The medical agreement, which governs the links between liberal doctors and health insurance, should in particular determine the conditions under which patients could be subject to a financial penalty.
MO12345lemonde with AFP
per year, nearly 27 million medical meetings would not be honored, according to national council of the order of doctors . In order to find a solution to the problem, the senators will put on the table on Tuesday, February 14, a mechanism paving the way for compensation for doctors and a financial penalty of indelicate patients. The initiative responds to a request from doctors’ representatives.
According to the National Academy of Medicine and the National Council of the Order of Doctors, several surveys suggest that “each week, 6 to 10 % of patients do not arise at their appointment, which corresponds to a Loss of time of consultation of almost two hours weekly for the doctor whatever the discipline “. The rapporteur Corinne Imbert (LR) notes, however, that the National Health Insurance Fund (CNAM) “recommends the greatest caution on these data”.
“Responsibility of social insured”
This article changes the public health code so that the medical agreement determines the doctor’s terms and conditions for compensation. It will also have to determine the conditions under which the sums paid will be borne by the patient who “failed without legitimate reason”. During On February 8, M Imbert declared that “this compensation would be charged to the patient responsible in order to empower the social insured. The Primary Insurance Fund Disease (CPAM) may, for example, deduce the sum of subsequent reimbursements paid to the patient “.
This penalty “would thus have a deterrent and responsibility effect”: reducing the number of appointments canceled at the last moment, or to which patients do not arise “would make it possible to restore medical time to doctors”, underlines the rapporteur .
Expand nurses in advanced practice
This article adopted by senators is additional to a bill for direct access to certain nurses, physiotherapists and speech therapists, to which liberal doctors oppose. It will be examined by the Senate at first reading in the hemicycle, after being voted unanimously in the National Assembly at first reading. With the abstention of the National Rally and the Republicans, the Deputy Proposal of the Renaissance Stéphanie Rist aims in particular to expand the missions of the nurses in advanced practice, a status created by the Touraine law of 2016 then a decree in 2018.
Patients could go to these caregivers without going through a doctor, but still as part of a “coordinated exercise” with the latter. The bill also allows “direct access” to physiotherapists and speech therapists working in health establishments.
In committee, the senators gave a first green light to these provisions, but amended, so as to “guarantee the safety of care” and “maintain the central role of the doctor in the coordination and monitoring of patients”. But, the commission regretted the “particularly inappropriate” calendar of the examination of this text, while “the negotiations of the next medical convention are in full swing”.