Medical shortage: a real problem in town?

The medical desert is a notion ofterritorial inequalities concerning access to healthcare for all. According to DREES, 8% of the French population lives in a commune considered to be a medical desert. Worse still, an estimated 0.5% of the population have difficulty accessing pharmacies, doctors and emergency services. The healthcare system and access to health are central concerns for local authorities.

What is a medical desert?

The term "medical desert" refers to areas where thesupply of doctors is insufficient to meet patient demand. This is due to the poor distribution of doctors across the country. This applies equally to access to doctors, medicines and emergency services.

An area is defined as a medical desert if the density of general practitioners is 30% lower than the national average. A town's medical desertification is characterized by :

• Lack of local medical care: Patients are forced to travel several kilometers to consult a healthcare professional.
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• Waiting times for appointments: The number of doctors is insufficient, and patients have to wait several days or even months for an appointment.
• The scarcity of pharmacies: Patients travel dozens of kilometers to find medicines.
• Distance from hospitals: The only health care center offering immediate and appropriate care in an emergency is around 30 minutes away by car.

Medical shortage in France: what are the causes?

Medical deserts have several causes, which are well known to the Ministry of Health. Here are the 3 main reasons for this phenomenon.

The shortage of doctors in France

The lack of doctors, both general practitioners and specialists, is the primary cause of medical deserts. At a time when the population is aging and requires more follow-up care, it is difficult to absorb the demand. What's more, retiring doctors are hard to fill, as young doctors aspire to other projects.

Unfortunately, because of the numerus clausus system designed to limit the number of medical students, the next generation of doctors is not assured. Young doctors, normally expected to cope with the aging of the medical profession, are in short supply. They are not enough to compensate and meet the ever-increasing demand. The result is a limited medical supply.

The attractiveness of certain regions

Not all French people have equal access to healthcare. Doctors are unevenly distributed across the country. It has to be said that some areas are better off than others. And this applies to both general practitioners and specialists.

Medical demographics are not only ageing, they also vary from one area to another. In fact, in most of the départements affected, the larger the population and the larger the area to be covered, the lower the medical density.

In the Loire, there are 201 general practitioners for a population of 227,283. The situation is even worse in the Ain, where there are just 383 active GPs for a population of 643,350.

However, there are a number of initiatives underway in the Ain to combat medical deserts. The town of Saint-Julien-sur-Reyssouze has installed a connected teleconsultation booth. Tessan facilitates access to primary care thanks to augmented telemedicine in French towns with a shortage of doctors..

Availability of healthcare professionals

The lack of specialists and GPs is compounded by theunavailability of practicing healthcare professionals. Doctors' surgeries that are open Monday to Friday are rare, as are those that open at weekends.

In large conurbations, medical overheating is also making itself felt. It's becoming increasingly difficult to find a regular doctor. Overwhelmed by their workload in the city, local doctors are unable to take on new patients, and limit themselves to their existing clientele.

The consequences of medical deserts in cities

Medical deserts have serious consequences for quality of life. Faced with the difficulties of making an appointment, the French are giving up on consulting a doctor.

Limited access to primary care medicine

Not being able to consult your GP is the first disastrous consequence of the medical desert. The absence of a local doctor means waiting times of up to 100 days for consultations with specialists such as ophthalmologists, gynecologists and dermatologists.

In these medical deserts, walk-in consultations are virtually impossible to obtain.

Patient care quality at a low ebb

Medical deserts deprive patients of the care provided by Social Security. Without a consultation, they are not entitled to the necessary follow-up and medical coverage provided by the health insurance system. And all this in the knowledge that the rate of reimbursement granted depends essentially on this pathway.

Beyond access to primary care, it's the quality of care itself that is called into question. The impossibility of immediate care means that patients are unable to treat themselves properly. The only option is often to go to hospital.

The Île-de-France region: France's largest desert

If you thought medical deserts only affected rural areas, you'd be wrong. 4.4 million people in the Paris region are struggling to find a GP. Yet this is the region with the most doctors. So how can Île-de-France be France's biggest medical desert?

Because of population density. The number of doctors is still not sufficient to meet demand. The medical situation in the IDF is unlikely to improve. In fact, the situation is alarming: over 55% of patricians in the IDF are over 60, and will soon be retiring.

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