Last time we gave you an idea of how the French health system works and what you will need if you intend to live in France permanently. In this article we have information on how to get a Doctor.
It is worth considering asking your doctor in the UK before you leave if they can provide your medical history for when you leave to go to France. If not compile a list of any major treatments or operation you have had, preferably dated. Your French doctor will find this very helpful.
The first step when moving to France would be to register with the local health provider in your area, in our case, CPAM, and although the full process can take some time, once you have commenced the registration application you will be able to get reimbursement of a percentage of your medical costs when you get your ‘Carte Vitale’ card, and, if you have not received it yet, the reimbursement will be back dated. It is unwise to delay registration as medical problems are no respecters of circumstance and illness or accident can arise at any time costing you a lot of money.
Everybody over the age of 16 years old and residing permanently in France has a free choice of who to nominate as their doctor who will then provide them with continuing care. Providing that the doctor you choose can accept you as a patient. In some small doctor practices, it is quite possible that he/she will be oversubscribed with patients and unable to put you on their books straight away. He/she may advise you to go to another doctor with more specialised skills if it would be more suited to your particular medical history and needs. There are no restrictions on how far you are away from the doctor, but it is obviously better if you register with a doctor a reasonable distance to where you live, (or intend to live). In a family emergency your doctor may be unable to respond personally if he has to travel a long way to assist you and an emergency, on call, doctor would have to be found. A doctor is unlikely to refuse you as a patient but many would discuss with you the benefits of finding one nearer to your home.
If you wish to register with a health centre or larger clinic with more than one doctor you will need to nominate only one doctor in the group. It does not mean you will never see another doctor in the practice but, in such circumstances, the other doctor would have to mark and refer details and treatment back to your chosen doctor.
Depending on your circumstances it is worth checking prior to selecting your doctor if he/she is ‘Secteur 1’ or ‘Secteur 2’ level. It will normally be displayed at the doctor’s surgery. Secteur 1 means that he/she operates under the standard health authority tariffs regarding charges. Secteur 2 means that they can charge whatever they like but you will only get back the same percentage of the standard tariff.
How do you find a good doctor? There are a number of ways. Many try to get recommendations from other expats or neighbours. This type of recommendation is often a good option but, remember, their opinion may not be that objective, most people believe that their doctor is the ‘best’ in town! So, instead of taking one persons word try asking around. One place to start is ‘Yellow Pages’, (Pages Jaunes). Doctors are not allowed to advertise but in Pages Jaunes you will find under ‘Medecins ’ contact details. Another port of call is to go to the ‘Marie’ at your local Hotel de Ville, (Town hall). If you are lucky enough to speak to someone who really wants to help, (it is what they are there for), then they will give you names and addresses of doctors in your area.
You can get the application forms to fill in online, from the doctor’s surgery or from ‘Marie,’ (town hall). It is worth making a rendezvous, (appointment), with the doctor once you have the form completed, to discuss with him/her any regular treatments or medications you already have. He/she will be your ‘Medecin Traitment’ and will then be responsible for your ongoing care and treatment. He/she will also authorise you to go for any specialist care or consultations you need. All care or treatment carried out by other professionals for you will be referred back to him/her.
Be aware that, just like the UK, there is a shortage of doctors in France. Their pay is recognised to be good but many work long hours and recruiting and training of doctors, we would regard as GP’s, is not sufficient to meet demand. Our own doctor has a prior appointment system up to late afternoon and a non appointment period in the evening. He is often there from 7am to 10pm+ on his working days. You will pay your doctor a fee each time you see him/her. At the moment his charge, (sectuer 1), is 23 euros, rising to 25 euros later this year. You will normally be reimbursed around 70% of that fee on a standard tariff basis.
You are allowed to visit another doctor other than your own for a second opinion or if you are unhappy with the treatment plan provided or, if away from your home on holiday or business etc. If, when your doctor places you on a care plan and you do not follow it. You may find that your health provider reimbursement is reduced
You do not have to go through your doctor for a number of other specialist treatments such as Dental care, Biology, Ophthalmologist, Gynaecologist or, if between 16-25 years old, Psychiatric services. There are also Health department sponsored treatments offered directly to you, some age related, some not, such as Breast and Bowel Cancer screening programs, Flu vaccinations, emergency treatment and Palliative care. As well as a number of after care services.
It has been said that the French are a nation of hypochondriacs. I cannot comment on the validity of that remark but doctors in France are, unlike the UK, not inhibited when prescribing drugs or treatments. You will often see people leaving pharmacies with large bags of medications. However, just like the UK, the French government is now taking action to reduce the huge national cost of medecins/medical care and moves are afoot to get doctors to prescribe more placebo or generic drugs and less prescriptive care.
Some larger clinics have their own pharmacy but most do not. When the doctor gives a prescription it is usually valid for 3 months. For regular prescription they can be issued to be drawn up to a year but this length of time would be unusual. Most doctors would want to get to know you as a patient, and your medical condition, before providing long term prescriptions. Almost certainly, strong or potentially habit forming medications such as sleeping pills would only be issued on a restrictive basis. Narcotic drugs on prescription are only valid for 3 days.
Pharmacies provide an excellent service to the communities they serve. They will often close Sundays plus a weekday but if there is more than one in a locality they will usually close on different days, (except Sunday), and take their holidays without clashing with each other. There will always be an emergency Pharmacy open when the rest are closed. Check at your local pharmacy for the telephone number or address of for on duty emergency cover. Often, the address of an open pharmacy will be displayed on the door when they, themselves are closed. Pharmacies will often offer advice on minor problems and suggest a suitable medication, (bites, stings, colds, gastric problems etc), without charging you a fee. If they are in doubt they will telephone the doctor themselves. On filling prescriptions they will normally explain to you what they are, how often you should take the medication, with or without water or food, and answer any questions you may have. Many Pharmacists do speak English or have staff that do. Whereas pharmacies have enjoyed a monopoly on providing prescriptive and non prescriptive medications the French government is opening up the sale of general drugs in supermarkets and other avenues. At the same time Pharmacies are pushing to be given the right to give certain medical advice to patients. One thing is certain; it is worth getting to know the people in your local pharmacy.
Last time I promised you a useful information guide you could put in your home or car on what to do in an emergency.
When you have a medical emergency
The language barrier can hinder/slow down a patient’s care or still be the cause of a mistake or of a lack of understanding for the carer or the person who is ill. This guide is set out as 8 themes (heart, bleeding, temperature, falls etc). Each sentence or phrase is numbered and is in both French and English. In a situation where someone does not know how to say/get the words out correctly, it is then possible to say just the number –or add the number to the corresponding sentence as an extra aid.
The Charente Emergency Services have copies of this guide; know it and how it works.
The guide comes in the form of an online booklet which you can print and make up yourself at minimum cost. You can just print it off in A4 size and collate it. Or, if your printer will allow you to print different sizes and on both sides then print 2 pages per A4 sheet on both sides, fold in the middle. After 4 sheets of paper only you can make up your booklet. Make up more than one for both home and car.
You can download the guide here: http://www.paysruffecois.fr/sante/guide-sante.pdf
I thoroughly recommend you to this information booklet and my thanks go to Isabelle Want of Allianz-BH Assurances for drawing our attention to it. This guide has been produced by the communication service of the Angoulême Hospital Centre (Girac ) and printed by the Regional Health Agency and the PETR of the Ruffec Region.