Measures underway to reduce 'medical deserts'

There has been much talk of ‘medical deserts’ in recent years – the fact that doctors are not evenly spread across France causing them to be lacking in some areas. The problem persists despite the latest (2024) medical demographics atlas published by doctors' professional body Conseil National de l'Ordre des Médecins (Cnom) showing that France had 237,300 practising doctors, up 10% since 2010 and 1.4% on 2023. Cnom predicts the number will continue to rise slowly, then more quickly in a few years' time.

It is partly because many doctors prefer salaried posts, for example in care homes, hospitals and private clinics as opposed to being independent. This trend has continued, with this year’s atlas showing that almost half of doctors are salaried. To underline the importance of good access for all, the post of health minister was, in 2024, renamed ‘minister for health and access to care’.

Among proposed solutions are more use of telemedicine and sending out ‘medical buses’ to rural areas. Around 100 of the latter – called médicobus – are now operational, carrying GPs and the same equipment as a typical surgery. Renault also unveiled a smaller ‘medical van’ concept, carrying equipment allowing patients to have telemedicine check-ups. The government has also increased the tasks that pharmacies, nurses, midwives and other health workers can perform.

Coverage of doctors in France by department

There has also been funding for ‘medical assistant’ positions, with priority to poorly-served areas, although the number of these remains limited (a target of 10,000 was set for the end of 2024). This job combines administrative work such as billing or arranging referral to a specialist with simple medical tasks such as taking blood pressure or temperature so as to free up doctors’ time.

Recent years have also seen more availability of seven-days-a-week drop-in health centres, where people can quickly see a doctor out-of-hours or at weekends. This will not usually be their own médecin traitant. 

However, a group called Médecins Solidaires, which organises rotas of doctors to volunteer for stints in centres in poorly-served areas, says patients can if necessary list these centres as their médecin traitant, even though they will not necessarily see the same person each time. The group currently runs services in Centre-Val de Loire, Bourgogne-Franche-Comté and Nouvelle-Aquitaine, and specifically targets areas that are less well-served.

The gradually rising number of doctors in recent years has been accompanied by a lowering of the average age (now 48 compared to 50 in 2010), addressing one of the concerns that the profession was aging, with too many doctors being close to retirement. At the same time, the number of doctors continuing to do some work after pension age has also increased. There are also now more female than male doctors, compared to 40% in 2010.

One measure taken (from 2020), to boost new doctors, was removing the ‘numerus clausus’ which was a limit on the number of medical students allowed to continue to second-year studies each year that was fixed by the Health Ministry. 

It was replaced by minimum targets set annually by regional health bodies and universities, based on a combination of the area’s needs and universities’ capacity.

Despite improvements, the issue of unequal access continues, especially in more rural areas in the centre of France. Departments which lack university teaching hospitals are especially affected. The problem especially concerns access to GPs and specialists, but also to facilities such as emergency units and maternity wards.

There is an official number to find a duty doctor out-of-hours (apart from via the SOS Médecins service), called a médecin de garde: 116 117.