Medical teleconsultation without appointment: what results in South Aveyron ?

Les bornes Medadom, leader du marché en France comme en Aveyron. AD

On en compte une petite vingtaine dans le département. Trois ans après leur installation dans les pharmacies, quel bilan tirer des bornes de téléconsultation ? 

If access to care for everyone and everywhere in the country remains at the heart of concerns, telemedicine, in particular remote medical consultations, has seen a resurgence# 39;interest with the Covid-19 pandemic. 

As in Millau, Saint-Affrique, Aguessac and in around twenty pharmacies in Aveyron, it is today possible to consult a doctor from a pharmacy where teleconsultation terminals have flourished over the last three years, the practice having been authorized and supervised since September 2019. 

"Our desire is to remedy medical deserts and provide access to care for all", explains Nathaniel Bern, one of the co-founders of Medadom. The leader of  market very established in the department which claims in France 2,800,000 teleconsultations since its beginnings for 4,000 terminals, cabins and consoles installed throughout France. On time where to find a general practitioner is sometimes an obstacle course, this new mode of care – which also confirms the creeping financialization of the health sector – could it be likely to green medical deserts ? 

"A good alternative"

"Faced with the impossibility of directing people to overbooked, understaffed doctors, with hours not really suited to patient demands, particularly in the evening, valid the Millavois pharmacist Michel Arnal, I turned towards teleconsultation, which for us has a cost, but which seemed to respond best to this type of problem. "

"A good alternative which helps out rather well", for her part Amélie Bonald, holder of the Aguessac pharmacy which also installed its terminal two years ago. According to her, very suitable for the "bobology", for mild pathologies, particularly in the summer period. 

There are ups and downs. Some weeks we have five teleconsultations. Weeks none. It's not a tool we really relied on

"Largely under-exploited", according to other professionals in the sector, teleconsultation represents a real time saving – 4 appointments out of 10 are obtained the same day or the next day – but remains, according to Michel Arnal, "victim of its success", although very relative in Aveyron… As the service is national, with doctors dispersed throughout the territory for all of the 4,000 terminals available, the duration of # The wait can lengthen drastically. Sometimes more than an hour compared to ten minutes in normal times. 

"One more limit to the system"

Another concern relayed by Michel Arnal, the penchant of certain patients for simulation with the ulterior aim of being prescribed sick leave. A marginal practice according to platforms such as Livi or Qare or Medadom questioned on the subject by the National Sickness Stop Fund (Cam). 

Medadom explaining that the rule of three days of maximum downtime has been applied since 2019. Provision included in its medical charter in the same way as the ban placed on the patient to request two appointments on the same day on the platform. 

"One more limit to the system", concedes Michel Arnal and which is very regularly denounced by general practitioners for whom nothing replaces physical consultation. Regrettable for&nbsp ;the 6 to 8 million – according to estimates – of French people who live today in medical deserts. 

Jean-François Rousset: “An important step forward”

At the forefront of the subject of health in South Aveyron, Renaissance MP and former surgeon Jean-François Rousset wants to "set in stone& ;quot; the principle according to which "the provision of care can never be interrupted." In a recent press release he explains: < em>"TAll options must be mobilized to ensure access to care. Indeed, the population is older and the demand for care continues to grow. At the same time, young doctors are favoring a new life balance, leaving more time for their personal life and less time at work than their elders who are retiring. We lack doctors and even though there has been a 27% increase in medical students since the removal of the numerus clausus, our health system must evolve. This is why the latest laws passed strengthen the skills of our nurses. Let’s take the example of the elderly and people with chronic illnesses. At the end of a first appointment with the doctor and nurse, the patient will be offered by the doctor a personalized health plan which will be returned to the nurse. ;monitoring. Thus the patient will benefit, through his nurse, from an available and accessible contact person. Likewise, with regard to the link with specialists, former colleagues from Toulouse will run a teleconsultation office within the La Poste office in Belmont. In an isolated office allowing confidentiality of exchanges to be respected, a nurse will accompany patients on videoconference consultations with specialists in the region. This is an important step forward for all those who have no other choice than to travel 50-100km to have an appointment with a specialist. We must also build more partnerships with the Toulouse University Hospital, and no longer limit ourselves to the historical administrative connection with the Montpellier University Hospital. This is the particularity of South Aveyron, we are between two metropolises and this double connection must become a wealth at least equivalent to the distance which separates us. All these new solutions overlap to restore working comfort to our caregivers and relieve our hospitals until the construction of the common hospital. The future must be thought of by setting in stone that the provision of care can never be interrupted. Finally, even though it may seem obvious to say it, we must find a positive and attractive discourse to attract health professionals, it is fundamental.