Medical deserts in France: the cry of alarm from rural mayors
REUTERS - Regis Duvignau
Text by: Aram Mbengue
3 mins
As the National Congress of Rural Mayors in the Dordogne began today, the AMRF, the Association of Rural Mayors of France, published this morning a study on medical desertification in rural areas.
And according to this survey, it is six times more difficult to consult a doctor in the countryside than in town.
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According
to the study on medical deserts published this Friday, September 30
by the Association of rural mayors of France, if in urban areas a general practitioner consults populations distributed on average over only 5 km², in rural areas, this coverage can go up to 30 km².
This situation largely explains the difficulty of populations in rural areas to access medical care.
“
We see that there are ten million French people who live in these rural areas, where access to care is of lower quality than the average for the country.
We also know that these millions of people live more than thirty minutes from an emergency service
, ”says Gilles Noël, president of the National Health Commission of the Association of Rural Mayors of France.
In these territories, 63% of living areas lack general practitioners.
For rural elected officials, more than 6,000 would be needed to achieve the desirable goal of one general practitioner per 1,000 inhabitants.
As for specialist doctors, their number varies according to the departments, but it is especially in the center and the west of France that there is a lack of them the most, particularly in anesthesia, gynecology, pediatrics and psychiatry.
Possible solutions
To remedy this desertification of rural areas, the AMRF therefore proposes to calculate the density of doctors per square kilometer, and not in relation to the number of inhabitants as is currently the case.
The association also recommends making it compulsory to diversify the places of internships for medical interns.
“
We need to ensure that students no longer only do internships in training places, but that they can come much more to rural areas to learn about, exercise and learn their future profession.
To do this, we need to support them in terms of accommodation, access to our territories and presentation of the advantages of the rural environment
”, defends Gilles Noël.
Rural elected officials also propose to facilitate the installation of health professionals in so-called under-dense areas and to authorize nurses to broaden their areas of competence: "
We also propose that health professionals can work in a logic of practical advanced.
It is necessary, as we saw during the Covid, that pharmacists or nurses can perform a certain number of acts which are today reserved only for doctors
, ”adds the president of the National Health Commission.
The Île-de-France region: the largest French medical desert
Medical desertification does not only affect rural areas.
It may seem surprising, but the first medical desert in France is… in Île-de-France.
The Regional Health Agency (ARS) draws up a damning observation
: 96.3% of Ile-de-France residents live in an area "
insufficiently equipped with general practitioners
".
And the situation is getting worse and worse.
Indeed, the proportion of inhabitants who live in a priority intervention zone (ZIP), the most extreme fringe of medical desertification, is only increasing.
It rises to 62.4% in 2022, while it was still 37.6% in 2018, mainly concentrated in Seine-Saint-Denis (93% of its population is under-equipped in white coats).
The distribution of doctors is also extremely unequal in Île-de-France.
Paris has an excess number of practitioners - only the 19th arrondissement of Paris is classified as a ZIP zone - while the vast majority of Seine-et-Marne (77), Essonne (91) and Seine-Saint -Denis (93) are sorely lacking.
In detail, the study published by the AMRF estimates for example that there is a shortage of 72 psychiatrists in Seine-et-Marne, with approximately three psychiatrists per 100,000 inhabitants, while conversely, Paris has 1,119. "too much".
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