Medical Deserts: “It is time to regulate the establishment of doctors and build a real territorial public health service”

We are healthcare providers, committed to our communities. And we are clear: we must regulate the practice of doctors. But this regulation can only work if it is accompanied by a coherent strategy that organizes and guarantees access to care and prevention, everywhere in France.

Today, millions of people no longer have a primary care physician. And where there are still plenty of doctors, many, particularly specialists, practice in sector 2 with excessive fees, making care financially inaccessible for many patients. This is no longer acceptable for patients or sustainable for healthcare professionals. It is unrealistic to think that we will resolve the crisis in access to healthcare simply by training more doctors.

Without regulation, they will mostly settle where the working conditions seem most favorable to them, further widening territorial inequalities. For twenty years, increasing the numerus clausus has not helped to resolve medical deserts, any more than the numerus apertus will be able to do so. Training more without organizing better is preparing for failure. Let's be clear: the current system no longer meets the needs of either patients or caregivers.

The response to healthcare needs in the community can no longer rely solely on the principles of private medicine. The current model, based on physicians' free choice of practice and fee-for-service payment, has shown its limitations and is completely ineffective in stemming medical deserts. It neither guarantees a fair distribution of professionals, nor ensures access to care without excess fees in all areas, nor ensures coordinated, relevant, and continuous patient care. We need a collective, structured framework capable of meeting the challenges of today and tomorrow.

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