2023-06-16 21:34:49
The new control campaign initiated by the national health insurance fund, which targets nearly 1,000 “atypical prescribers”, does not pass with general practitioners.
White coats see red. This Thursday, the union of general practitioners (MG France) stepped up to the plate against Medicare, in a vitriolic statement. Professionals are engaged in a tussle with the authorities, who accuse some of them of providing too many work stoppages to their patients. “Letters threatening to set targets for daily allowance prescriptions (MSO) begin to rain down on general practitioners” denounces the union, which deplores the “menacing tone“letters sent by Medicare.
At the origin of the conflict are the checks on the rate of daily allowances issued by each doctor. These are carried out by Medicare, which also monitors drug prescriptions. Thanks to fine statistical work, the administration identifies practitioners whose prescriptions are considered abnormal, either “those who prescribe 5 to 10 times more than the national average“, she explains to the Figaro. Pinned professionals expose themselves to a procedure of potential “setting under objectiveswhich enjoins them to lower and justify their work stoppages issued, under penalty of financial penalties of up to 9000 euros.
While this procedural framework has existed for about ten years, a new control campaign was launched a few weeks ago. Only 1,000 professionals, i.e. nearly 2% of doctors, are targeted by Health Insurance: these are practitioners prescribing at least twice as many work stoppages per active patient (of working age) as their colleagues. of the same territory, taking into account the structure of the patient base. 30% of general practitioners will receive a visit from a representative of their Primary Health Insurance Fund to guide them in their prescriptions.
Anger of doctors
Among professionals, this campaign does not pass. General practitioner in rural areas, Florence * was pinned down a few days ago. “I received a call from the Primary Health Insurance Fund of my department telling me: “here you are a bad doctor, you prescribe too many daily allowances, you are placed under target” she explains. She then received a registered letter, inviting her to explain herself. “If you accept the objective, you are tracked for three years, to justify each work stoppage», Underlines the one who has already been the subject of a similar procedure a few years ago. “I do not over-prescribe», however assures the practitioner. «It happens that I consult in an agricultural environment, where long-term illnesses and accidents at work are extremely frequent.“, she defends.
This time, Florence will not accept her goal setting. His union, the Federation of Doctors of France, encourages professionals to refuse reinforced control, as does the Union of Liberal Doctors (SML) and MG France. The organizations are unanimous in denouncing the process. “It’s a real witch hunt“Warns Sophie Bauer, president of the SML, before arguing that the reproach addressed to the doctors is a statistical offence. “The only fault of these doctors is to move away from the curve. Medicine is not statistics“says the union representative. Same story for Agnès Giannotti, president of MG France. “Doctors are directly targeted, without dialogue, without consultation with the profession“, she laments. Like Sophie Bauer, she would have liked to “pedagogy» and «explanations» rather than «menaces».
Health professionals also agree on the “bad timingof this call to order. “The profession is already heated“warns Sophie Bauer. The examination, at the beginning of the week, of the Valletoux bill revived the specter of a regulation of the freedom of installation of general practitioners. The latter were also unsuccessful in their request for a price increase. The health insurance control campaign is therefore perceived as yet another “bamboo shotfor the profession. “Especially since it is mainly young doctors who are targeted and who come to us for help.“Adds the president of the SML, who says to herself”worried about the future». «More and more young GPs put on target tell me that they are going to drop out at the end of the year“, she reveals.
Increase in stops
For its part, Medicare emphasizes that this is not a new campaign but the first post-Covid campaign, “which may explain the surprise of the doctors“. She also highlights the details of the procedure, recalling that upon receipt of the letter from Health Insurance, “doctors have one month to submit their written observations or ask to be heard“, referring to”an essential contradictory phase“. Thus, in view of the deadlines granted, “the setting under objectives will only be effective from September 1st“. Not right away, then. According to the national fund, young doctors would not be more concerned than others by the procedure.
«Doctors fall victim to the state fraud hunt, as if we were the fraudsters“Is however indignant Marcel Garrigou Granchamp, union representative of the FMF. Health Insurance does not hide its concern about the increase in daily allowances. “In 2022, daily allowances represented 14 billion euros of expenditure for the State, excluding Covid. This is 6% more than in 2019“, points out the fund.
A dynamic corroborated by provident institutions which, in a press release published Thursday, are concerned “of a structural drift of work stoppages“. Contributions “foresight“, which cover compensation needs related to work stoppages, increased by 9.3% compared to last year. “Of course there is an increase», admits Agnès Giannotti. “But we did not change our practices overnight. It is the population that has changed, due to the evolution of society, the aging of the population, the increase in the retirement age…“, she adds, before wondering:”Is it the population that is targeted or the doctors?»
*Name changed
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