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Medical deserts, a reality also 40 km from Paris

"The only doctor in the village retired on May 1, 2021.

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Medical deserts, a reality also 40 km from Paris

"The only doctor in the village retired on May 1, 2021. Since that date, there has been no general practitioner in Vert-le-Grand", explains Olivier Josse, deputy mayor of this peaceful town, who highlights before "the calm of the countryside".

A departure which had however been anticipated: "it's been four years since we started research", underlines Mr. Josse, in charge of the medical center where he practices as a podiatrist. "We have a paramedical part which is full (...). But the other part, two premises of 30 m2, which can accommodate two doctors with a waiting room and everything up to standard, is empty".

Despite "2,500 announcements" on all media, despite the population base, the proximity of universities and even the capital (50 minutes via the A6), Mayor Thierry Marais says he is "disarmed". "It is not necessary to be in the depths of Lozère" to have "this type of concern", abounds Mr. Josse.

"Everyone manages through Doctolib, hospitals or clinics. We try to support the elderly as well as possible (10% of the population). We even go so far as to transport them to their appointments and the pharmacist helps us a lot thanks to the installation of her teleconsultation cabin", says the mayor.

A doctor in Bruyères-le-Châtel, a neighboring town, Patrick le Fur points out that "the problem has been raised by the medical profession in Ile-de-France for almost 30 years". And he is hardly optimistic for the years to come: "the problem that arises now is that there is significant urbanization and living costs. Young doctors know this, the intern that I I currently plan to settle in Clermont-Ferrand..."

- The IDF, a complex medical desert -

These choices weigh on the number of Priority Intervention Zones (ZIP), where the proportion of general practitioners is in deficit. "Ile-de-France has gone from 37% of its population living in ZIPs in 2018 to 62% today, while in France it is more like 30% (against 18% in 2018)", underlines Sophie Martinon, deputy director general of the Regional Health Agency (ARS) Île-de-France.

The problems have been identified: low recruitment, requirement of young doctors and strong competition between municipalities.

The ARS tries to stop the phenomenon by putting "more than 20 million euros each year on the table to support, facilitate, promote the installation of liberal doctors" in IdF, indicates Ms. Martinon.

“We are also developing an axis of financing for interns and medical students. We pay for part of their studies and we support them up to 1,200 euros per month with the counterpart of settling then in a deficit area, the number years during which we helped them", explains Pierre Ouanhnon, deputy director of the offer of care (DOS) at the ARS.

The ARS also says "to work on all doctors who have graduated for 10 years in Île-de-France". "For those who are not installed or those who have not yet chosen their mode of exercise (for example replacements), we will try to help them, and if they have a project to install in Île-de- -France, to offer them potential reception structures", says Mr. Ouanhnon.

Medical deserts could benefit from the additional year of studies, known as "consolidation", that future general practitioners would carry out outside the hospital and "as a priority in under-resourced areas", according to a project from the Ministry of Health. .

A good solution according to some patients, like Julie Blatanis, 42, childminder in Vert-le-Grand, who consults a doctor outside the town.

"If doctors can finish their studies in small towns to get a closer look at the profession already, I think it's a very good idea," she says. It remains to be seen whether future GPs will be on the same wavelength.

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