the CNAM announces a 19.5% increase in the number of GP patients in four years

Encouraging results since 2019

From 2019the system to support the employment of medical assistants allows doctors to delegate administrative tasks and organizational to focus on care. Medical assistants work in three areas:

• administrative management : reception of patients, updating of files;
• preparation of consultations : taking constants, monitoring vaccinations, etc. ;
• care coordination with other health professionals.

In order to October 2024, 7,240 contracts were signed, including 77% by general practitioners et 23% by specialists. This represents approximately 15% of eligible GPs (sector I or Optam) and 11% of specialists.

Among these medical assistants, 54 % were previously medical secretarieswhile 9 % held nursing positions and 4 % caregivers.

To assess the impact of the system, Health Insurance analyzed a sample of 402 general practitioners having recruited a medical assistant for four years, comparing their activity to that of 18,600 non-signatory colleagues. The results are significant:

1. 19.5% increase in the treating physician patient base
   In four years, doctors accompanied by an assistant have seen their attending physician patients go from 1,318 to 1,576 patientseither 258 additional patients. In comparison, GPs without an assistant only recorded an average progression of 6,6 % over the same period.

2. Two additional consultations per day
   The signing doctors now realize 29.5 acts per day against 25 acts for their colleagues without an assistant, either 2 additional consultations daily (7.2%).

3. Moderate increase in active queue
   The active list of supported doctors has increased by 4,5 %against a decrease in 5,3 % for non-signatory doctors. This increase, although moderate, demonstrates better monitoring of patients over time.

Disparities according to profiles and territories

The study also reveals notable differences:

• Generational effect : The doctors of under 40 years old recorded the strongest growth in their patient base (34.1%) and achieved 4.9 additional acts per day.
• Gender inequalities : The men supported by an assistant carry out 31.5 consultations per day against 25,7 consultations for women.
• Underdense areas : Doctors practicing in priority areas (ZIP) are more likely to use the system (57% of signatories) and manage to increase their activity despite initially higher patient numbers.

Limits that call for adjustments

If the results demonstrate the effectiveness of the system in freeing up medical time and improving the activity of doctors, Health Insurance recognizes a methodological limit. The sample of 402 doctors studied, made up of pioneers motivated by the system, does not necessarily reflect the entire profession.

Despite these positive results, several critiques can also be formulated with regard to the device:

1. Limited impact on medical deserts
   well that 57% of signatories practice in under-dense areas, the system has not made it possible to sustainably attract new doctors to these territories. The issues linked to desertification (settlement conditions, professional isolation) remain insufficiently addressed.

2. Adoption still low
   With 7,240 contracts signedthe system remains far from the government objective of 10,000 medical assistants. Alone 15% of eligible GPs adopted this measure, in particular because of financial and organizational constraints.

3. Binding objectives
   Doctors must reach progression thresholds for their patients to continue to benefit from assistance. This can be difficult, particularly for already stretched practitioners, deterring some from commitment.

4. Structural inequalities
   The data reveals gender disparitieswith a significant gap between men (31.5 acts per day) and women (25.7 acts). The system does not provide specific solutions for part-time doctors, often women.

5. A perfectible financial model
   The aid, decreasing over three years, can represent an obstacle for small firms. For example, a part-time assistant often costs more than the financial aid granted from the third year onwards.

6. Focus on quantitative activity
   By favoring an increase in the number of consultations, the system risks increase the quality of care and to intensify the pace of work of doctors.

Although the medical assistant system shows encouraging results, it can still be improved to fully meet the challenges of access to care and quality of practices. Adjustments are necessary to better support isolated doctors, reduce organizational constraints and maximize the impact in under-dense areas. The CNAM underlines the importance of continuing the evaluation of this measure in order to confirm its benefits on a larger sample and in the long term.

See the study