A first step has just been taken towards the reimbursement of certain treatments, without having to go through a visit to the attending physician in order to obtain a prescription. Deputies and senators indeed agreed last week on a bill from Renaissance MP Stéphanie Rist which aimed to open direct access to physiotherapists and speech therapists, or to nurses in advanced practice (say " IPA", intervening in particular on certain chronic diseases).
The primary goal? Unblock the offices of general practitioners a little while it is increasingly difficult for many French people to have access to them. The agreement was found with difficulty, during the joint joint committee (CMP) on Thursday, and "after bitter and long discussions", recognized Stéphanie Rist.
Under pressure from doctors, senators insisted to the end on limiting this direct access to physiotherapists and advanced practice nurses as much as possible. Finally, it will be reserved only for those who practice in association with doctors, in structures such as MSPs (multi-professional health centres).
Exit direct access for professionals who work alone, but are registered in a Professional Territorial Health Community (CPTS), as wanted by the government and the deputies. There are about 400 CPTS in France today and cover about half the population - several hundred more are planned.
The text "will only have a cosmetic effect," said Sébastien Guérard, president of the French Federation of Rehabilitation Physiotherapists Masseurs (FFMKR).
"Only 3%" of physiotherapists practice in MSP, regretted Sébastien Guérard, stressing that doctors or emergency services will have to continue to take care of minor accidents - sprains for example - that one of his colleagues could perfectly take care of.
For speech therapists, the senators were a little less inflexible. If they are members of a CPTS, they will be able to receive patients not referred by a doctor. But it is still necessary that this territorial community explicitly authorizes direct access in its "health project".
“It amounts to leaving it to the goodwill of local health professionals,” regrets Sarah Degiovani, president of the national federation of speech therapists. "We got an opening, but we're still going to have to convert the try. »
"We will have to do conventional work to organize all this, but I hope it will be done by the end of the year", welcomes Philippe Besset, the president of the federation of pharmaceutical unions of France (FSPF).
Rapid tests for certain conditions - such as those for bacterial angina or cystitis - will become widespread. And pharmacy assistants will now be able to vaccinate, like the pharmacists themselves.
In total, "a dike has jumped in terms of the sharing of skills between the doctor" and other caregivers, says Maria Roubtsova, of UFC Que Choisir. "But we shouldn't be under too many illusions about the immediate impact for patients," she adds.
"We took a small step when we could have taken a big leap forward," sums up Gérard Raymond, president of France Assos Santés, which federates patient associations. "These are profound transformations" of the professions of each other, "that must be brought about little by little," he acknowledges, however.
