Collective Doctors for tomorrow and several unions are calling for the offices of liberal doctors to be closed, from Monday December 26 until Monday January 2. The previous mobilization, the 1er and December 2, had led to a drop in activity of around 30% among general practitioners, according to Medicare. The collective is planning a day of national protest in Paris on January 5.
Their main demand is the doubling of the price of the basic consultation (going from 25 to 50 euros) in order to create a “attractiveness shock for young doctors to settle in private medicine” and D’“Also avoid the flight towards more attractive, less restrictive practices” Where to “the foreigner”. Strong incentives are also requested to reduce the medical deserts towards a city medicine in lack of manpower.
Over the past ten years, the number of general practitioners working exclusively in private practice has fallen by 11%, from 64,142 in 2012 to 57,033 on 1er January 2022. At the same time, the number of GPs practicing both in practices and in hospitals almost doubled (from 4,780 to 8,437), which limited the decline in all GPs practicing in practices 5% over the last ten years.
A recent study of the National Association of Medical Students of France (Anemf) testifies “a major loss of attractiveness for the (…) general medicine “ ; Among the students who had opted for it, more than one out of two (50.4%) questioned this choice, and 7.7% abandoned it.
The phenomenon worsened with the creation of a fourth year of internship to be carried out as a priority in medical deserts: according to the study, 54% of students who wanted to settle as a general practitioner in France “are thinking more and more about practicing outside the country”.
84 doctors per 100,000 inhabitants, compared to 102 in 2012
While the French population has continued to grow, and to age, since 2012, the density of general practitioners has been in constant decline, falling from 101.7 to 84.34 doctors practicing exclusively in private practice per 100,000 inhabitants, and from 109.28 to 96.82 doctors per 100,000 inhabitants by integrating general practitioners practicing in private practice and in hospitals.
As for the other specialties, the finding is similar, although less marked, with an 8.2% drop in specialists practicing exclusively in the city, which is reduced to 4% by integrating specialists practicing both in the city and outside. ‘hospital.
The Department of Research, Studies, Evaluation and Statistics has published a study in March 2021 on medical demography by 2050. It confirms a scarcity of liberal practice since 2012, in favor of mixed or exclusively salaried practice. Assuming that these behaviors continue and with constant legislative policies (number of doctors trained per year and arrival of foreign doctors), the model predicts a stagnation in the workforce until 2030, before a fairly significant increase until 2050 : “This increase would translate in part to an increase in salaried exercise, which is the mode of exercise at the facility most often chosen by newly graduated doctors. » Projection reports 63,683 liberal generalists in 2030, 75,760 in 2040 and 89,007 by 2050.
But, due to population growth, the decline in medical density will continue until the mid-2030s, before returning to its current level. Moreover, this reduction will be accompanied by a “increase in care needs induced by the aging of the population”, adds the study. Medical density is then expected to pick up again and exceed the current density level of 23% in 2050.