diseases or psychological suffering“.
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To prevent professional wear and tear, the government’s pension reform project proposes a “reinforced medical follow-up» of the most exposed employees, in order to identify weaknesses as early as possible. Concretely, an adaptation of the workstation could be proposed from the age of 45, following a mid-career medical examination. For these same workers, a new end-of-career medical examination would be required at age 61, possibly giving rise to recognition of incapacity, and therefore to early departure from age 62. During the examination of the project in the Assembly, the executive had also adopted an amendment providing that this medical examination “could be carried out by health professionals other than occupational physicians», such as nurses, physiotherapists or attending physicians.
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These provisions are still under debate, at a time when the examination of the text must continue in the Senate. La Mutuelle française is already inviting the State to go further, by “widening access to early retirement for permanent incapacity linked to professional wear and tear“. The federation of mutual insurers also recommends reintroducing into the professional prevention account the four hardship factors removed in 2017 (painful postures, heavy loads, mechanical vibrations, and dangerous chemical agents).
Prevention, the flagship of the Ministry of Health, is still struggling to establish itself in France. While one out of two French people surveyed considers that “companies are not mobilized on the subject of occupational health prevention», La Mutuelle is also advocating for the implementation of a universal occupational health service and the generalization of access to provident insurance coverage.