access to specialists is increasingly difficult


A retired volunteer doctor at the Montluçon medical center (Allier), in May 2021. The establishment is about to close for lack of doctors.

Restoring access to care for all citizens is the main ambition displayed by the government within the framework of the consultation devoted to health which is due to launch on October 3. In addition to the hospital in crisis, the medical deserts will, for sure, find themselves at the heart of the discussions. “Too many of our compatriots today do not have a doctor and have more and more difficulty accessing specialists”recognized Emmanuel Macron, during his speech at the Mutuality Congress, on September 7. “This situation is not acceptable”, added the President of the Republic, without advancing on the response of the executive. There is no question of commenting on the conflicting question of the questioning of the freedom of installation of the liberals – red flag for the profession – that local elected officials or even parliamentarians have been asking ever more strongly in recent months.

The lack of general practitioners often concentrates alerts, but the desertification among specialists, as witnessed by many French people who can no longer find an appointment and sometimes go so far as to give up treatment, seems just as worrying. Pediatricians, gynecologists, gastroenterologists… What is the situation of specialized medicine?

According to an indicator that The world reveals exclusively, produced by health geographer Emmanuel Vigneron as part of work for the Association of Rural Mayors of France, the fall has continued over the past ten years. And sometimes even more strongly than in general medicine.

Read the interview: Article reserved for our subscribers “Specialized medicine is even more affected by the renunciation of care than general medicine”

In terms of density, the number of city professionals (liberal or in mixed practice) has thus increased from 68.4 per 100,000 inhabitants in 2012 to 65.5 in 2022 in around ten of the most “common” specialties. (paediatrics, medical gynecology, gynecology-obstetrics, psychiatry, ophthalmology, dermatology, rheumatology, cardiology, otolaryngology, gastroenterology, radiology, anesthesia-resuscitation). “By selecting twelve specialties to which the population has recourse most frequently, we see that the situation has only worsened over the past ten years, but also that the fractures are widening between the territories”, observes Mr. Vigneron. These specialists represent 44,398 physicians, a figure that has stagnated since 2012, unlike the population, which has continued to grow.

“Phenomenon of metropolisation”

Three quarters of the 101 departments are still at a rate below the average density. But if twenty-two departments were in 2012 below the critical threshold, according to the researcher, of 40 specialists per 100,000 inhabitants, they are now almost double.

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