What if tomorrow we had to pay 50 euros for our consultation with the general practitioner instead of 25? In any case, this is the main demand of the Doctors for Tomorrow collective, at the origin of the strike which was renewed for a week. In their eyes, this price should make it possible to “rekindle the desire of young doctors to settle down” by aligning itself in particular “with the average cost of consultations in Europe”. Because, according to the collective, the price of the consultation in France is much lower than that of our neighbors. What is it really?
In France, the price of the consultation is currently 25 euros for general practitioners who do not practice excess fees, ie the vast majority of them. If, in Belgium, the amount of the session is 27 euros, it rises to 40 in Portugal and reaches 76 euros in Germany. By confining itself purely and simply to the price of the consultation, France actually charges some of the lowest prices in Europe. “The consultation fee is extremely low,” confirms Frédéric Bizard, professor of economics at ESCP Europe.
A difficult comparison
But this amount is not necessarily a good indicator of the income of liberal doctors. Because, if in France the latter are paid by the act – that is to say that they receive remuneration for each consultation – this system does not prevail in Europe. “In the United Kingdom, for example, doctors are paid by capitation, that is to say the number of patients registered in the practice,” explains Philippe Batifoulier, professor of economics at Paris-13. The consultation fee therefore has much less impact on the doctor’s income. And the economist to insist: “We cannot compare totally different systems. It is not the same working time, nor the same configuration. »
In Spain, Italy, Sweden and the United Kingdom, the health models are state-run: either the doctors are civil servants, or they work in the private sector and are then paid by private insurers. “The model that comes closest to the French system, with liberal medicine, is the German model”, considers Frédéric Bizard.
A high income for French doctors…
Rather than comparing the price of the consultation, let’s rather compare the income of the practitioners. In France, according to a 2017 study by the Department of Research, Studies, Evaluation and Statistics (Dress), liberal general practitioners earn an average of 92,000 euros per year. However, there are major disparities within the profession. Surgeons earn an average of 185,000 euros per year, compared to 86,000 and 89,000 euros for pediatricians and psychiatrists.
“French liberal general practitioners are paid 20 to 30% less than German liberal doctors”, assures Frédéric Bizard. “Overall, the income of doctors is very high, believes for his part Philippe Batifoulier. Their median income is higher than the salary of the 10% of the richest employees in France. »
… but lower than that of other European doctors
But earning 92,000 euros when living in Sweden or in Greece, it’s not quite the same thing. So let’s compare what is comparable: the income of doctors compared to the national average. The OECD, in a report issued in 2013, indicates that French liberal general practitioners are paid 2.4 times more than the average French worker. This figure rises to 2.8 in the Netherlands and Luxembourg and even to 4 in Germany. But again, there are disparities within the profession. “French specialists are paid 5.1 times better than the average French person,” notes the professor of economics at Paris-13.
The fact remains that at 25 euros per consultation, if they want to maintain their salary, general practitioners in France must see a lot of patients. “This income, which everyone considers more or less high according to what they want, is only kept at their level thanks to Stakhanovism and a very large volume of acts. The new generation of doctors does not want to work less, but better. This system is unthinkable for the younger generation, and it is they who are rebelling today. »