There is a term that we almost no longer use in France. A term that the rest of the world uses without complexes, whether in the United States, Canada and even, closer to home, in Spain or Germany. A term that the international organization which brings us together this week in Paris, Wonca (World Organization of General Practitioners), has placed in its own name. This term is that of “family doctor”.
Wonca represents 500,000 practitioners in 130 countries who identify with this title. But, in France, we prefer to speak of “general practitioner”. This is not just a semantic debate. It is above all a revealer of the way in which our society perceives a medicine that is nevertheless essential.
An on-demand service logic
Defending family medicine is not advocating a step backwards. Far be it from us to resurrect the doctor of yesteryear, available to his patients at any time of the day or night.
The family doctor that we embody is a modern doctor: listening to his patients, committed to building a relationship of trust over time, attentive to his conditions of practice and his life balance. Because an exhausted doctor provides less care. And because our profession does not have to be defined by sacrifice.
However, for the past ten years, a transformation as dangerous as it is silent has threatened this model. Online appointment booking and teleconsultation platforms have introduced into the very heart of our profession a logic that was foreign to it: that of on-demand service.
The patient is no longer looking for his doctor: he is looking for a niche. The first one available, no matter with whom, no matter where. These platforms responded to a real need for access to care. We do not deny it. But by solving the problem of immediate access, they have created another, more insidious one: the gradual erosion of monitoring.
Because caring does not consist of responding to a one-off request. Caring means first of all knowing: the patient’s history, their antecedents, their fragilities. It is this knowledge, built consultation after consultation, which allows early detection and effective prevention. A doctor who doesn’t know you can treat your angina. But he cannot perceive the fragility that lies behind your third consultation of the winter.
This system produces two crises that it is wrong to treat separately. The first affects patients. The patient who consults five different doctors in one year does not receive any better care: he is examined five times, but never really followed up. He accumulates medical opinions without ever benefiting from a global view of his health.
The second affects us, family doctors: reduced to a slot in a directory, considered as interchangeable providers, we lose the sense of our vocation.
And, beyond the medical issues, it is the very efficiency of our health system that is threatened. Some platforms have an economic model based on volume: the more patients consult teleconsult, the more they prosper. It doesn’t matter if it’s with the same doctor or not.
And how many of these teleconsultations end with “if things don’t get better tomorrow, I invite you to see your doctor again”? Under the guise of access to care, they actually produce unnecessary intermediate consultations which overload the system and fragment follow-up.
Defend a humane and united system
We are not the adversaries of digital technology: we are daily users of it. What we refuse is a digital technology that stretches the patient-doctor relationship instead of strengthening it. We want tools that serve long-term monitoring, that allow us to know our patients better and communicate with them, without ever coming between us.
We call on public authorities to measure the real effects of these platforms on the quality of care. And we ask that family medicine be recognized for what it is: not medicine by default, but the backbone of an effective, humane and sustainable health system.
We, proud family doctors committed to our patients, refuse supermarket medicine. We refuse to become mere care providers. And we are convinced that practicing modern family medicine is still possible. A medicine anchored in connection and trust, equipped with the right tools, respectful of the doctor’s balance and concerned with the patient’s well-being.
Family medicine is not a heritage to be preserved. It is a model to defend, in the service of a humane and united health system.
About opinions
This text is signed by a guest author. He expresses his opinion and not that of the editorial staff. Our Live section aims to allow the expression of pluralism on religious, social and current affairs subjects, and to encourage dialogue, according to the criteria set by our editorial charter.
Share your opinion in comments or by writing to us at: readers.lacroix@groupebayard.com
