Medical consultations at a distance: téléconsultations

Telemedicine – involving the use of a webcam or other internet-connected devices to link patients and medical experts remotely – is seen as one partial solution to a lack of healthcare provision in some areas of France.

This is especially the case in parts of France with relatively low numbers of doctors and specialists and/or hospitals per resident. This often happens when doctors retire and no replacement is found. The Covid-19 pandemic also made doctor consultations over the internet – téléconsultations – much more common.

There is no single platform that is used for this, and doctors are free to choose from several secure options, including using systems offered by commercial companies such as Doctolib. Payment, if required, is often made by credit card, although the doctor can offer other means such as bank transfer.

Teleconsultations are billed for at a standard rate of €25, as opposed to the usual €30 (as usual, some doctors can charge extra) and are reimbursed at the same percentage rates as in-person doctor visits. You may book direct appointments with certain specialists without reimbursement rates being affected, such as psychiatrists. Where possible, téléconsultations should be with a doctor in your area. Such consultations should also, in the case of regular consultations with a certain doctor, be alternated with traditional in-person ones.

It is also not necessary to go via your own GP for a téléconsultation in cases such as: patients aged under 16, in emergency situations, for patients who do not have a médecin traitant or whose médecin traitant is not available in a reasonable time-period taking account of their health condition, or for people in nursing homes or residences for disabled people.

Teleconsultations can be in your own home, or at special booths in public spaces. Increasingly, pharmacies are equipped. A closed room must be provided for pharmacy-based téléconsultations to guarantee privacy. A connected stethoscope, otoscope, oximeter, and blood pressure monitor is provided so basic health checks can be carried out.

Some pharmacies have arrangements with certain doctors so people can access help in this way even when it is not with their own GP and in some cases on a ‘drop-in’ basis without an appointment. This raises questions over reimbursement levels. If in doubt, speak to the pharmacy staff. Full reimbursement might, for example, be allowed if it is not possible for you to consult your own GP in a reasonable amount of time.

In one pharmacy we visited, with equipment provided by a group called Medadom, the patient inserts their carte Vitale, puts on headphones, receives a code on their mobile, and then can speak to a health professional. The state-reimbursed part of the care usually does not have to be advanced. In most cases, teleconsultations are most suited to milder issues or, in some cases, prescription renewals.