During the forum dedicated to the provision of care in Loir-et-Cher, organized on October 17 by the territorial health council in partnership with The New RepublicPhilippe Gouet had not beaten around the bush. Yes, competition between territories is keen to attract health professionals and refusing to take part would expose the department to an increase in medical desertification.
However, the UDI president of the departmental assembly knows the dangers of financial overbidding. BeLC, the attractiveness agency headed by Karine Gourault, therefore mainly plays the part of support, to convince caregivers to set up in Loir-et-Cher. Help in finding accommodation or a job for the spouse, discovery of the territory, creation of a network with other health professionals: the levers are multiple.
Housing at the top of trainees’ concerns
“Logistical assistance also concerns internship students,” underlines Philippe Gouet. With housing and even mobility at the top of the list. The Department thus has a fleet of six vehicles, made available to those who need it.
“As far as accommodation is concerned, we work in conjunction with the communities of municipalities and we have just signed a partnership agreement on October 21 with Crédit agricole Val de France,” reports Karine Gourault. In this case, the green bank renovates apartments in rural areas in the areas of Saint-Aignan, Selles-sur-Cher and Saint-Amand-Longpré and then offers them for rental – at moderate rates – to students or replacements. .
In the same vein, several local players (CD 41, Crédit Mutuel, Crédit Agricole, Mutualité Française), supported by the Public Investment Bank, have created a “health fund” which allows new settlers to invest in a technical platform, up to €50,000. In 2023, around ten professionals will benefit from this system.
So many assets that BeLC highlights to its “prospects” encountered at trade fairs or identified through the collection of digital data, “an exercise that the attractiveness agency masters perfectly”, confides Doctor Bruno Harnois, himself elected from the canton of Romorantin.
Develop teleconsultation
Next step: the experimental establishment of a one-stop shop for the installation of health professionals, in order to relieve them of administrative tasks. This proposal from the “health” working group of the Assembly of Departments of France, led by Philippe Gouet, is the subject of negotiations with the ministry. The experiment could be carried out in 15 to 20 departments, in co-piloting with the Primary Health Insurance Fund and the local branch of the Regional Health Agency.
Another area of work, the improvement and development of teleconsultation, defended by President Gouet who advocates the disappearance, for the benefit of areas in tension, of the threshold which prohibits doctors from carrying out more than 20% of their volume of activity from a distance. “In return, a teleconsultation could not last less than 15 minutes and it would be carried out in pairs because the patient would necessarily be accompanied by a physiotherapist, a pharmacist or a nurse, who would use certified equipment, which we would help to finance, explains Philippe Gouet. As for the doctor, he should practice on national territory. »
A lot of work in progress therefore, inevitably with a cost. “We have earmarked 25 million euros over the term of office for our “Le 41 en bonne santé” plan and this amount is protected,” concludes the head of the Department.
reactions
> Doctor Perrine Paccou: “Without financial assistance, I am still here”
Doctor Perrine Paccou is a general practitioner and practices at the Multiprofessional Health Center (MSP) in Dhuizon. In an email addressed to our editorial staff, she deplores that doctors who set up in deficit areas can be considered to have the sole motivation “than the lure of gain”.
She testifies about her personal case. “At the time of my installation, in December 2020, I did not receive any financial assistance from anyone, she writes. I came from Strasbourg. I had my entire family move for this project, without my partner even having found a job beforehand. »
She continues: “I have been working in the Sologne countryside for four years with the difficulties of access to care that we all know and which are unfortunately only getting worse. We all work in degraded mode, around 50 hours per week for me. And yet, without any financial help, I am still here. »
She explains having obtained from elected officials the construction of a structure up to standards “in order to attract other health professionals”. This project made it possible, she rejoices, “the installation of young physiotherapists in September 2021 and a fellow general practitioner in 2023, all convinced that this project, which is not just a building, would allow better access to care in the region by continuing to attract other health professionals ».
Professionals whose primary motivation remains, she insists “to treat our patients correctly and in good conditions”.
> Étienne Panchout: “Putting the patient back at the center of the system”
President of the council of the order of masseurs-physiotherapists of Loir-et-Cher and opposition municipal councilor in Blois, Étienne Panchout reacted to our series of articles devoted to access to care published in recent days.
“It is time to make radical decisions and put the patient at the center of the health system”he wrote in a press release sent to our editorial staff. “One of the key solutions would be to establish primary care directly accessible without a medical prescription for all health professionals with the necessary skills, in particular physiotherapists, speech therapists, nurses, etc. This approach would make it possible to rebalance roles and better promote each profession, while maintaining a central place for general practitioners. »
A central place certainly, but Étienne Panchout pleads for a reform which “no longer focuses on the hierarchy between health professionals, but on the patient who must become the main actor in the care pathway”. According to the representative of Loir-et-Cher physiotherapists, this distribution “more balanced” responsibilities would make it possible to create “more fluidity in access to care”while “optimizing doctors’ medical time”.
He claims that “international examples show that this model works”and cites in particular the case of Norway, where care has been improved, “without leading to an increase in medical incidents and expenses”.
Key figures
> During the 2022-2024 period, 75 healthcare professionals were supported in their installation by the Loir-et-Cher attractiveness agency. 15 replacements also received support.
> 36% are general practitioners, specialists or dentists. 70% come from Be LC’s “direct prospecting”. The balance comes from professional orders, the Regional Health Agency, health establishments and even elected officials.
> In 2024, 46% of these health professionals will settle in the Agglopolys territory, 27% in Val de Cher Controis, 14% in Vendômois and 11% in Romorantinais-Monestois.
> For 24 CVs sent to public or private hospitals in the department, 9 practitioners were recruited as employees by the hospital centers of Blois, Romorantin and Vendôme.
> Since November 2022, 600 interns and 150 physiotherapist students have been individually welcomed by BeLC.
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