HEALTHlife

It’s not just life, it’s PROVENCElife© PROVENCElife 2007 Going to the doctor might seem different in France to that we’ve been used to in UK or other European countries. We are likely to find, especially in the smaller towns that the GP (médecin généraliste) works single-handed and only in the larger towns and cities are there the group practices familiar in Britain’s NHS.  In fact, 50% of French GPs work alone, usually without secretaries and certainly, even in the groups no nurses or other health care workers. So ladies, don’t expect there to be a chaperone present, even though it’s a French word!              

A further difference is the way your doctor is paid. In UK GPs receive an annual fee for each patient registered with them, so he gets the same pay whether the patient sees him every day or not at all (a higher fee for the elderly and children).  
In France the doctor receives only the fees that the patient pays him- fees fixed by the CPAM that reimburses you, 70% of his fee. This has tended to treat the patient more like a consumer, and some say has led to the high esteem in which health care in France is held. In Britain, every patient is registered with a GP who keeps their medical records; the average GP has around 2,500 patients on his or her “list”, changing your GP is possible but discouraged. Now France is changing to British system so that you have to register with a GP, your “médécin traitant” who will eventually keep you (electronic) medical record. If you visit your médécin traitant for a consultation CPAM will reimburse you at the usual 70% rate but if you choose to see another GP reimbursement will be at a much-reduced rate.    

In the UK, the GP acts as the “gatekeeper” to secondary i.e. specialist services and
British patients are accustomed to being referred to specialists by their GP. This has two results, it reduces specialist’s time being wasted on conditions easily dealt with by the GP, and it helps to direct the patient to the correct specialist.     
Not so in France where patients can go directly to specialists without seeing their GP.  But things are changing; now if you visit a specialist without being referred by your médécin traitant, your reimbursement from CPAM will be reduced. (This does not apply to follow up visits to the specialist.)



Selwyn Glick FRCS is a regular contributor to PROVENCElife magazine, if you
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