15,000 Nîmes do not have a general practitioner: doctors create a health center in the face of overloaded emergencies

1. An alarming finding: 15,000 Nîmes have no attending physician

“Can you imagine, 15,000 Nîmes have no attending physician, not counting the surrounding villages, it’s not possible”, is alarmed Professor Pierre Costa, retired urologist and president of the association which carries the SIS project (Immediate first aid care). In the 800 m2 building of the future SIS health center still under construction along the Sauve road, the doctors behind the project (1) recall its genesis in a healthcare system that is struggling to meet the demand of patients.

“Each time a doctor retires, 2,000 patients are on the floor. And the replacement rate is only one in three. In Nîmes, 58% of general practitioners are over 60, half will retire within five years. A shortage that will last at least 13 years, the time that the relaxation of the numerus clausus acts. “Not to mention that patient demand continues to increase”insists Professor Costa.

Another observation: overloaded emergency services (+19.7% visit to the CHU in 2021) with a median visit time of at least four hours while “60% to 70% of cases are not life-threatening”says Pierre Costa.

2. The genesis of the SIS Health Center

Around these observations, the project was born more than a year ago carried by doctors, “and supported by the City, the Department, the Region, the CPAM, and private and public health professionals. The director of the regional health agency (ARS) is following us”, enthuses Sadia Podlunsek, the director of the SIS.

“There are major unscheduled care needs during the day (with care within 48 hours), this health center will be able to respond to them, for patients without a doctor, minor traumatology… Vital emergencies will be obviously sent back to the CHU”, specifies Pierre Costa, convinced that the center will unclog the emergencies but also SOS Médecins and the Medical Center at the CHU, “where 30 patients are sometimes already queuing when it opens its doors at 8 p.m.”.

The mission of the new Professional Territorial Health Communities (CPTS) is to organize the reception of all patients at the scale of a territory. “but how are overwhelmed GPs who already have unscheduled care slots for their own patients going to do it?”, asks Professor Costa.

3. The novelty: salaried doctors

“This immediate care center will be managed by a non-profit association awaiting recognition of public utility”, details Sadia Podlunsek, its director. “He is expected to join the CPTS Nîmes Nemausa and participate in the Care Access Service (SAS) system”.

To start, the center will operate with two salaried doctors, “we will not work on the act, it is very important”insists Pierre Costa. “The new generation of doctors craves this quality of life. They will not be alone and will be free from paperwork.” Also present will be three nurses, a radio operator and two medical assistants. “The CPAM has planned to cover the salaries of caregivers for two years”, he adds.

Five boxes will allow the simultaneous care of several patients, an X-ray and ultrasound device, means of suture, plaster and dressing to take care of benign traumatology. A scanner is even considered in the long term. “When there is one, the attending physician will always be informed of the diagnosis and the proposed treatment”, explains Professor Costa.

The SIS, which plans to receive 80 to 100 patients a day, could quickly become a victim of its own success. “In Nîmes alone, it would take 4 or 5 health centers of this type”, believes Pierre Costa. And already Béziers and Alès are asking us to do one in their city”.