Un first step has just been taken towards the reimbursement of certain treatments, without having to go through a visit to the attending physician in order to obtain a prescription. Deputies and senators indeed agreed last week on a bill from Renaissance MP Stéphanie Rist which aimed to open direct access to physiotherapists and speech therapists, or nurses in advanced practice (known as ” IPA”, intervening in particular on certain chronic diseases).
The primary objective? Unblock the offices of general practitioners a little while it is increasingly difficult for many French people to have access to them. The agreement was found with difficulty, during the joint joint committee (CMP) on Thursday, and “after bitter and long discussions”, recognized Stéphanie Rist.
Limit
Under pressure from doctors, senators insisted to the end on limiting this direct access to physiotherapists and advanced practice nurses as much as possible. Finally, it will be reserved only for those who practice in association with doctors, in structures such as MSPs (multi-professional health centres).
Exit direct access for professionals who work alone, but are registered in a Professional Territorial Health Community (CPTS), as wanted by the government and the deputies. There are around 400 CPTS in France today and cover around half of the population – several hundred more are planned.
READ ALSODoctors against nurses: war is declared “Once again, we have caved in to mainly senatorial medical lobbying […]ignoring the difficulties of access to care for our fellow citizens, ”reacted Emmanuel Hardy, president of the National Union of Advanced Practice Nurses.
The text “will only have a cosmetic effect”, estimates for his part Sébastien Guérard, the president of the French Federation of masseurs physiotherapists re-educators (FFMKR).
“Only 3%” of physiotherapists practice in MSP, regretted Sébastien Guérard, stressing that doctors or emergency services will have to continue to take care of minor accidents – sprains for example – that one of their colleagues could perfectly take care of.
“A dam has burst”
For speech therapists, the senators were a little less inflexible. If they are members of a CPTS, they will be able to receive patients not referred by a doctor. But this territorial community still has to explicitly authorize direct access in its “health project”.
“It amounts to leaving it to the goodwill of local health professionals”, regrets Sarah Degiovani, president of the national federation of speech therapists. “We have obtained an opening, but we will still have to transform the test. »
READ ALSOJean de Kervasdoué: “Inequalities in care are only getting worse” The MP-Senator compromise is more open to a greater role in pharmacist care. Pharmacists will thus be able to renew a prescription for a chronic condition on their own, for three months.
“We will have to do conventional work to organize all this, but I hope it will be done by the end of the year”, welcomes Philippe Besset, the president of the federation of pharmaceutical unions in France (FSPF).
Rapid tests for certain conditions – such as those for bacterial angina or cystitis – will be able to become widespread. And pharmacy assistants will now be able to vaccinate, like the pharmacists themselves.
In total, “a dike has jumped in terms of the sharing of skills between the doctor” and the other caregivers, estimates Maria Roubtsova, of the UFC Que Choisir. “But we shouldn’t have too many illusions about the immediate impact for patients,” she adds.
“We took a small step when we could have taken a big leap forward,” sums up Gérard Raymond, president of France Assos Santé, which federates patient associations. “These are profound transformations” of the trades of each other, “that must be brought little by little”, he recognizes however.