“For ten years, due to a lack of young practitioners, pulmonology practices in Gironde have been closing one after the other. A large part of the department is deserted. The remaining pulmonologists concentrate on Bordeaux, often more than an hour’s drive from their patients. Their consultation times are exploding and today you have to wait six to eight months for a first consultation. »
These are the first words of the alert letter which has just been sent to the Regional Health Agency (ARS) by five practitioners based in Gironde (1). They evoke an alarming situation. There are only 27 pulmonologists left in this department, for more than 1.6 million inhabitants. At the initiative of this letter, Doctor Monge, a pulmonologist established privately since 2015 in Lormont, in the suburbs of Bordeaux. “Initially, there were six practitioners in our center created in the 1980s, there are only two today. And we have been looking for a colleague to join us for seven years! » he laments.
Lung health in question
“Liberal pulmonologists treat patients with asthma, smokers’ chronic bronchitis, lung infections, sleep apnea syndrome, lung cancer, as well as former workers exposed to asbestos. In Gironde, they are supported by three hospital services (the pulmonology services of the Haut-Lévêque hospitals in Pessac, Bagatelle in Talence and Robert-Boulin in Libourne). Hospital pulmonologists take care of serious cases and only monitor the most severe patients. Correct management of the lung health of the population can only be envisaged with the proper functioning of the liberal sector and the hospital sector,” they write to the ARS.
However, the signatories affirm that “the reasons for consulting a pulmonologist are more and more numerous”: new illnesses (sleep apnea), allergies, asthma, smoking… Due to a lack of sufficient number of practitioners, “patients having less access in community care are patients who will consult the emergency room more often. They will not have been able to benefit from early diagnoses and will arrive with more serious pathologies. Asthmatics will consult for an asthma attack due to lack of an appointment with the specialist, a certain number of winter bronchitis will not be avoided and will clog up the already saturated emergency services. »
Number closed en case
If the numerus clausus is in question, practitioners point out that the Regional Health Agency can influence the distribution of the number of interns by specialty.
“It’s up to them to only take care of patients for whom their specialty is essential, with procedures that only they can perform,” responds the ARS
Director of the ARS, Benoît Elleboode recognizes that “there are not enough pulmonologists” and proposes, “while waiting for the end of the numerus clausus to bear fruit, […] to work multidisciplinarily and multiprofessionally. It is up to them to only take care of patients for whom their specialty is essential, with procedures that only they can perform. For this, they must rely on general practitioners in particular.”
(1) The signatory pulmonologists: Emmanuel Monge and Laurent Nguyen in private practice, Julie Macey (head of Haut-Lévêque hospital department, Pessac), Laurent Portel (head of Robert-Boulin hospital department, Libourne), Jean-Michel Peloni (head of Bagatelle hospital service, Talence).
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