Sending doctors to medical deserts as reinforcements will ultimately be done on a voluntary basis.

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The dispatch of general practitioners to reinforce medical deserts will be done on a "voluntary" basis and in return for compensation of 200 euros per day, Health Minister Yannick Neuder announced on Monday, September ¹ , in the Landes region.

This system, requested in April by Prime Minister François Bayrou, will be deployed "from next week" , the ministry specified, in 151 inter-municipalities located mainly in the center and southwest of the country, excluding the coast.

In total, 2.5 million patients living in these "red zones" will be affected by these reinforcements of general practitioners, up to two days per month.

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François Bayrou had mentioned a coercive measure in the spring, but then referred such a possibility, rejected by many doctors, to the development of "legislative provisions" . In June, some deputies, led by the socialist Guillaume Garot, had promoted stricter measures, imposing constraints on doctors setting up, but arousing even more marked opposition from the latter.

200 euros per day

The system will ultimately be deployed on a "voluntary" basis, declared Yannick Neuder on Monday, who is opposed to "forced installation" , during a trip to Pissos, a village of 1,400 inhabitants in the Landes forest.

The minister did not, however, state the number of doctors already volunteering in the region, who will be compensated up to 200 euros per day, "since we are in the process of launching these schemes." In the Landes region, more than fifty have already reported their services.

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In Pissos, Raphaël Duquenoy, a general practitioner based 20 kilometers from Bordeaux, a little over an hour's drive away, will begin his reinforcement on September 16. He comes out of "brotherhood," even though "they are poor people helping other poor people," he summarizes. "Concretely, it's shortage management, because I have to manage my absence for two days, without being sure of finding a replacement." In his practice in Ambarès-et-Lagrave, three doctors have retired, without replacements.

In Pissos, the health center "found itself without doctors" in 2021, following a retirement, says Mayor Denis Saintorens. The current general practitioner, who arrived in the area in 2022, sees patients from a catchment area of ​​approximately 3,000 residents.

"Two days a month is not enough, we should have at least once a week," regrets Chantal Bonan, a 71-year-old former grocer, sceptical about the idea of ​​"seeing a different doctor each time."

Dr. Duquenoy concedes a "gamble" in the face of the "medical shortage," but says he is "reassured" by the model of volunteering and "trust," "which makes people want to get involved . " "We already have our patients who need us, and we don't necessarily have to move from our chairs. So volunteering is perhaps more mobilizing," he explains.

Yannick Neuder wants to first mobilize "doctors who have time," such as "replacements, retirees or those working part-time," so as not to "depopulate an area ." To "improve the provision of care," the minister intends to coordinate this system, managed by the regional health agencies (ARS) and the prefectures, which is aimed at doctors "in reasonable proximity" to under-resourced areas, with the "complementary" system of the Médecins Solidaires association in more remote areas. This collective, launched three years ago, now claims 800 general practitioners who provide one-week reinforcements in nine different centers.

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