They are on the front line facing patients. They welcome grievances, frustrations, emergencies and sometimes anger. The profession of medical secretary is essential in a context of medical desertification which amplifies the phenomenon of waiting. With passion, perspective and experience, two of them bear witness to their daily lives.
The phone rang six times. In thirty minutes. Time to meet Isabelle Rigaud, in her daily life, on a Monday morning. Secretary of the cardiologist Frédéric Pellerin in Bourges, that day at the Guillaume-de-Varye private hospital in Saint-Doulchard, she manages the appointments, alone in the office, behind a Plexiglas window, the last vestige of the Covid era, but also the first line of defense between the patient and her.
Immersion into the heart of palliative care teams in Cher
“Appointments are made until the end of November,” she announces. An expectation amplified by the medical desertification that she deplores. “I’ve been doing this job in cardiology for twenty-one years. In 2003, when I started, I had to have a patient every thirty minutes, now it’s every quarter of an hour. But fifteen-minute appointments with a cardiologist are obviously longer.” Patients who have already had to face the search for a general practitioner before, a necessary step to consult any specialist.
“Vocifering is useless”
The nerve of the profession is to make this expectation heard: “Some are very understanding, others not at all. Waiting breeds worry and anxiety. They become afraid and become aggressive. The most recurring phrase for years has been: “We have time to die by then”. People who are very ill, out of breath, will minimize it when others will scream. In these cases, I tell myself that it’s okay. »
Calm by nature, the medical secretary ensures she never enters into head-on conflict: “They won’t get me,” she smiles. My job doesn’t affect my state of mind, and I won’t give up. Vociferating is useless. » The distance allowed by the telephone poisons the speeches:
“In person, it’s very rare, I’ve never seen any angry people. On the phone, people do more and more things. Insults. There’s a lot of verbal violence.”
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For Isabelle Rigaud, a turning point seems to have occurred during the Covid-19 period: “We no longer have the same relationship since that time. The Covid has caused panic, but in a generalized way in society. And we still feel the stigma today.”
Aggravating factor, the thorny specialty of cardiology: “Before being a medical secretary in cardiology, I was in allergology. It’s not the same job. Neurology, cardiology, pulmonology, it’s delicate. I’m not even talking about oncology or psychiatry. We don’t welcome people in the same way. »
Myriam Touren, secretary of a practice of five physiotherapists in Guillaume-de-Varye, notices more disarray than tension behind her desk. “I often repeat the same phrase: “We have no availability at the moment.” We must also succeed in associating the right pathology with the availability of the right physiotherapist. If people are not used to this type of waiting, they are helpless, because they need physiotherapy to return to work. It’s their priority. »
“We react differently depending on the person we interact with,” continues Isabelle Rigaud. Sometimes I defuse with a little humor, other times, when I sense panic, I try to calm things down. We ask for information, we have to make them talk. I’ve already been on the phone for twenty minutes.”
She also learned to compose:
We no longer have the capacity to receive people quickly but if it is really serious, we cannot refuse people. When we have no other solutions, we redirect to the emergency room, but that can scare patients.
Myriam Touren fully embraces this social vector of exchange: “I would say that it’s 50% of the job. Help others, provide physical or psychological support. » She was very enthusiastic about her career change a year ago. And the impressive patient base of the physiotherapists, to which are added the patients of the balneotherapy and the clinic’s follow-up treatment groups, has not dampened her. On the contrary: “I love my job, the contact with patients, the organization…”
Demonstration when a follow-up care patient, lost and panicked while searching for ice, was able to count on the availability and knowledge of the 27-year-old secretary: “It’s written on my forehead so you know all that ? » the patient is surprised even though Myriam Touren had already drawn up the solution to the problem, barely had it been stated.
Each year, the Jacques-Cœur hospital in Bourges manufactures 10,000 chemotherapies
If the notion of instinct remains present, secretaries also rely on practitioners to make certain decisions. “I’m afraid of making mistakes,” admits Isabelle Rigaud. I am lucky to have a good teacher. We look at the files together, I ask him as soon as I can. » “I try to understand the mechanisms, I like to learn, to look for information”, supports Myriam Touren, supporting photocopy of skeleton. A way of reminding us that she believes in her profession, while a propensity for making appointments online, via Doctolib for example, is growing.
“It’s more complementary than competitive,” puts Thierry Baland, president of the order of doctors of Cher, into perspective. Secretaries have the advantage of knowing the patients, of knowing that if it’s Mrs. And there is the human connection, for older people, that remains essential. »
At the Bourges hospital, the unions, through their right to alert, participated in the holding of an F3SCT committee
extraordinary on the working conditions of secretaries:
“There is growing discomfort among staff, both physically and mentally, linked to too much workload,” confides Sophie Radet, CFDT representative in Jacques-Cœur. In response, we only had a desire for help on a technical level. » empty
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“There is a delay in typing reports, fluctuating depending on the service,” summarizes Rémi Fauquembergue, director of the establishment. The ideal would be for the patient to leave with this letter. This is a subject that I looked into very quickly, particularly at the request of the medical profession and this committee was a stepping stone. The medical workforce has evolved without there being any rehabilitation of secretaries. »
To make up for the delay in the reports, several areas of support will be distilled, notably voice recognition.
“Unlike digital dictation, this device allows, via artificial intelligence software, that the report is typed directly automatically while the doctor speaks,” summarizes Gaëlle Gédéas, coordinator of medical secretaries at the Berruyer hospital. Then it is transferred to the secretary who only has to proofread it. This will speed up the flow and, above all, allow secretaries to return to their core business, that is to say physical and telephone reception, programming, supporting patients.”
Specialized training in health, safety and working conditions.
