Doctors in France have outlined seven “useless, stupid or insulting” tasks that they have to do but which take up time and stop them seeing as many patients as they could do otherwise.
The calls come in an open letter published in L’Express, signed by 200 GPs from across the country.
They have called for the simplification of the medical system and a reduction in their administrative tasks, within the context of a major lack of healthcare workers, and the fact that six million people in France do not have a regular GP.
The seven tasks in the firing line are:
1. Child illness notes
A doctor’s note to prove to a parent’s employer that their child is sick enough that the parent needs to stay at home to care for the child.
2. Short-term work sickness notes
Quick proof from a doctor that an employee has an everyday medical condition that is bad enough that they need to stay at home (for example, fever, mild flu, gastroenteritis, period pains, etc).
France allows employees to self-declare a work stoppage (arrêt maladie) via the declare.ameli.fr website but people are asked to use this service sparingly.
3. Medical prescriptions for transport
Proof that a patient needs to call a non-emergency ambulance vehicle to go to a health professional.
Assurance maladie currently requires that these drivers be given proof to confirm the medical validity of the journey.
4. At-home care or nurse prescriptions
Proof that a patient needs a home help service or regular monitoring, for example, for an elderly person or someone with diabetes.
Assurance maladie currently requires a GP certificate signed off for this care every six or 12 months, even if it has been in place for years.
5. Prescriptions for medical beds
Proof that a patient needs – or continues to need – a medical bed provided by a pharmacist or medical equipment specialist.
6. ‘Unnecessary’ sports certificates
Proof needed from a GP if a patient wishes to practise a sporting activity. This is usually required so that the club or other association is insured.
As an example, the GPs said that the certificates often state the obvious, such as that a child in good health, can run, or that an adult has no contraindication to playing pétanque or chess in competition.
Another example stated that a patient can swim 50 metres, which is difficult to test in a consultation.
7. Certificates for private insurers
Proof needed that a patient who has been on long-term leave wishes to benefit from income maintenance or assistance with a loan, thanks to a contract taken out with a private insurer.
GPs are asked to prove a patient’s medical history before the insurer will return the money provided for in the contract.
Calls for simplification
The letter continues: “Many other things could also be improved [including] procedures for housing for disabled people, and the reimbursement of dieticians’ consultations.
“Our health system deserves to be simplified. Today, several branches and several health insurance schemes coexist, whereas they would gain in efficiency if they were grouped into a single national scheme.”
The doctors conclude: “In a context of declining medical access, it is time to rethink the role of GPs.
“We are not here to be ‘checkers’ or ‘proof’ for Assurance maladie for private insurance companies or for public or private employers.
“If these various bodies wish to carry out checks, they can hire staff for this purpose and do so. They should stop considering GPs as the guarantor of their distrust of their fellow citizens.”
The GPs added that simplifying the system would save millions in public money and would free up hundreds of thousands of GP consultation slots per day in France.
It comes after GPs and lab analysts held a strike from the end of 2022 to the beginning of January this year.
Read more: Why GPs in France are threatening to strike
Grievances included a similar complaint about too much admin, as well as calls for better working conditions, more ways to attract younger people to the profession and a doubling of the standard consultation fee.