Health: desperately seeking doctor

He should have retired for nine years. Nine years that he remains in his post in the hope of a succession which does not come. Yvon Dahan, 73, is a kind of country doctor as we now come across especially in films. For a long time her days began at 7 a.m. and ended at 2 a.m. “It cost me my marriage,” he says.

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In 1977, he put down his suitcases in Crépy-en-Valois, in Hauts-de-France. The medical center was then 4 years old, it was open 24 hours a day, with at least 12 general practitioners, almost as many specialists, an emergency service Today, the latter has closed, only a specialist remains and they are no longer than five GPs. “Two of which are past retirement age,” says Dr Dahan. In this community of municipalities in the country of Valois, a pool of 57,000 people, the lack of doctors is not new, but it is worsening every year as people retire.

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“The inhabitants are forced to travel further and further to access care. So they go there less and less, ”worries Fabrice Dalongeville. He has been mayor for twenty years of a small village, Auger-Saint-Vincent, 530 souls, 8 kilometers from Crépy. “We no longer have daycare on weekends,” he adds. In an emergency, it’s Creil or Compiègne, more than thirty minutes away by car. ” The referral hospital is the Amiens CHU. To get there, it takes more than two hours by train with a change in… Paris! In addition to medical desertification, there is a lack of public transport.

So when, in March 2020, a first cluster was detected in Crépy, the whole system was overwhelmed. Even positive for Sars-CoV-2, the doctors continued their consultations. And everywhere in the countryside, it’s the same story. Edith Théodose-Poma is vice-president in charge of the health of the community of communes of Deux Morin, 27,000 inhabitants, in Seine-et-Marne. In 2017, there were 13 general practitioners there against 7 today, or one for more than 3,800 inhabitants. Six times less than the national average. “Half of the inhabitants no longer have an attending physician,” she says. Even though the elderly are very numerous there.

In Crépy-en-Valois, faced with the threat of closing the medical center, a collective of residents has come together

In 2018, during the yellow vests crisis, the mayors of the villages opened notebooks of grievances. They read the concerns of residents facing difficulties in seeking treatment. The association of rural mayors has since launched a study on health. The first two sections underlined the worsening differences in life expectancy between rural and urban departments (it is two years less in the countryside) as well as the difficult access to hospital care. The conclusion of the third section, devoted to the lack of doctors, is clear: “Ten million inhabitants live in a territory where access to care is of lower quality than that of the average for French territories.”

In Crépy-en-Valois, faced with the threat of closing the medical center, a group of residents has assembled. Three years of mobilization and soon the opening of a health center, a structure paying doctors, with the hope that a community will support them. “This is the model that attracts the most professionals”, wants to believe Hélène Masure, at the initiative of the collective. “Young people no longer want to spend their evenings doing paperwork,” adds Dr. Dahan. They ask for fixed hours to have a family life. ” He has become an internship supervisor again and is hopeful that one of his two interns will stay. It will not be enough. In France, medical centers employing practitioners – a small revolution – are opening all over the place. But they have on average between 30 and 50% of vacant positions.

INFO
55 years Half of the doctors practicing in rural areas are over this age.
20 % less hospital care for the inhabitants of the villages compared to those of the towns

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