Medical appointments not honored: senators want to make patients pay

Europe 1 with AFP 6:44 p.m., February 13, 2023

Senators will put on the table on Tuesday a mechanism paving the way for compensation for missed medical appointments and financial penalization of dishonest patients, an initiative that responds to a request from doctors' representatives.

The Senate will examine at first reading in the hemicycle a bill for direct access to certain nurses, physiotherapists and speech therapists, which liberal doctors oppose.

Approximately 28 million medical appointments not honored per year

In committee, the senators adopted an additional article to this text in an attempt to find a solution to the problem of missed medical appointments, which would reach the number of 28 million per year, according to the doctors' unions cited by the rapporteur Corinne Imbert (LR).

It notes, however, that the Cnam "recommends the greatest caution on this data", evoking an appointment cancellation rate between 3 and 4%.

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The additional article modifies the public health code in order to provide that the medical convention determines the terms and conditions of compensation for the doctor.

It will also have to determine the conditions under which the sums paid are charged to the patient who "fails without legitimate reason".

The device could take the form of a recovery of the sum by the health insurance fund on subsequent reimbursements paid to the patient for other services, suggests the Social Affairs Commission.

"Dissuasive and empowering effect"

This penalization "would thus have a dissuasive and empowering effect": reducing the number of appointments canceled at the last moment or to which patients do not show up "would make it possible to restore useful medical time to doctors", underlines the rapporteur.

But for patient associations, "the idea of ​​a financial sanction is a bad solution to the problem", reacted France Assos Santé, denouncing "an absurd measure in terms of public health and in total contradiction with the reduction of social inequalities health".

Calling for the "pure and simple abolition" of what it describes as a "rabbit tax", this federation deplored that the text, bearing "concrete progress on access to care", had been "scandalously planed by senators in commission".

Voted unanimously in the National Assembly at first reading, with the abstention of the RN and LR, the bill by Renaissance MP Stéphanie Rist aims in particular to broaden the missions of nurses in advanced practice (IPA), a status created by the Touraine law of 2016 then a decree in 2018.

"Direct access" to physiotherapists and speech therapists

Patients could go to these caregivers without going through a doctor, but always as part of a "coordinated exercise" with the latter.

The bill also allows "direct access" to physiotherapists and speech therapists working in health establishments.

In committee, the senators gave a first green light to these provisions, but amended, so as to "guarantee the safety of care" and "maintain the central role of the doctor in the coordination and monitoring of patients".

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But the commission regretted the "particularly inappropriate" timetable for examining this text, while "negotiations for the next medical convention are in full swing".

The liberal doctors are also called to stop work on Tuesday and to demonstrate between the Ministry of Health and the Senate, to demand price increases and oppose the Rist bill.