After a week of strike, the showdown continues.

The Doctors for Tomorrow collective renewed for a week, Monday, January 2, its call for the closing of practices.

Bringing together nearly 15,000 liberal doctors, according to its spokesperson, the psychiatrist Noëlle Cariclet, the collective calls in particular for the doubling of the price of the consultation, in order to establish it at 50 euros, against 25 currently.

Around 57,000 of the 80,000 general practitioners and 43,000 of the 126,000 specialist doctors practiced in private practice in France in 2022.

“Due to the lack of response, we have decided to renew the strike, explains this liberal psychiatrist who practices in Seine-et-Marne in a medical desert. Faced with the contempt of the government, we have no other choice. We are extremely worried about the future of medicine."

The Minister of Solidarity and Health, François Braun, indeed reacted on December 27 by "firmly condemning" the strike movement, while France is in the grip of a triple epidemic of influenza, Covid-19 and bronchiolitis. .

For his part, the director general of Health Insurance, Thomas Fatôme, deemed Monday "extravagant" the doubling of the price of consultations, while the Samu deplored a strike "at the worst time".

But for the collective, which does not budge, it is a necessary "incentive measure" to compensate for the lack of doctors.

"One in two doctors is in burnout"

“The consultation rates have not increased for twenty years, unlike the charges, especially in the current context of inflation, underlines Dr. Cariclet. We are witnessing the deterioration of the health system, one in two doctors is in burn -out… While it is possible to improve things thanks to our proposals."

The increase in the price of the consultation would allow private doctors in particular to invest and hire more staff, while the administrative costs are growing and "exhausting", according to Doctors for tomorrow.

They would thus represent up to 20% of the working time of a liberal doctor, that is to say approximately 12 hours per week, out of the 55 that he works on average.

>> To read also: "Overwhelmed emergencies, general practitioners' strike ... the French health system out of breath"

"In my office, we share a secretary for nine doctors, continues Dr. Cariclet. Suffice to say that, even if I pay her, I never call on her, she has no time! I had to no longer mobilize it for three and a half days out of 2022. So I have to manage everything on my own, which makes me waste a lot of time."

Behind this work overload, the certificates required by various administrations and institutions, but also the exchanges with the National Health Insurance Fund (CNAM).

"For example, communities ask for a medical certificate to reimburse the three euros of a sick child's canteen, points out Dr. Cariclet. It's completely useless! There are also all the exchanges with the various Social Security funds, when information is missing on a consultation, for example. Personally, I prefer not to fill out these papers to save time, even if it amounts to sitting on my remuneration, since Social Security does not pay me. I don't even prefer to calculate my shortfall."

"General medicine is mistreated"

In the midst of conventional negotiations, the main unions have not called for a strike, but they claim to share the "anger" expressed by Doctors for tomorrow.

"We all make the same diagnosis. I spend an hour every evening to settle the administrative, while I have a secretary, and I work 60 hours a week, explains Jean-Christophe Nogrette, general practitioner and deputy secretary general of the MG France union (majority). General medicine has been mistreated for a long time and fewer and fewer young people want to do it, which was predictable and infuriates. But demanding the doubling of fees does not hold water."

The union believes that the revaluation of consultation fees should mainly focus on general practitioners, who represent 50,000 of the 80,000 general practitioners.

Because, according to the Confederation of French Medical Unions (CSMF), while more and more young doctors are giving up on their own due to lack of visibility, doctors in office have seen their patient base increase by 20% since 2016.

“It is a priesthood, and it is the most difficult and least paid form of general medicine, points out Jean-Christophe Nogrette. We therefore need a massive revaluation of treating medicine, but not necessarily of all In concrete terms, 50 euros for a consultation diagnosing angina is too much, it is already profitable at 25 euros. is not enough."

Towards a hierarchy of the price of the consultation?

The CSMF is also in favor of a hierarchy of the price of the consultation according to its complexity.

It nevertheless calls for limiting the strike to Saturday morning, so as not to destabilize a health system already strained by winter epidemics.

"We have called for responsibility, but we expect the government to hear us during the conventional negotiations, which will resume next week until the end of February, underlines Franck Devulder, gastroenterologist and president of the CSMF. 50 euros the consultation seems unlikely to us, but it is true that 25 euros has become unsuitable, and we share the general frustration.In my office, most of my young colleagues earn less than their spouses. They are the ones who become the adjustment variable for the household, this is unprecedented. If the negotiations do not succeed, we will react firmly."

In the meantime, Doctors for Tomorrow is calling for a demonstration on Thursday January 5, after which the collective should be received by the Minister of Health.

All with us on 5/1/2023 at 1 p.m. in Paris place du panthéon pic.twitter.com/Dss5lllOgK

— Doctors For Tomorrow (@MedPourDemain) January 1, 2023

"The showdown will continue, that's for sure, but probably not in this form, says the spokesperson for the collective. This strike should not have taken place, our goal is not to affect our patients. We are therefore going to think about actions that will put more pressure on the institutions so that things change and that they stop ignoring us as has been the case for years. We hope that the public authorities will finally listen, and we expect a lot from collective bargaining. Because it makes no sense for a doctor to go on strike."

Health Insurance recorded a 10% drop in activity for liberal doctors last week, while the committee says that 70% of general practitioners have closed their practices.

Liberal biologists also went on strike.

Since Monday, they have been called upon not to report the results of the Covid-19 tests making it possible to follow the evolution of the epidemic, in order to dispute the amount of the savings which are asked of them after a sharp increase in their profits during the crisis. sanitary.

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