511. This is the number of our readers who responded to our call for testimonials on the price of the consultation requested by the Doctors for Tomorrow group, which would go from 25 to 50 euros for “general practitioners”. Created in August and supported by certain unions, the collective will be received this Thursday by the Minister of Health, François Braun, to initiate the discussion on the pricing of consultations, the working conditions of liberal general practitioners and the reorganization of the healthcare system in general, while the strike movement continues.
According to Doctors for tomorrow, the “consult” at 50 euros would serve to create a “shock of attractiveness”, in order to attract young practitioners to city medicine. Because, the general practitioners regularly complain about the administrative and financial burden of a liberal installation which, according to them, would discourage the youngest to take over the cabinets. On the other hand, this price of 50 euros “would be relatively extravagant, it would mean an increase for each general practitioner of the order of 100,000 euros”, underlined the director general of the National health insurance fund (Cnam), Thomas Fatôme, at the microphone of France Info Monday, while saying he was in favor of an increase. To compare, in 2017, the price increase had been two euros.
“They are doctors, not managers”
And our readers, too, say they are, for the most part, in favor of an increase. Like Jean-Marie, for whom “it seems essential to ensure a better quality of consultations”. They defend these doctors who have done long studies. “Nine years, at least, to train a general practitioner… So why is the price of a consultation almost the same with a hairdresser? asks Thomas. A comparison that we find very (very) often in the answers of our readers. To justify a price increase, there is the question of working time: “I currently work fifty hours a week without counting the guards”, confides Marion, one of the general practitioners who answered our questionnaire.
And, more than the number of hours worked, it is the ever-increasing place that “administrative” takes up. “They need help managing their practice, because they are doctors, not managers,” says Aurélie, a reader. They need medical secretaries so they can spend more time caring for their patients instead of handling calls and booking appointments themselves. For this, the generalists assure him, the price of the consultation must be increased in order to be able to hire.
“Ten minutes of consultation is shameful”
So more time given to medical, better quality of care and better attractiveness for young doctors? Some of our readers are not convinced. For Agnès, a doubling of the price of the consultation could be done, “provided that it does not combine with the overruns of fees practiced by a good number of doctors”. Lilian, he thinks that this increase could only take place if “the general practitioners take into account the mutual, so that we have nothing more to advance. »
Anne-Marie, she claims in this case, that “a zoning map be created with overstocked areas, where it would be prohibited [pour des médecins généralistes] to settle there”. She would also like them to be obliged to provide “call duty at night and on weekends, in order to obtain continuity of care”. And above all, what most often annoys or worries our readers is the time granted to the patient at each consultation. Thus, Isabelle would agree to an increase in the price of the consultation, “if it is not done with a slingshot as is the case now”. “Ten minutes is shameful! she exclaims.
GPs already well paid?
And then there are those who don’t agree at all. “It’s indecent to ask that in the current situation,” says Christian. Like him, many see in this increase in the price of the consultation, a doubling of the salary of general practitioners. But, according to Marion, the general practitioner, “out of 25 euros, around 11 euros goes into our pocket, before income tax. This increase in the price of the consultation would therefore not represent a direct increase in salary. Nevertheless the average income of general practitioners amounted, in 2017, to 92,000 euros per year, before taxes, according to the Department of Research, Studies, Evaluation and Statistics (Drees). In comparison, the average income from activity of self-employed people, all sectors combined, is 43,000 euros.
The risk, according to Roz, one of our readers, is that “even more people give up seeking treatment”. A fear shared by Alice, 25: “Let’s think of the students for whom this sum sometimes represents more than a third of their budget and who will have to think about eating properly or taking care of themselves. »
Negotiations “next week”
For some of our readers, finally, money is not the heart of the matter. The training conditions, the distribution of medical acts between the different nursing professions (nurses, advanced practice nurses, physiotherapists, etc.), the relationship with emergencies, are thus recurring subjects in the feedback from our readers. The essential place of “referent” of the general practitioner in the course of care and the sometimes strong attachment which exists between the patients and the practitioner make that this subject of the increase in the price of the consultation is found at the epicenter of many questions on the healthcare system in general.
If the debate between our readers was mainly limited to whether or not GPs “deserved” this increase, the question of the price of consultations arises above all in an almost permanent epidemic context for nearly three years. Negotiations around the price of medical acts, between the unions of practitioners and health insurance, which came to a standstill in November, should resume “from the beginning of next week”, according to Thomas Fatôme, the boss of the Cnam.