Will patients who fail their doctor soon be punished? The hypothesis is in any case on the table. Senators will debate on Tuesday a mechanism paving the way for compensation for these missed medical appointments and financial penalization of unscrupulous patients. This initiative responds to a request from physician representatives.
At the same time, the Senate will examine at first reading in the hemicycle a bill for direct access to certain nurses, physiotherapists and speech therapists, which the liberal doctors oppose. In committee, the senators adopted an additional article to this text to try to find a solution to the problem of medical appointments not honored, which would reach the number of 28 million per year, according to the doctors’ unions quoted by the rapporteur Corinne Imbert (LR).
However, it notes that the Cnam “recommends the greatest caution on this data”, citing an appointment cancellation rate of between 3 and 4%. The additional article modifies the public health code in order to provide that the medical convention determines the terms and conditions of compensation for the doctor. It will also have to determine the conditions under which the sums paid are charged to the patient who “fails without legitimate reason”.
What will this penalty mean? The device could take the form of a recovery of the sum by the health insurance fund on subsequent reimbursements paid to the patient for other services, suggests the Social Affairs Commission.
“A dissuasive and empowering effect”
This penalization “would thus have a dissuasive and empowering effect”: reducing the number of appointments canceled at the last moment or for which patients do not show up “would give back useful medical time to doctors”, underlines the rapporteur.
Passed unanimously in the National Assembly at first reading, with the abstention of the RN and LR, the bill by Renaissance MP Stéphanie Rist aims to further expand the missions of nurses in advanced practice (IPA), 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 always as part of a “coordinated exercise” with the latter. The bill also allows “direct access” to physiotherapists and speech therapists working in health establishments.
A next demonstration of liberal doctors
In committee, the senators gave a first green light to these provisions, but amended, so as to “guarantee the safety of care” and “maintain the central role of the doctor in the coordination and monitoring of patients”. But the commission regretted the “particularly inappropriate” timetable for the examination of this text, while “the negotiations for the next medical convention are in full swing”.
The 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.