When Émilie Zard launched the creation of the Épinay-sous-Sénart (Essonne) health center in 2016, she knew that the lack of doctors was going to become “a disaster on the territory”. “60% of them were over 65, retirements had to be anticipated”, she notes, leaning against her desk, recalling that nearly 6 million French people have no attending physician. Moreover, in the neighboring town of Brunoy, one of the four doctors who will have ceased his activity at the end of 2023 will be… 96 years old!
Children’s drawings are taped to the powder pink wall. The structure which houses six general practitioners, a sonographer, three nurses and several specialists opened in 2019. “I wanted to work in a group”, explains Emilie Zard.
“We are overwhelmed with requests”
To guarantee a ” family atmosphere “she received each health professional in her office before their installation. “We have joint meetings where we discuss patient cases and we eat together every lunchtime,” rejoices the thirty-something. The project was so successful that students who wanted to settle there after their internship were unable to do so, for lack of space, “while we are overwhelmed with requests from patients seeking a doctor”.
Faced with the needs, the practitioner has been trying to open a second health center for more than a year, but she comes up against the town halls “who have no premises or money to invest in the project”. The local authorities support the nursing homes in various ways, for example by financing the construction project or the renovation of the premises.
3:30 p.m.: a patient arrives for her consultation. Émilie Zard welcomes her, her smile hidden behind a surgical mask that matches her blouse. To obtain an appointment with the general practitioner, it takes two months. Here, each doctor sees no less than 20-25 patients a day. “Freeing ourselves from administrative work time would allow us to see three more patients on a daily basis”, she calculates. To alert on the difficulties of access to care, the practitioner’s office will be closed on Tuesday, February 14.
“Being in contact with doctors facilitates the care pathway”
Among the demands of liberal doctors on strike: the fight against a bill brought by MP Stéphanie Rist (Renaissance), which broadens the prerogatives of “nurses in advanced practice” (IPA). The latter follow two additional years of training to broaden their area of expertise.
The goal, according to the parliamentarian: to free up time for doctors’ care. In Épinay-sous-Sénart, the structure has one, Laetitia Pischedda, recently installed in a brand new office. If the possible expansion of the responsibilities of IPAs makes a lot of doctors’ unions scream, Laetitia assures “not wanting in any way to replace the work of the general practitioner, but to be complementary by taking care of certain chronic patients”.
“It helps patients to confide”
To get to the first floor of the structure, you have to pass in front of the reception. There, the medical secretaries seem overwhelmed. “We receive more than 200 calls a day even though we are no longer taking new patients”, regrets one of them, a hand ready to take another call. In the hallway leading to the “health sports” house integrated into the establishment, Laetitia is challenged by Élise Lefils, pedicurist and podiatrist. “She has a background in wound and healing, so I come to ask her advice for a common patient,” explains the specialist.
According to caregivers, in addition to allowing faster care, the concentration of different specialists in the nursing home “reassures patients and helps them to confide”. The two caregivers affirm it: these nursing homes are a solution “to preserve the health of patients, as well as that of caregivers”.
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A strong mobilization expected
Liberal doctors are called to stop work Tuesday, February 14 and to demonstrate in Paris between the Ministry of Health and the Senate.
They oppose the bill of the deputy Stéphanie Rist (Renaissance), examined the same day in the Senate, which aims in particular to promote direct access to nurses in advanced practice.
They ask for a revaluation of the consultation : from €25 to at least €30 for large organizations (MG France, CSMF); €50 for the “Doctors for Tomorrow” collective. For the moment, Medicare is offering an increase of €1.50.
SOS Médecins joined the mobilizationcalling on its members to stop work for twenty-four hours from Tuesday morning.
