scholership

Medical deserts – For the URPS of Corsica “UFC Que-Choisir does not attack the State for the right reasons”

The study carried out by UFC-Que Choisir takes into account the geographical distance of doctors. It considers any municipality with a density of practitioners 60% lower than the national average to be a medical desert. “While keeping in mind the fact that the supply of doctors throughout the country is generally insufficient, this classification illustrates the poor distribution of the supply of care, at the source of the health divide.“, comments UFC-Que Choisir in the preamble to its study.

Thirty minutes of travel by car to consult a general practitioner, and forty-five minutes for a specialist, are presented as the travel times not to be exceeded. Travel times often reached in Corsica, given the lack of geographical continuity caused by the island relief, which contributes to distancing the different living areas, organizing them into micro-regions.

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But when it talks about inequality of access to care, UFC-Que Choisir links the geographical dimension to the financial dimension: “By only taking into account access to practitioners who do not overcharge, the situation becomes absolutely catastrophic with regard to access to specialists, both in rural and urban areas.“, criticizes the consumer association which put online a map which identifies the reality of medical deserts in France. Strangely, she chose to do it commune by commune, whereas the reality of medical deserts is approached first and foremost through the prism of living areas.

But it doesn’t matter, according to Antoine Grisoni: “Two or three more or less medical deserts are not going to change things. The reality is that there is a shortage of doctors, period.“In Corsica, another reality must be taken into account: the aging of the profession. In 2023, the proportion of active doctors aged over 60 is 44.6% in Haute-Corse, or nearly one in 2. In Southern Corsica, it is 38.9%

.

“This is the reality of everyday life…”Mapping medical deserts in France, UFC-Que Choisir is not the first to do so. INSEE, the Order of Physicians and Health Insurance also have a database provided on this subject. For Corsica, we will retain the zoning carried out on April 20, 2023 by the Regional Health Agency. This takes into account insufficient care provision for a given population, low turnover of professionals or retirements of the latter. And it allows financial aid for installation and maintenance to be allocated directly to private doctors, where the situation requires it. However, in Corsica, the sectors identified as priorities by the ARS go from Cap Corse to Sartène, following a line which passes through Nebbiu, Cortenais or Fiumorbu. A fragility which is also recognized for other territories such as Balagne or the Far South, but to a lesser degree. On the other hand, Bastia and Ajaccio are not considered medical deserts. The two cities were excluded. not because there is no problem, but because funding must be prioritized, analyzes Dr. Grisoni.Because otherwise, go find a rheumatologist in Bastia… And for an ENT, the first appointment that was offered to one of my patients was at the end of February… I had to call my colleague to ask him to take it first. We operate like this 90% of the time… This is the reality of everyday life.

In its study, UFC-Que Choisir limits itself to general practitioners and three specialties to which patients can have direct access, without a prescription: ophthalmologists, gynecologists and pediatricians. Excluding all other specialists from this study, Antoine Grisoni does not understand: “Because the lack of specialists has an impact on the activity of generalists

“, assures the president of Corsican liberal doctors.

UFC makes “an ideological analysis of the situation”But the main singularity of the UFC-Que Choisir study is, as we have already said, to consider that the health divide is also financial. “Excess fees paid by users continue to grow. For most specialties, it is becoming more and more difficult to find doctors who respect the Social Security rates. Thus, nearly 7 out of 10 patients reside in a medical desert in terms of access to gynecologists in sector 1 (without exceeding fees) less than 45 minutes from home, and almost one in two children reside in a medical desert. regarding access to pediatricians at social security rates. Therefore, fee overruns are borne by users

“, concludes the organization.This argument does not pass at all for Doctor Grisoni: “I am very angry. UFC-Que Choisir makes an ideological analysis of the situation, it rushes into classic populism. Everyone knows that our turnover is stagnating or decreasing, particularly due to inflation. We sometimes work 70 hours a week, we have made significant sacrifices during the Covid crisis. Is all this forgotten today?

“, asks Solenzara’s general practitioner bitterly.He nevertheless finds merit in this study: “Give the state an extra kick. UFC just needs to ask him to stop playing hypocritically with budget constraints “, he advances in an allusion to the savings plan of 3.5 billion eurosthat the State wants to undertake on the health insurance budget. According to Antoine Grisoni, financial assistance for the installation of the ARS for a doctor does not work in Corsica: “Money is not enough to move to a remote corner“, he says a bit provocatively. Because according to him, it is up to the State to set the example: “A medical desert is often a public services desert. So why would we force a young doctor to compensate for what the State no longer does?

Source: 2023 atlas of medical demography from the National Council of the Order of Physicians.

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