I received the controversial form from the social security today: the formulaire de déclaration de choix du médecin traitant.
Unlike the UK, where you are registered with one doctor or doctor’s surgery, who have your file detailing your every ailment from childhood to the present day, the French have always been able to consult whomever they please, whenever they please, as often as they please. There is nothing to prevent someone who is horrified at the appearance of four insolent blackheads on their nose from making an appointment to see a dermatologist directly. Or someone suffering from a mild bout of indigestion from missing out the GP middle-man and opting to see a gastroenterologist instead. No system of referrals has hitherto existed to ensure that taxpayers’ money is not wasted by hypochondriacs electing to visit several specialists for their maladies imaginaires, and soliciting a second, third or even fourth opinion.
The social security system has unquestioningly picked up its share of the tab all this time (the same amount for every patient, no means testing required), while mutuelles, private health insurers, whose policies every worker subscribes to as part of their employment package, pay some or all of the rest. Or very little, in the case of dental work. Serious financial planning is advisable if, say, you need a tooth crowning in this country – you may have to forfeit your holiday plans or that nice Ipod photo you had set your heart on in order to pay the dentist.
The eminently sensible change being wrought by the innocent looking form is that everyone now has to choose a GP to be their first point of contact: their médecin traitant. The only specialists that people will be able to consult without a GP referral are gynecologists, dentists, ophthalmologists, paediatricians and psychiatrists. Other appointments can presumably still be made, but will no longer be reimbursed. Which is very dissuasive indeed.
Understandably perhaps, there is a lot of opposition to this new measure. Old habits die hard, and many people resent having to go and see a GP, who might be a complete stranger, just to obtain a referral to the specialist they have been frequenting for a decade or more.
Personally I’ve never seen a French GP more than once. Depending on where I was working at any given time I tended to see someone close to my office, and I’m very British about ailments like colds that the French invariably to see a doctor about, preferring to dip into my large stock of generic UK supermarket cold cures. Tadpole has a doctor she sees fairly regularly, a GP chosen mainly because the local paediatricians recommended to me were taking on no new patients. She is lovely, and less heavy handed with the antibiotics than most French physicians I’ve crossed paths with, but I have no idea whether she will consent to signing Mr Frog’s and my forms. Doctors are under no obligation to accept everyone, and do not have to give any justification for their refusals. As she happens to be very popular in our neighbourhood, she is undoubtedly fully booked already. The forms have been sent out in three huge postal waves, meaning that people with surnames ending in A – O may have bagged all the available places. Desperate times call for desperate measures: I’ll have to take my chequebook and see if she can be bribed.
Who knows, she may be one of the doctors boycotting the new system in protest at becoming some sort of clearing house and refuse to sign any forms at all.
In any case we now have until July 1st to be ill, visit the doctor and get the forms signed. And if we remain in perfect health, we’ll probably end up making an appointment anyway (at a cost of just over € 20 to the social security system) just to get the signature and coveted inky stamp on the form (the French are VERY attached to their ‘tampons’, and no official form would be complete without several illegible stamps).
If every single French person does this before 1 July, at a cost of € 20 per adult, I think we can safely expect an even bigger social security deficit this year. Thereby defeating the cost-cutting object of the whole excercise, at least in the short term. And creating a swathe of paperwork for the bureaucrats to process.
Atchoum! I feel a cold coming on. Off to the doctor’s I go…
*French for Atishoo! I have actually heard people pronouncing the ‘m’ when they sneeze. I swear.