The collective Corsica liberal doctors Had he underestimated the success of his approach? There is always that the conference room at the Mercure hotel in Biguglia was a little too narrow, which Saturday March 16, to welcome all participants to the seminar on “collective unconventionality” organized by this structure bringing together some 300 island liberal practitioners, with the help of the union French Union for Free Medicine (UFML).
Unconventionality? Behind this word, a threat. The one brandished by a number of liberal doctors, in Corsica as on the Continent, in case the current negotiations between their unions and the National Health Insurance Fund (CNAM) do not give them satisfaction. Tough negotiations, restarted six months ago, after a first attempt remained unsuccessful.
Sixty-one cents per act
In practice, private doctors – and in particular general practitioners – are demanding an improvement in their working conditions, notably through a revaluation of the price of the consultation and an reform of the rules for pricing procedures. Failing to win their case, they threaten to deconvention, that is to say to break the agreement which binds them to the CNAM. A break which would allow them to freely set the amount of their fees but with a major disadvantage for their patients: they would no longer be reimbursed by Health Insurance up to 61 euro cents per procedure.
“For years, we have accepted seeing our working conditions deteriorate, particularly in Corsica, which is the region where doctors earn the leastunderlines Doctor Cyrille Brunel, spokesperson for the Corsica Liberal Doctors collective. Why have we accepted such degradation? Because we felt that if we demanded better practice conditions, our patients would suffer. This fueled a sort of feeling of guilt which the State used as a lever for action.” A page that these professionals say they are determined to turn.
12,000 euros monthly
The seminar is thus punctuated by around ten interventions intended to show the merits of their demands and the mode of action they have chosen to put pressure on Health Insurance.
Among the speakers, doctor Franck Chaumeila general practitioner based in Bordeauxwho chose, in 2019, to leave the France and go and settle in Suisse. A country where liberal medicine works with “a pricing system linked to the time spent with patients and the complexity of cases”of which he gives a presentation in the form of an inverted mirror of the situation in France: respectful patients, paid administrative tasks, around twenty acts per day and and average income for a mid-career generalist equivalent to 12 000 euros monthly.
Then come the testimonies of practitioners who have taken the plunge, like doctor Rosalie Nguyena professional based in Seine-Saint-Denisderegulated since September 2023. “Since then, I have finished working days that end at midnightshe explains. When it comes to pricing, I proceed with tact and moderation. Over the last six months, I have performed 8% free procedures, 28% underpaid procedures and for the rest, I applied my own pricing. In this way, I managed to maintain my income and I adapted to the individual situation of my patients.”
“We want to maintain the dialogue”
Health Insurance claims to take the threats of withdrawal from these angry doctors very seriously. Nicolas Adjemianthe director of the CPAM of Haute-Corse, also took part in the seminar. With one objective: to maintain the dialogue. “If France has a unique model where everyone has access to care, it is thanks to the agreement which links doctors to Health Insurance, which is why we want to continue discussions and achieve to a compromise”he confided a few hours before attending the invitation of the collective.
Before detailing the proposals put on the table: an increase in the price of the basic consultation from 26.50 to 30 euros, the establishment of a long consultation at 60 euros for the elderly, an increase in the mountain allowance for Corsican practitioners…
Will these proposals be enough to push back the doctors who are threatening to withdraw? If we trust the tone of the speeches this Saturday in Biguglia, nothing is less certain.
2024-03-16 18:20:56
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