Ihealth is a precious good, of constitutional scope, which should escape purely lucrative logic. Today, in a context of scarcity of health resources, commercial abuses are multiplying, shaking the values of our system and thereby compromising the foundations of equitable health, solidarity and accessible to all, as it results of the principles of social security of 1945.
With regard to the provision of local health care and primary care in particular, these principles of equal access to care, quality of care and solidarity, weakened and threatened, must be vigorously defended. Many forms of care offers are flourishing: unscheduled care centers, teleconsultation booths, or even teleconsultation offers “24 hours a day – 7 days a week”, sometimes against a paid monthly subscription.
This last type of initiative raises questions about the economic model. Is it mainly focused on financial profitability, thereby validating the idea that consulting a health professional is a simple commercial transaction? Or does it seek to steer patients towards further explorations or lucrative interventions within the private sector, thereby generating significant revenue?
Prioritize prevention and sustainable follow-up
We wish to alert and warn against this short-term vision of primary care management, maintaining the illusion of an immediate response to any felt need, without taking into account the complexity of the situations, and in defiance of the excesses and long-term adverse consequences for users. Firstly, there is a risk of deterioration in the quality of care.
A medicine exclusively centered on the demand for unscheduled care leads to a fragmentation of care, when studies show that good continuity of care is associated with a reduction in hospitalizations and mortality. This simplistic approach, which neglects the holistic dimension of health, constitutes a setback for the quality of care. It is a source of (over) inappropriate prescriptions and could lead to excessive medicalization of everyday issues, including social ones.
The urgency consists in prioritizing prevention and lasting follow-up, in responding to the crucial issue of the management of patients suffering from chronic illnesses and the elderly, rather than (over)valuing specific medical acts. Secondly, this initiative constitutes a disorganization of the supply of care with the risk of accentuating the medical deserts.
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