Entrances to the emergency room now filtered by intercom day and night, at the Montauban hospital

“We are waiting for you at the immediate care center” two kilometers away, said a voice over the intercom, in front of the closed door of the emergency room of Montauban. Disconcerted, the man turns back, with his sick brother and his handicapped son.

Red or green? Screening at the entrance to the hospital

To avoid overcrowding in its emergency department due to a lack of doctors, the Montauban hospital is one of the first in France to filter inputnight and day, thanks to two intercoms, from 1^is July 2022.

The vert is reserved for patients who have obtained a prior telephone agreement for treatment. Through the rouge, the others can explain their case, before being allowed to enter. Or not.

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Sorting out to deal only with “real” emergencies

This “filtering”, put in place since the beginning of July, aims to sort out to deal only with cases “really relevant” to emergencies, explains one of the heads of the department, Hélène Pizzut, 45 ans.

The new process results in a “average reduction of 25% in the number of passages” and “refocusing on its core business” of the service, in order also to attract more emergency physicians, who are insufficient in number in France.

People showing up without an appointment are referred to other medical centers likely to treat them, such as this man in his forties, his brother pale with pain and his autistic son.

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Twice as many emergencies in 20 years

With more or less success: three hours later, he is there again, sent back from the center to which it was addressed. In front of the same closed door, he remains polite, but seems tired and angry.

In recent years, the number of patients coming to the emergency room has exploded. “We were twenty years ago at 20,000 admissions, we are currently at 40,000” per year, told AFP the other head of department, Dominique Coppin.

This growth coincides with a drop in the number of liberal generalists. In Tarn-et-Garonne, 10% of the population has no attending physician, recalls this 67-year-old emergency doctor.

No waiting in the hallways

If the activity remains sustained, it is less intense than it would be without “filtering”, he underlines, pointing to the waiting room, where three patients are seated. “The twenty places would all be occupied”.

In a hallway, several empty stretchers. Without “regulation” at the entrance, they would all be taken too, continues Dominique Coppin. That evening, only an elderly woman was waiting there to be treated.

A little further on, two patients are bedridden, each in a room equipped with measuring devices. A fifteen people in total are at that time taken care of in the emergency room.

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More “serenity” for caregivers

With rapid steps, doctors and nurses pass from one room to another, from one cubicle to another, stop in front of a screen to consult the patient’s files, talk to each other.

If they never stop, they do not seem particularly stressed. For Hélène Pizzut, since the introduction of intercoms, staff can indeed work with more “serenity”.

“Emergencies can no longer be open bar! “, says the minister

The choice made in Montauban corresponds, she admits, to the idea that the government has of access to emergencies. To limit their congestion, the new Minister of Health, Francois Braunurged to contact “the 15th” first, where the calls increased at the same time.

Thus, in Montauban, the 25% drop in emergency room activity was accompanied by a more than 50% increase in calls to the Samu.

The Prime Minister, Élisabeth Borne, also wished at the beginning of July “that everyone could take the reflex of the” 15 “and not systematically come to the emergency room”.

She thus relayed more soberly the message of Mr. Braun who had estimated, before taking office: “Emergencies can no longer be be open bar! “.

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The association of users more mixed

But the president of the association of users of the Montauban hospital, Maurice Souleil, see things differently.

According to him, it would be better to go back on decades of “policies of destruction of the public hospital »cause of the saturation of emergencies and medical deserts.

He also denounces the limitation of entries into the faculty of medicine – numerus clausus abolished in 2018 – or the hospital funding depending on their activity level.

In Montauban, users are also worried about the project to build a new hospital outside the city centre, which would be less accessible to them.

_{With AFP}

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