Dr. Papinot *, a liberal gynecologist, is not very ” computer gifted ” But the current health crisis has forced her to go beyond her “software anxiety ” ” At the beginning, it was frankly not simple … Then I watched lots of tutorials “, Said the now more comfortable 50-year-old. Now, his day in the office is divided between a dozen video consultations and a little less than “face-to-face“
One in three doctors
Dr. Papinot is one of some 29,000 liberal physicians who billed for at least one tele-consultation during the second week of confinement. During the month of March, one in three doctors tele-consulted when, just the month before, Health Insurance had only one in ten.
As a reminder, this practice corresponds to ” a consultation carried out remotely during which a patient and a doctor – generalist or specialist – talk and see each other by video transmission “According to the National Health Insurance Fund (Cnam).
In view of the exceptional circumstances, the tele-consultation methods have been largely relaxed. First, the reimbursement is fully covered by the Social Security when they were previously reimbursed only at 70% – like the “classics”.
Second, tele-consultation is no longer just a “follow-up” consultation. Until then a first date in situ was required for ” respect the course of care Of the patient.
Finally, while they were exclusively on video, tele-consultations are now possible by a simple phone call. These emergency provisions established by decrees of 10 and March 19 will be in place until May 31, 2020.
A “forced discovery”
This legislative flexibility responds to the logistical difficulties experienced in the field. It was necessary to react quickly so that the cabinets did not become centers of transmission of the Covid-19.
” We transformed our schedules, spaced the appointments so that there was only one patient in the waiting room, made the children pass in the morning, removed the toys in the waiting room… consultation allows us to “pre-sort” to determine who should absolutely be seen “Explains Dr. Giraud, replacement general practitioner.
But, for him, the instructions arrived late. “ City medicine was the poor relation of the government plan. At the beginning, we did as we could. We have implemented “house” protocols to disinfect the cabinet”
To overcome the ” silence Authorities, Dr. Giraud was able to count on digital assistance. In the Facebook group “ The Doctor's Divan – recently tainted by a media scandal – some 13,300 professionals exchange advice, opinions and recommendations in this ” forced discovery Of the tele-consultation. The young support the older.
100,000 tele-consultations in one day
The Ministry of Health and Solidarity has now hung up the wagons. All can refer to ministerial recommendations crystal clear, doubled with those ofDoctor's orders available online. An exhaustive classification by security level, listing more than 100 remote consultation solutions was published on March 18 (PDF).
Doctolib, which prided itself on hosting two out of three tele-consultations in September 2019, saw the number of appointments taken in video consultation be multiplied by 100 since March 5.
On Monday, March 30, the platform recorded a record 100,000 remote consultations. During the confinement period, the widely popular appointment-making service made its video consultation services free – instead of 79 euros per month. Participation in the “collective effort” argues the platform – which competitors have done the same.
A “disabled consultation”
So even if his specialty is less suitable, Dr. Trouiller, a liberal rheumatologist, has also activated the video option on Doctolib. ” VSIt was a great tool for certain pathologies “He summed up after a short week of use. However, the specialist in joints still speaks of ” disabled consultation “, Fatally evoking” screen screen “
However, like him, even the most reluctant got into it. According to the social security system, 486,369 tele-consultations were billed between March 23 and 29. This curve ” exponential Logically follows the government's announcements. Health Insurance accounts for less than 10,000 per week until the beginning of March, then 80,000 just for the week of March 16. A forced craze, therefore, but national.
“In fact, I did it before”
” It allows me to bill for working time outside of consultations for which contact is not essential, such as refilling prescriptions for patients I saw a short while ago. “Underlines general practitioner Dr. Giraud who had been considering the use of tele-medicine since the beginning of the year. Same observation ” finally For Dr Papinot. ” In fact, I did it before, especially for the analysis of certain exams. Today at least it’s framed “Rejoices the gynecologist despite the efforts still necessary to get used to.
In total, remote consultations today represent 11% of all consultations compared to less than 1% before the crisis. While their number has skyrocketed, medical appointments nationwide have declined sharply. Both Dr. Giraud and Dr. Trouiller report an approximate 70% drop in their activities and only open their offices one day a week for “emergencies”.
In the gynecology office, activity has only halved. Dr. Papinot continues to open daily to give priority to pregnant women and those who use voluntary termination of pregnancy.
The three are, in any case, shared on the continuation. Dr. Giraud will continue “It's certain !As Dr Papinot hesitates. But Dr. Trouiller does not want it to continue. ” We can't wait to resume our activity! ”
* The name has been changed.