Medical deserts: according to the vice-president of the national council of the Order of doctors “from 2025 the medical demography will inevitably rise”

The finding

“Public authorities have gone too far in lowering the numerus clausus. In 1969, 15,000 young people entered the 2nd year of medicine, before the first competition in June 1972 where there were 8,500 and in the mid-1990s we dropped to 3,500. The second point is the widening of inequalities. territoriality in medical demographics. Some have seen their medical demographics drop slightly and others dramatically. Unfortunately, the Lot-et-Garonne has not escaped the domination of the rural or semi-rural departments, far from the university hospital centers, with a greater decline than the more preserved urban and coastal departments. “

The plateau theory

“We are on a plateau but, from 2025, the medical demographics will inevitably increase by several thousand doctors per year. After a period of sharp decline in medical demographics, the question could arise on the 15 or 20-year horizon of a new plethora. Because the doctors of generations with the numerus clausus of 5,000 or 6,000 will retire and will be replaced by young doctors of generations without the numerus clausus of 10 or 12,000. There will be 5,000 more doctors a year. And when it is the turn of the generations of the 90s with the numerus clausus of 3,500 retire, perhaps we will go up from 5,000 to 10,000 more doctors a year. We could find ourselves in the debate of the 1980s when it was said that there were too many doctors. “

A perspective view

“You have to have a forward-looking vision with 5 or 6 criteria. One: what demographics according to the studies do we foresee in the different health professions? Doctors, nurses, midwives, pharmacists, etc. Two: what are the health needs, which will depend on the demographics of the general population? Three: What is the field of expertise of each category of healthcare professionals over the next 10, 15 or 20 years? Four: What is the time paved for a professional career as a healthcare worker? Five: what is the contribution of new technologies, such as remote consultation, telemedicine, tele expertise, even if they cannot solve everything? Six: perhaps, what is the place of the new health professions? It should be noted that the Order of Doctors opposed the creation of intermediate medical professionals, as Olivier Véran was the bearer after the Segur of health. Namely, to create a kind of health officer status. “

The difficulties of Lot-et-Garonne

“Lot-et-Garonne has several handicaps, with a low medical density and an elderly population. As for our department, we also have a crisis that is not just about general medicine. It concerns other medical specialties with the virtual disappearance of liberal medicine specialists such as psychiatrists, dermatologists, etc. It is also in the consolidation of the hospital offer within regional hospital groups, so that there is equity in access to care and that patients can benefit from quality care in relative proximity, as can be understood in a republican dimension. “

Ways to explore

“When general practice internships incorporate periods out of hospitals and irrigate territories, we know that, in the process, there is a significant increase in early exercises in disadvantaged areas. It is important that in the last stage of the internship there is a better geographical territorial distribution of the different specialties, because we know that it pays off. It is necessary to loosen the too “hospital” vice for certain specialties, which does not correspond sufficiently with the territorial needs. The fact that there is a collective exercise of health professionals, not necessarily under the same roof but in professional cooperation links, also favors installations. “