The practice of “private consultations” at public hospitals always causes some turmoil in the ranks of hospital staff. But this year a little more, at the Assistance publique-Hôpitaux de Paris (AP-HP). Authorized by law, this liberal activity open to salaried practitioners should allow hospitals to remain attractive, in the face of the sirens of a much more remunerative private sector. But at what cost ?
The presentation of the annual report on liberal activity, Tuesday April 9, before the establishment medical commission (CME) of the group of 38 Ile-de-France hospitals provoked more intense debates than usual, several participants report. . The document, which The world obtained, is particularly detailed: for the year 2022, the median fees of the 367 practitioners who have used this exercise – which must be limited to two half-days per week at most, and less than half of the activity of the practitioner – reach 112,620 euros (before payment of a fee to the hospital, which represents between 15% and 60% of the amount). That’s an increase of 25% compared to the previous year. With extremes: the average amount of fees received by radiotherapists thus amounts to some 600,000 euros, a jump of 140% in seven years.
“Some figures are dizzying”reacted geriatrician Christophe Trivalle on social networks. “Radiotherapy-cancerology” represents a very “atypical, concentrating very high average fee levels”note the authors of the report, recalling that the “fee due for this specialty is also the most important”up to 60%.
Practitioners authorized for self-employed activity overall received 54,573,949 euros, i.e. fees up 18% compared to 2021, with a royalty amount to be recovered of 14,890,589 euros.
“Problem for a public service”
But, if the tone has gone up a notch, even in the ranks of the establishment’s management, it is for another reason: “Overall, the 15% increase in liberal acts and consultations should be put into perspective with the 2% decline in public activity between 2021 and 2022”, we can read in the report. In other words, in the ranks of this small portion of practitioners, it was possible to give a real boost, while the resumption of public activity remained difficult, at the AP-HP as in many hospitals, after the Covid-19 crisis and the strong tensions on human resources which have continued.
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