Restoring access to medical care for all citizens is the French government’s main ambition in the context of the public consultation on health to be launched on October 3. In addition to the hospital crisis largely due to a lack of staff, medical deserts will, for sure, be at the heart of the discussions. “Today, too many of our fellow citizens do not have a regular doctor and have increasing difficulty in accessing specialists,” Emmanuel Macron acknowledged speaking before private insurance providers on September 7. “This situation is not acceptable,” added the president, without giving any information on the government’s solution. It was out of the question for him to comment on the contentious issue of the freedom of where doctors can live and practice. The issue is serious a threat to the profession and one that local elected officials or even parliamentarians have been raising more and more loudly in recent months.
The lack of general practitioners in medical deserts often garners a great deal of attention, but the increase in areas with no specialists seems just as worrying. Many French people state that they can no longer find appointments and sometimes go as far as giving up on treatment. What is the situation for specialized medicine, like pediatrics, gynecology and gastroenterology?
According to one indicator published exclusively by Le Monde and calculated by health geographer Emmanuel Vigneron as part of his work for the Association of Rural Mayors of France, the decline has been ongoing over the last 10 years. And in some cases, it is even stronger than in general medicine.
In terms of density, the number of professionals working in cities (self-employed or in mixed practice) fell from 68.4 per 100,000 inhabitants in 2012 to 65.5 in 2022 in a dozen of the most “common” specialties (pediatrics, gynecology, gynecology-obstetrics, psychiatry, ophthalmology, dermatology, rheumatology, cardiology, otolaryngology, gastroenterology, radiology and anesthesiology). “By selecting 12 specialties that the population turns to the most frequently, we can see that the situation has only worsened over the past 10 years, but also that the divide between areas is widening,” said Mr. Vigneron. These specialists represent 44,398 physicians, a figure that has remained largely unchanged since 2012, unlike the population, which has continued to grow.
The impact of urbanization
Three-quarters of the 101 French departments are still at a rate below average density. But according to the researcher, the number of departments below the critical threshold – 40 specialties per 100,000 inhabitants – has nearly doubled since 2012, when it numbered 22 departments.
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