Medical deserts. Last consultations for Doctor Marchesseau, general practitioner in a village of 2000 inhabitants

In Sarthe, as in many departments in France, medical desertification is growing. Difficult for country doctors to find a successor. This is the case of the doctor from the village of Parcé-sur-Sarthe. This Saturday, he carried out his last consultations

On the exterior wall of the medical office, at 4 rue de l’Epervier, the gray plaque which indicates the consultation days and times will be unscrewed.

Franck Marchesseau settled in this small town in September 1987, after studying in Paris, at the Broussais hospital.

“At the time, remembers Franck Marchesseau, When we were young GPs looking to set up business, we looked at the classified ads in professional newspapers. We looked at the area we wanted to set up in, if there was a clientele to sell. The idea was to buy, for half an annual turnover, the clientele of a doctor who was retiring. I wanted to leave the suburbs, go west instead.”

The very young doctor Marchesseau found, in Parcé-sur-Sarthe, interesting conditions in this office whose premises were rented for a modest sum by the municipality.

“It was pretty easy to get started.” he said.

Satisfied with this choice, Franck decided to stay and bought a house, just opposite.

“It was comfortable to go for a coffee when there weren’t many people and come back, he smiled. There aren’t many colleagues who can do it like that now.”

The man has always wanted to be a general practitioner, for the variety of actions that this entails.

“Seeing a 3-year-old baby, a 90-year-old grandmother, it’s very varied and you have to adapt. My goal was to practice this medicine,” confirms Dr. Marchesseau.

But he acknowledges that it is a solitary profession, unlike current medical centres where several carers come together.

For this commuter, arrived “by chance” in Sarthe, the time has come to hang up the stethoscope. And there are many of them in this case in this department which is experiencing the full force of the medical desert phenomenon.

“We are training as many doctors as before and even a little more with the numerus clausus which has increased by 10%, he explains. We need to train a lot more, there was a sort of baby boom of doctors who all arrived at the same time, I was one of them, except that we are all going to retire at the same time.”

The policy imagined in the 80s and 90s to reduce the Social Security deficit by reducing the number of prescribers, and therefore doctors, is now generating its deleterious effects.

“It was easy to predict that the curve would deteriorate thirty years later, notes Franck Marchesseau. It was not at all thought out as it should be.”

“We are turning a page”recognizes Nicole, who has just left the medical office with her husband, Jean-Yves.

“We have been coming to our doctor for 33 years, continues Jean-Yves. Walking through the door is strange. We know we’re not going to come back. We were used to our doctor. He knows us, he knows the problems we have. I had heart problems, he sent me to the emergency room in Les Mans to have a pacemaker fitted. He saw it right away.”

For this couple, Dr. Marchesseau was more than a family doctor, they also know his family. But this retirement is in the order of things.

“You have to know when to stop”said Nicole. “Life is short after“, adds philosopher Jean-Yves.

Meanwhile, in the office, Franck Marchesseau finishes the next consultation, returns her health card to the patient who came this Saturday morning, the last one spent here for this 67-year-old practitioner.

“Have a good retirement” the patient wishes her before passing through the door of the office one last time.

A mother with her little girl worries about what will happen next.

“It leaves a big void, she says. We say to ourselves that, behind, there is no doctor. Especially for children. That is an additional complication that is added. We are also a little afraid for the village, to say to ourselves: “Is the pharmacy also going to close?”

In this town of 2000 inhabitants, southwest of Le Mans, we appreciated this general practitioner who took appointments without appointments and still did home consultations.

“He was a very accessible doctor for everyone, said this mother. We know that it is complicated to find a specialist or a treating physician. Now, we say to ourselves: how are we going to do it?”

Dr. Marchesseau was keen on home visits. An escape that allowed him to get some fresh air and get out of the office.

“It allowed us to see people at home, he said, we realize the social reality, their real living conditions. And then, in the countryside, there are isolated people who cannot move around. It’s part of being a generalist. Beyond the general practitioner, the profession of liberal nurse is extremely important in the countryside. They can quickly raise the alarm when they see someone declining and not daring to call. They don’t get paid much for the work they do.”

Several patients brought him a gift for this retirement. After sharing family stories, seeing children born, separations also happening, after seeing the village evolve, lifestyles change, practicing a little amateur theater with some, Dr. Marchesson leaves, without exploding happy to take a well-deserved retirement.

He would have preferred to pass on his practice to a successor. The practitioner will, however, continue to provide care in a nursing home in the town, as a coordinating physician, which he has been for 20 years. But for the residents of Parcé-sur-Sarthe, the search for a new general practitioner has begun.

“They have always had the habit in this village of having a full-time doctor since 1900 I believe, he points out. It’s going to be funny.”

A doctor should come and do a day and a half a week starting in October. It’s almost a done deal. But it won’t be enough.