Doctor Raphaël Dachicourt chairs the young general practitioners’ union ReAGJIR, spearheading the first Purple September campaign to simplify administrative procedures for doctors.
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The difficulties of access to care concern today the entire French population. The health system has found its limits. Faced with this reality, young liberal doctors have decided to take the bull by the horns, starting their fight by simplifying their administrative tasks. Objective: save medical time. Doctor Raphaël Dachicourt, a doctor in a town in the north of France, chairs the ReAGJIR union (Autonomous grouping of young established and replacement general practitioners).
The first Purple September communication campaign is being organised this year, relayed by your union but also by the College of General Medicine. Can you explain its outlines?
We want to alert the public authorities about the loss of medical time, which is directly linked to the time lost in responding to administrative requests that sometimes have no medical justification. Currently, during this back-to-school period, 20% of my activity in the office is devoted to medical certificate slots that are not essential.
You talk about “absurd” certificates, what exactly are they?
Sometimes, we are asked for ridiculous certificates of aptitude, to play chess, for example, or of aptitude for community life. In the rush of the September school year, we need certificates of aptitude, of sport for new licensees, for school entrances, daycare, for childminders and sports or stamp collecting clubs… Then, in winter, patients make appointments for certificates attesting to minor flus, sick children and other seasonal viruses, and we are again at a ratio of 15% to 20%. Most of the time, we cannot even check whether the child is really sick. Clearly, this is clogging up doctors’ surgeries in a context of difficulty in accessing care and medical deserts. Nonsense.
“It is not the patients who are asking for it, but the system that has gone haywire”
However, not all requests for certificates are useless – they can help to detect a pathology, for example, right?
Yes, they must be distinguished, indeed. We have listed in a report all the requests in order to be able to make an intelligent sorting. Some have legal justifications but not at all medical ones. Sometimes, the law requires requesting a certificate when this does not correspond to any medical criteria. We must clean up and concentrate on what is necessary.
Would you like the law to change?
Of course. We have launched a whole series of proposals to the ministry to change the law. Why not ask parents for a sworn statement for a sick child? Legally, some requests are not valid. We should open up the possibility of absence from work without medical justification, in the form of a self-declaration of short-term sick leave, less than the number of waiting days. Do away with the certificate of fitness for community life…
Certificates that have no legal validity, which ones for example?
Each school has its own rules, sometimes totally absurd. A colleague had to sign for each new student a certificate of fitness to follow a normal curriculum in the school environment – astonishing! It is not the patients who are asking for it, but the system that has gone crazy. For this case of the certificate of fitness, the general practitioners tried to convince the school in question of the lack of legal validity, in vain. The Order of Physicians of the department had to get involved by explaining that their request was contrary to the law.
“Our Purple September campaign also aims to raise awareness among the general public; everyone will benefit. Doctors’ time is precious.”
How to manage sports fitness certificates? It seems complicated to do without…
A healthy minor does not have to produce a medical certificate to practice sports. Since 2021, the latter – or his parents – must complete a simplified questionnaire provided by clubs affiliated to a federation. It should be extended to clubs not affiliated to a federation, then extended to adults for sports license applications. Our Purple September campaign intends to raise awareness among the general public, everyone will benefit. Doctors’ time is precious.
