Chez le médecin

IMG_2965I am blessed with good health, a gift for which I am more grateful with each passing year. (She says, knocking on noggin). This despite the fact that I have spent many long hours chez le médecin.

You cannot raise a family in France without becoming painfully familiar with the doctor’s waiting room. You are given a carnet de santé or health record book that tracks your child’s health from birth to age 16. There are checkups – visites obligatoires – at various ages and stages of development. There are vaccinations, height and weight charts. There are vitamins and prescriptions for every imaginable ailment. You don’t leave a doctor’s office in France without a prescription for something (more on that to come).

But oh, the hours spent in the salle d’attente! The unending, crashing bore of it. The dog-eared, outdated magazines. The stale air and germ-infested space with little to distract a child.

Le toubib, as the doctor is called in familiar fashion, tends to be a lone wolf. Most doctors practice under the category of ‘profession libérale’ which is a fancy way of saying self-employed. There is no receptionist or medical secretary to take calls or welcome you at the door. Le médecin généraliste, meaning GP or family doctor in French, runs his own practice, does the paperwork and answers the phone.

Another reason for the endless wait is that many doctors offer a daily ‘permanence’ or walk-in clinic. The advantage is that if you are suddenly ill you can get in to see the doctor the same day – provided you are well enough and willing to wait.

In our country village outside of Lyon there were two GP’s, each with his own cabinet on opposite ends of the main street. I saw both early on and quickly chose Dr. Fourré, a heavyset fellow (like his name, which means stuffed) with a calm, soft-spoken manner who actually listened when I spoke, and looked me in the eye. The other doctor was younger and more modern with a computer on his desk. He spent the whole time looking at the screen and seemed like a scared rabbit every time I tried to catch his eye.

How well I remember the long hours in Dr. Fourré’s small and shabby salle d’attente. The permanence was in the afternoon and the after-school rush at 4:30 was epic. Sometimes people would open the door, stick their head in to do a quick count, then disappear. I later discovered that some would literally run across the village to the other doctor’s waiting room and go where the queue was shortest. Later on the two doctors got together and coordinated their hours, so that one had permanence in the morning and the other in the afternoon.

I am not a patient person. I simply do not wait well. Which makes me a very poor patient indeed.

But I will always be grateful to Dr. Fourré as he was the one who sent me for the MRI that revealed my acoustic neuroma, a benign but mushroom-size tumor growing in my inner ear. It was removed by a specialist in Paris a few months later with no lasting consequence other than a total loss of hearing on the left side. But it was the simple country doctor who actually listened to my complaint about not being able to understand conversation – the specialist I’d seen a few weeks before had sent me away with platitudes about hearing loss and aging.

French doctors work long hours for little pay. They are the unsung heroes of the healthcare system.

Many GP’s in France still make house calls, surprisingly enough, although these are an increasingly rare species. There is also a service called SOS Médecins. If you’re lucky enough to live in an area covered by them, you can get a doctor to come to you within hours. Unfortunately, where we now live in the Haute Savoie, it’s either the nearest hospital or the waiting room of the local GP.

The first time I went to see a doctor in France, a couple of things surprised me. One was the complete lack of modesty accorded to the patient. In this case it was a gynecologist who had me undress for the physical exam without providing any kind of gown or sheet to cover up. Fortunately he kept up a steady stream of chatter with a lot of eye contact to cover any awkwardness.

Another surprising thing was the fact that the doctor is addressed as Monsieur or Madame rather than ‘Docteur.’ You can call him Doctor if you wish, but not doing so is not the blasphemy it would be in North America, where medical professionals are like gods.

What I found even more embarrassing than being à poil was having to take out my cheque book and pay the fellow (although I was dressed by then). This had never happened in Canada, or if it had I’d always dealt with a secretary. It seemed almost insulting to write a doctor a cheque. Especially for so little.

Unless you see a physician as a private patient, the amount you will pay for a basic medical consultation is 23 euros. Even my hairstylist charges more than this.

How do you feel about le toubib?

18 thoughts on “Chez le médecin

    1. Fortunately it doesn’t happen everywhere….perhaps it was just a sophisticated Parisian thing? As for the cost, it is regulated by the Sécurite Sociale – they should probably increase the fees to discourage people from running to the doctor so often!

  1. Oh French doctors, such a love-hate 🙂 Glad that you were able to sort out that tumor, however! How scary!

    One cultural difference I haven’t quite been able to shake is the idea that French people seem to go to the doctor for absolutely everything, even if it’s just a head cold. I realize that is the only way to get reimbursed for medicines. But, I can’t be bothered to waste my time in the salle d’attente when the only thing s/he is going to tell me is that I have a cold! I’ll have to start thinking about putting my MGEN to good use for the gyno, optometrist, and thyroid specialist sooner rather than later!

    1. Yes, although as the cliché goes, if you’re going to have a brain tumor, this is the best kind 😉 As for running to the doctor for a cold, I’m with you (and the less time I spend there, the better I feel.) But my late Belle-Mère used to chastise me and hint I was a terrible mother if I didn’t take the kids in for every sniffle. I think this attitude is common among the French both for the free drugs and the placebo effect of seeing the doctor!

  2. I’m so glad your Docteur was on the ball enough to pick up the tumour and that you got it seen to.The lack of modesty you were afforded does make me cheer even more for our beleagured NHS over here though where you not only get privacy but don’t pay for the privilege.
    xxx Massive Hugs Mel xxx

    1. Thanks, David. Somehow it’s always more complicated than it needs to be in France….but the French system is quite good despite my complaints. You don’t always have to pay if you’re covered by the Sécurité Sociale (equivalent of NHS), but it depends on how well you’re covered and how much you earn. They should definitely raise the rates for the GP’s though – they deserve it! Big bises xx

  3. I arrived here 16 months ago to find our Maire with a very big problem. All 4 of the Doctors in the village are past retirement age …. and they had all announced their intention to go and live by the sea on the same day. The elections last year were keenly fought on this issue. Our maire was rightfully returned – he is not a fantasist with illusions of creating a modern multi disciplinery medical centre in our coin perdu, but understands the reality that young doctors simply don’t want to work in General Practice it being so poorly paid when they can be Dr Kildaire in the hospital (the very reverse of the situation in the UK where there is a glut of GPs and a stampede to get away from the hosptials as soon as a doctor earns his or her title). Last heard (from Martine, la patissiere, the most reliable source in the village) there is the possibility of a young Chilean couple – he a doctor, she a nurse being tempted in by the lure of a proper surgery next door to the lightening research lab …. the mind boggles. I loved your piece as ever …. these really are the unsung heros of medicine.

    1. Cheers, Osyth! This is a real problem in France, ‘la désertification médicale’, one I had heard about but never experienced first hand before. Living near Lyon, there was an abundance of medical professionals and hospitals in our region, but now that we’ve moved to the Haute Savoie, I begin to see the problem. I’ve actually run into ‘foreign’ doctors here several times, so I think the strategy of attracting young grads from abroad is becoming quite common. I do hope your Maire works out a solution – the local doctor is a vital public service!

    1. Ha, ha…had quite some difficulty with that word at first. Kept confusing it with ‘foiré’ which is something else altogether – much to the amusement of my kids. 😉

    1. Good grief, now I am envious! No complaints on the quality of medical care in France but we sure could do with a few improvements on the communication and customer side of things. Maybe I’ll start my own French revolution… 🙂

  4. Ugh. Healthcare. What a collective world-wide headache. Although, in fairness, advances have been astounding–despite the pains research and development goes through. I think we’ve just not figured out the most sound and efficacious way to treat and charge folks. There’s much unwinding to do with this mess yet.
    And what a relief to have found a doctor who listened to what you had to say and didn’t dismiss you. Thank goodness, Mel.

    1. You are right – there is a huge gap between the progress in science and the care delivered to patients. Seems it’s hardest to manage the human factor, which is what really makes the difference. As for the doctor – I was fortunate indeed. But I also listened to my gut and shared my nagging worries about hearing loss after the ‘expert’ told me I was fine. Thanks for your comments, Shelley!

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