New rules making it compulsory for trainee pharmacists to spend time in rural pharmacies are essential for the latter’s survival, according to Gérard Deguin, newly appointed vice-president of governing body the Ordre des pharmaciens.
He had made boosting rural pharmacies one of the goals of his mandate.
“They are the backbone of the health service in many rural areas,” Dr Deguin told The Connexion.
“In places where there is no doctor, and where district nurses are mainly involved in home care, having somewhere you can get medical help is essential.”
His pharmacy is in Colayrac-Saint-Cirq, in Lot-et-Garonne, not far from Agen.
Gérard DeguinGérard Deguin
“We are in an area described as semi-rural, but even so we have had cases where our medical help was vital,” he said.
“Last year, for example, there were three separate cases involving Asian hornet stings where we were able to provide vital medical intervention.
“The people arrived in a bad way, we called the emergency number (15) and spoke to a doctor, and under the doctor’s guidance we were able to dose the correct amount of adrenaline and inject it straight away, before ambulance teams with medics arrived.
“They all survived, and being treated quickly like that probably helped.
While the number of pharmacists in France rose last year, there were also 240 pharmacies which closed. Dr Deguin estimates that between 30% and 40% of those were in rural areas.
The problem is likely to be exacerbated this summer as unions threaten continually more disruptive strike action after workers at emergency pharmacies (pharmacies de garde) walked out in June.
They accuse the government of destroying France's pharmacy network by dipping into their coffers to compensate for spiralling public spending.
For Dr Deguin, the future of rural pharmacies depends on attracting new practitioners to the area.
“Over the past 10 years the problem has been that when pharmacists want to retire, they can find no one to buy the business as a going concern,” he said.
“So they retire, often with much less money for their retirement than they had planned, and the village or small town loses its pharmacy.
“The chances of someone else coming in and starting from scratch are slim, especially in rural areas.”
Newly qualified pharmacists have four main career choices: they can become salaried pharmacists in hospitals, with fonctionnaire status in state hospitals; they can move into industry; they can move into teaching and research positions outside industry; or they can work for themselves with profession libérale status in high street pharmacies.
The number of pharmacies is controlled by the Ordre des pharmaciens to ensure they are spread throughout the country. The right to run a pharmacy is given roughly at the rate of one pharmacy for every 2,500 people.
“Rural pharmacies often struggle to find people, and when we ask students why, it is often because there is a bias in the selection of students for pharmacy studies, which means they come from large towns and cities and have never experienced rural life,” Dr Deguin said.
“By making work experience in a rural pharmacy compulsory, they will have a chance to experience rural life, and also the attractions of working in such places where the variety of patients and treatments pharmacists give is often much wider than in a town.”
Rural pharmacies do best where there is a GP surgery in the same town or village. With the number of rural GPs also under pressure, there is a knock-on effect on pharmacies.
“As pharmacists, we can work to improve our sector but it is essential that there is a co-ordinated effort to boost all health services in rural areas,” Dr Deguin said.
“In general, there is help from banks and other sources for young pharmacists wanting to start out on their own. However, more must be done: at the moment there is an ageing population of rural pharmacists, due to retire at 70, and we as a country have to make sure they are replaced.”
Pharmacy has an ‘image problem’
It is not just rural areas facing a shortfall of pharmacists. According to the French Federation of Pharmaceutical Unions, France has lost nearly 2,000 pharmacies over the past 10 years, leaving only around 20,000 operating nationwide.
Lack of career progression, difficulties achieving a work/life balance, modest salaries, decreasing social status and anti-social hours are among recruitment obstacles cited.
Experts also agree the profession suffers from something of an image problem, with some students only choosing pharmacy as a ‘second best’ because they failed their exams to be a doctor.
To make the profession more attractive to youngsters, a website has been launched dedicated to pharmacy professions, as well as accounts on Instagram and TikTok. There has also been a video campaign about a day in the life of a pharmacist using footage taken by young practising pharmacists.
Steps to simplify professional retraining, and build bridges between the different branches of pharmacy, are also being taken.
