France considers charging patients for no-shows at the doctor

Up to 10% of patients fail to show up for booked doctor appointments, new studies reveal, prompting calls for a charge for ‘no-shows’ to be introduced.

The time corresponds to almost two hours of lost time per week for a doctor, and almost 27 million missed appointments per year, the Conseil national de l’Ordre des médecins and the Académie nationale de médecine have said.

They said this “reduces the availability of the doctors impacted, limits access to care for patients who need it, and contributes to raising the number of patients in A&E.

Read more: How does France’s doctor shortage compare to other countries?

“While forgetting an appointment made far in advance, or a last-minute difficulty, are sometimes to blame, an analysis of these no-shows underlines the frequency of double appointments made with several practitioners to suit the patient.

“This is evidence of the lack of consideration given to health treatment, which is seen as a consumer good.”

The professional bodies have called for a public awareness campaign to highlight the consequences of this behaviour.

Several doctors’ unions have called for patients who skip an appointment without warning to be made to pay between €1 and €5.

In September, Health Minister François Braun said “everything is on the table” to find a solution.

Medical deserts

That is just one idea put forward in response to the increasing problem of ‘medical deserts’ – areas where there is a lack of doctors.

More than 200 MPs from across the political spectrum, except for the far-right Rassemblement National, recently signed a bill that would regulate where doctors can practise.

It would prevent them from settling in areas which already have enough doctors, unless one of these leaves or retires.

To support their cause, the MPs have launched an online petition, entitled Pour en finir avec les déserts médicaux (To put an end to medical deserts).

Read more: Eight facts to understand France’s issue of ‘medical deserts’

Read more: How can I find out which parts of France are lacking doctors?

Around a third of towns and villages in France are located in a medical desert, they say.

These are mostly in rural areas, but also in certain zones surrounding major cities.

“In certain areas, there are three times fewer GPs, four times fewer dentists, 18 times fewer ophthalmologists, and 23 times fewer dermatologists than in the best-served departments,” according to the petition’s introduction.

Currently, six million people do not have a designated GP, including 600,000 with a chronic illness, as doctors are unable to take on more patients.

These 600,000 will be contacted by health officials by June with “concrete solutions”, the Health Minister has said.

In recent months, striking private practitioners have called for the price of a GP appointment to rise from €25 to €50 (70% state-reimbursed) to allow them to hire secretaries to reduce the administrative burden and take on more patients.

Negotiations are continuing, with Assurance maladie having proposed raising the fee to €26.50, according to reports.

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