Émilie Bérard and Emmanuel Vigneron have undertaken a deep study of the ‘medical deserts’ problem for Futuribles. A first instalment of their work was published in our previous issue. In that article, the authors presented a series of brief dramatic scenes depicting concrete situations over a long time-period as exemplifications of the notion. This article represents the second strand of their reflections and draws on a more quantitative analysis, enabling them to propose a topography of the French medical desert.
To this end, the authors focus on two crucial elements: the development over time of doctor numbers, and the access to emergency services (a later, third instalment will deal with technical facilities). Working from the numbers of physicians (both specialists and generalists), the ratio of doctors to the general population and their geographical distribution, they present what we may properly call a ‘medical desert’, caused in large part by factors linked to national territorial planning (preference for metropolitan centres, coastal regions, the South etc.). Where emergency services are concerned, Bérard and Vigneron point out a twofold problem. First, many patients are having recourse to emergency services for unscheduled treatment that could be delivered by other medical services (more than two thirds of emergency consultations): this problem is linked to the distribution of doctors across different catchment areas. The second problem concerns the ability to access emergency services quickly—either at a local facility, via mobile-intervention structures, or through rapid transfer to ad hoc services. Here again, not everything depends on how medical services are organized; a large part of the solution depends on educating patients and on rational territorial planning.
The article is downloadable only in French. It is not available in English.
