Per year, nearly 27 million medical appointments are not honored, according to the National Council of the Order of Physicians. In order to find a solution to the problem, the senators will put on the table on Tuesday, February 14, a mechanism opening the way to compensation for doctors and financial penalization of unscrupulous patients. The initiative responds to a request from physician representatives.
According to the National Academy of Medicine and the National Council of the Order of Physicians, several surveys suggest that “every week, 6 to 10% of patients do not show up for their appointment, which corresponds to a loss of consultation time of almost two hours per week for the doctor, whatever the discipline”. The rapporteur Corinne Imbert (LR) notes, however, that the National Health Insurance Fund (CNAM) “recommends the greatest caution on these data”.
“Empowering the socially insured”
This article modifies the public health code so that the medical agreement determines the terms and conditions of compensation for the doctor. It must also determine the conditions under which the sums paid will be charged to the patient who “false without legitimate reason”. During the examination in committee of the bill on February 8, Mme Imbert said that “This compensation would be charged to the responsible patient in order to make the insured persons responsible. The primary health insurance fund (CPAM) may, for example, deduct the sum of subsequent reimbursements paid to the patient..
This penalty “would thus have a deterrent and empowering effect” : reduce the number of appointments canceled at the last moment, or to which patients do not show up “would give back useful medical time to doctors”emphasizes the rapporteur.
Expand the roles of advanced practice nurses
This article adopted by the senators is additional to a bill for direct access to certain nurses, physiotherapists and speech therapists, which the liberal doctors oppose. It will be examined by the Senate in first reading in the hemicycle, after having been voted unanimously in the National Assembly in first reading. With the abstention of the National Rally and the Republicans, the bill of the deputy Renaissance Stéphanie Rist aims in particular to expand the missions of nurses in advanced practice, a status created by the Touraine law of 2016 then a decree in 2018.
Patients could go to these caregivers without going through a doctor, but still within the framework of a “coordinated exercise” with the latter. The bill also allows a ” direct access “ physiotherapists and speech therapists working in health establishments.
In committee, the senators gave a first green light to these provisions, but amended, so as to “guarantee the safety of care” et “maintain the central role of the doctor in the coordination and follow-up of patients”. But, the commission regretted the timetable “particularly inappropriate” of the examination of this text, whereas “negotiations for the next medical convention are in full swing”.
Liberal doctors are also called to stop work on Tuesday, and to demonstrate between the Ministry of Health and the Senate, to demand price increases and oppose the Rist bill.