The National Assembly examines Tuesday, January 17, in the evening, a text aiming that patients no longer need to go through the general practitioner box to obtain an appointment with a physiotherapist, a speech therapist or a nurse in practice advanced.
The objective of the bill, led by MP and rheumatologist Stéphanie Rist (Loiret, Renaissance) and supported by the executive, is to improve access to care by freeing up time for doctors and creating cooperation effective among healthcare professionals.
Three professions are concerned: nurses in advanced practice (APN), physiotherapists and speech therapists. If the text is adopted, patients will be able to go directly to these paramedics without having first seen their attending physician. But always within the framework of a “coordinated exercise”in a nursing home, a health center or even in professional territorial health communities.
Prescription of care and medication
Advanced practice nurses, whose status was created by the Touraine law of 2016, have a baccalaureate + 5, i.e. two more years of study compared to state-certified nurses. In March 2022, they were around 1,400. If the text is voted on, they would also be authorized to prescribe certain care and medications.
Consultations with a physiotherapist as a first resort would allow “to avoid certain medical consultations for musculoskeletal disorders or minor traumatology, in particular for the most frequently performed acts (common low back pain, ankle sprain, hip prosthesis, operated shoulder)”, pleads the bill.
This device would thus shorten the intervention time, since the patient will no longer have to wait to obtain a first appointment with his doctor to go to his physiotherapist if he has back pain.
General practitioners protest against the text
The text is highly criticized by generalists. ” Declaration of war “, “insult to the profession”, “dangerous deregulation of the health system”… The Order of Physicians considers in particular that these measures will lead to “delays in diagnosis and a loss of opportunity for patients”.
Reassembled, the collective “Doctors for Tomorrow”at the forefront of the recent strike of liberal practitioners, has just written to elected officials and prefects to be moved that “medical acts are performed by non-medical professionals”. The generalists of the MG France union, they claim to want ” absolutely “ work with IPAs, but refuse to let them do “something they weren’t trained for”.
In a daily interview Releasethe member who carries the text retorted that studies proved “that cooperation between health professionals improves the quality of care provided to patients, and not the other way around”.
“The place of the doctor remains intact”
During the examination of the text by the Assembly’s social affairs committee, Stéphanie Rist pointed out that “the place of the doctor remained intact”. “Direct access is only open to professionals who practice in the coordinated care structures and a report must be sent to the attending physicians”recalled the rheumatologist.
Since 2017, several such measures have been adopted. Pharmacists can diagnose and prescribe treatment for angina, cystitis, chickenpox and allergic rhinoconjunctivitis. Physiotherapists and speech therapists are already authorized to prescribe certain medical devices.