Telemedicine: A Response to Medical DesertificationFebruary 23, 2021 2021-02-23 15:02
Telemedicine: A Response to Medical Desertification
Telemedicine: A Response to Medical Desertification
The phenomenon of medical desertification is accelerating and could continue to grow in the coming years without radical and concrete measures. The alert has been raised, especially by the Social Security in France. But France is no exception, this phenomenon is found all over Europe.
An ageing population
In 2019, 11% of the population, or 7.4 million French people, lived in so-called medical deserts, demonstrating a real inequality in access to care throughout the country. Indeed, one in three French cities is short of general practitioners. Although the number of active physicians has increased by 93% since the 1980s, medical density continues to decline as practitioners go to retirement in a country where population keeps ageing and life expectancy increasing. Today, 20% of French people are at least 65 years old. Moreover, a report by DREES (Department of Research, Studies, Evaluation and Statistics) confirms that medical deserts are more of a problem of general practitioners availability than an issue of geographical accessibility.
It is all the more difficult to respond to the increase in demand for care and the lack of health professionals asnumerus clausus has limited the number of future doctors until September 2020. Also, there are not enough hospitals to accommodate more interns. So, as it becomes increasingly urgent to address the challenge of this growing desertification, the 2019 Health System Organization and Transformation Act, which aims to increase access to care, has removed the PACES (Common First Year for Health Studies) and the numerus clausus to meet the needs of the territory.
Low attractiveness in rural areas
However, the regulation of medical demographics would not fully respond to the issue of medical deserts, especially in rural areas. Their lack of attractiveness for young doctors is also an indicator of the inexorable deterioration of the situation. New graduates aspire to a balance between work, private and social life, where rural areas have a reputation for lowering the social aspect through the absence of cultural life. Some action levers can be used to attract young doctors to these geographic areas. Through communication and awareness among young graduates and the support of more experienced doctors to welcome trainees, new doctors could see a real added value in terms of experience, both on a human and professional level. Financial compensation could also be a way to increase the attractiveness of areas lacking doctors.
These understaffed areas in terms of doctors are a problem also affecting medical emergencies. In some parts of France, almost a quarter of SAMU (Emergency Medical Aid Services) interventions require delays exceeding 30 minutes. In an emergency situation, such long delays severely limit the timely care of patients whose vital functions are impaired. This is a true indication that not all French people are equal when it comes to accessing care. Appropriate solutions must be thought through to meet care needs throughout the country.
Teleconsultation to facilitate access to care
Regional authorities and the French Mayor Association are calling for solutions to stop the decline of rural medicine. In addition to financial incentives, it is becoming necessary to reform the health system and propose innovative solutions.
After many years of experimentation and the reimbursement of medical teleconsultations by the Social Security, teleconsultation finally arouses the adhesion of the French population during the pandemic of Covid-19. In fact, there were 5.5 million teleconsultations carried out during the first confinement in March 2020. By highlighting some flaws in the health system, the health crisis has really led to the development of telemedicine practices in order to conduct remote diagnosis and monitoring of patients. Telemedicine can then respond to the lack of care in rural communities and the need for EHPAD (retirement homes) healthcare workers by greatly facilitating the lives of health professionalsand patients.
Teleconsultations increase the availability of practitioners by initially reducing their travels, optimizing their practice management to be more responsive to a wider patient base, and responding to consultation requests from patients living in medical deserts. EHPAD practitioners have significantly reduced their travels. Undoubtedly, these remote medicine practices allow to cover the territory in terms of care and reduce waiting times to consult.
Its quasi-instantaneous nature is attracting more and more patients who want to be diagnosed and followed by telemedicine. Remote consultation is a real tool that can reform the health system by enabling diagnoses and prescriptions, especially for chronic diseases or benign pathologies. Although online consultations cannot replace physical ones, it is intended to provide people with the opportunity to overcome logistical barriers such as travel or excessive waiting times to see a general practitioner or a specialist.
A long time marginalized, today one in two specialists uses telemedicine and one in five citizens over the age of 70 uses teleconsultation. Through its teleconsultation solutions and thanks to its stations to carry out health self-assessments, Bodyo responds directly to inequalities in access to care. The AIPod and the Health Lounge are a real way to increase care offerings by providing quality consultations where its medical grade sensors make it possible to have a diagnosis that a conventional teleconsultation cannot offer. Its ease of use is one of its many advantages so that all French people, whatever comfortable they are with new technologies, can use it. With Bodyo, access to healthcare for all becomes more than a principle but a reality.
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