There is an emergency: the system can no longer cope with current health needs.
The population is aging and more and more users or citizens carrying chronic diseases.
Access to healthcare is often difficult, especially for the most vulnerable users. Six million French people do not have an attending physician. Consulting a medical specialist is sometimes an obstacle course, with several months of waiting in certain regions and several weeks for a prescription renewal. There is little investment in prevention, health promotion and health education activities, although they are essential to act before illness or to avoid complications. These difficulties in accessing day-to-day care, present in many regions, lead users either to give up essential care or to go to emergency rooms, which are however saturated.
It is prejudicial that a minority of doctors has blocked for too many years any possibility of development of the health system, widely acclaimed in the field by health professionals, including doctors.
Signatories of the platform
The Covid-19 pandemic has highlighted the weaknesses of a breathless system, generating discomfort and exhaustion of professionals, who nevertheless wish to flourish in their work with patients.
The public hospital collapses.
The closures of services due to a lack of caregivers - who no longer find meaning in their work or in the consideration given to them - are on the increase.
In the public, as in the private sector, operating theaters, emergency services and maternity hospitals are closing one after the other, everywhere in the country, for lack of human resources.
All this is no longer acceptable.
Every day, health professionals are forced to practice illegally to keep the system going.
The simple administration by a nurse without a medical prescription of an analgesic such as paracetamol to respond to a patient's pain is illegal, although this drug is freely available in pharmacies.
Examples like this are numerous and hamper the functioning of the French health system.
The health context, health issues and technologies are constantly evolving.
Lifelong training for professionals does not grant them any recognition of new skills.
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However, today, the inescapable dogma of the medical monopoly prevents any rapid adaptation of our health system.
This is why several amendments to the Social Security Financing Bill 2022 (PLFSS), voted by the National Assembly, propose the experimentation of the direct access of patients to physiotherapists, orthoptists, speech therapists and advanced practice nurses.
This is a major development for the health system and its users: this must be supported unanimously!
Direct access to these professionals is, for citizens, the possibility of consulting without medical guidance or prescription a health professional competent to intervene on a health problem.
This can be a physiotherapist for low back pain or a speech therapist for a language disorder, for example.
This is in no way a transfer of skills since doctors can always prescribe this care to their patients.
However, on November 2, the Council of the Order of Physicians and seven liberal doctors' unions sent a letter to the president of the Senate Social Affairs Committee, Madame Catherine Deroche, to express their opposition to direct access. from users to non-medical health professionals who would gain autonomy.
Direct access to trained non-medical health professionals is a given for many countries.
Several studies confirm the improvement of care pathways.
Signatories of the platform
We, health professionals, but also users of the health system, unanimously and firmly denounce these conservative and backward-looking positions to protect corporate interests.
It is prejudicial that a minority of doctors has blocked for too many years any possibility of development of the health system, widely acclaimed in the field by health professionals, including doctors.
Beyond an assumed contempt for all health professionals, in opposition to the code of ethics for physicians which encourages respect for the independence of other health professionals, and against the opinion of the vast majority of the medical community, this letter goes against a vision of the future of the health system, which nevertheless has to deal with an insufficient and unsatisfactory health care offer for our fellow citizens today.
So much so that many French people are turning to so-called “alternative” therapies which benefit from direct access never contested by these same bodies.
And yet they are mostly based on unproven theories that may be charlatanism.
By surfing on the users' loss of confidence in a dying health system, the risk of loss of opportunity linked to these practices must alarm us and be fought.
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Health, "a state of complete physical, mental and social well-being, [which] does not consist only of the absence of disease or infirmity" is the concern of all health professionals who must work in collaboration, user service.
The role of non-medical health professionals is to collaborate with the medical profession in order to strengthen diagnostic and therapeutic management, ensure patient adherence and support them in their care path with a view to improving their health. quality of life.
However, these missions are currently insufficiently invested, because time-consuming and without associated specific remuneration.
The rise in skills of each of the health professions can only benefit users by offering the right skills at the right time in the health process.
Today, these professionals develop a variety of expertise, acquired in recognized and qualifying training courses: university degrees, masters or doctorates, for example.
But nothing is done for them to acquire any autonomy, essential to the use of their training acquired.
Direct access to trained non-medical health professionals is a given for many countries.
Several studies confirm the improvement of care pathways.
The State must take its responsibilities and urgently rethink the health system, which is slow to reform.
Let us trust all health professionals.
Let us promote interprofessional collaboration in the service of users to improve access to care.
Let's promote the skills of all healthcare professionals.
Save the French health system!
Signatories in alphabetical order:
Florence AMBROSINO - Nurse - Master in Clinical Nursing Sciences, Marseille (13)
Ibrahim AMIRAT - Nurse, Pediatric Emergency Health Officer, Elected to the departmental council of the order of nurses of 91, Villeneuve Saint Georges (94)
Jean-Pierre ANTHONY - Retired nurse anesthetist, Strasbourg (67)
Marie-Ange BARBIER, Dietitian Nutritionist, Noyant d'Allier (03)
Dr Damien BARRAUD - Resuscitator Anesthesiologist, Metz-Thionville (57)
Adélie BARTHELET - Liberal midwife, Chaource / Bar sur Seine (10)
Dr David BEAUSIRE - Doctor - Home Hospitalization, Toulouse (31)
Delphine BLANCHARD - User representative - Expert patient - Teacher at the faculty of medicine & midwifery Catholic University of Lille, Grenoble (38)
Dr Benoît BOURDET - Anesthesiologist Resuscitator - CH Intercommunal des Vallées de l'Ariège, Saint-Jean-de-Verges (09)
Dr Jean-Christophe BRETON - General practitioner, Talange (57)
Dr Marina BRODBECK - General practitioner, St Maurice (94)
Florent CACHON - Nurse - Trainer in nursing care - Doctoral student in educational sciences, Grenoble (38)
Rémy CALLEDE-BELLAÏCHE - Nurse in post-intervention surveillance room - Master in Public Health, Lyon (69)
Alain CARTIGNY - Operating room nurse - Senior health manager - Pedagogical manager and trainer in IBODE school - President of the National Council of Operating Room Nurses, Montpellier (34)
Catherine CERISEY - Former patient - Teacher of patient perspective at the Paris XIII Faculty of Medicine, Paris (75)
Patrick CHAMBOREDON - Nurse - President of the National Council of the Order of Nurses, Paris (75)
Marie CITRINI - User representative on the Supervisory Board of Public Assistance Hospitals of Paris, Paris (75)
Dr Franck CLAROT - Radiologist and forensic doctor - Vice-president of the National Federation of Radiological Doctors of 76, Rouen (76)
Hugo COMPAGNON - Physiotherapist, Montpellier (34)
Benoît DAUMONT - Nurse on availability for the hospital public service, Grenoble (38)
Dr Pierre DE BREMOND D'ARS - General practitioner, Malakoff (92)
Dr Julien DEGREMONT - Emergency doctor - Head of Pole of CH Le Cateau Cambrésis (59)
Merlin DESCOURS - Emergency nurse, Toulon (83)
Julie DEVICTOR - Advanced practice nurse - Beaujon Hospital (APHP), PhD student in public health - President of the National Council of Advanced Practice Nurses, Clichy (92)
Stanis DEVICTOR - Private nurse - Clermont-Ferrand (63)
Tom DEVICTOR - Liberal nurse - Paris (75)
Jean-François DUMAS - Liberal physiotherapist - Secretary general National Council of the Order of Masseurs Physiotherapists, Thiberville (27)
Charles EURY - Pediatric nurse - Project manager at the Agency for New Social and Health Interventions - President of the College of Pediatric Nurses, Angers (49)
Jérémy GAILLARD - Nurse Anesthetist - Master student in Public Health - Eaubonne (95)
Dr Anne GERVAIS - Gastroenterologist - Louis Mourier Hospital, Colombes (92)
Romain GRIVILLERS - Physiotherapist, Leforest (62)
Laure GUÉROULT-ACCOLAS - Pharmacist - Former patient - Founder and director of network patients - Expert patient, Paris (75)
Dr Marion GUITARD - General practitioner, Serres-Castet (64)
Jérémy GUY - Student Anesthesiologist - Health popularizer on networks, Paris (75)
Anthony HALIMI - Physiotherapist, Dijon (21)
Benjamin HENG - Physiotherapist, Grans (13)
Tatiana HENRIOT - Advanced practice nurse - Master in Clinical Nursing Sciences - President of the National Union of Advanced Practice Nurses, Thoiry (78)
Dr Ludovic JOULAUD - General practitioner, Saint M'Hervé (35)
Romain JUILLARD - Cardiothoracic intensive care nurse, Grenoble (38)
Pr Karine LACOMBE - Infectious disease specialist - Head of the Infectious and Tropical Diseases Department at Saint-Antoine Hospital (APHP), Paris (75)
Marie LANGLOIS-CLAROT - Clinical hospital psychologist - Unit for difficult patients, specialized hospital of Rouvray (76)
Anne-Laure LARATTE, Dietitian-nutritionist, Balazé (35)
Dr Magali LAVIELLE-GUIDA - Speech therapist - Doctor in Psychology, University lecturer, Saint-Malo (35)
Dr Thomas LE BERRE - General practitioner, Rennes (35)
Prof. Philippe LE CONTE - Emergency physician at the CHU, Nantes (44)
Dr Elodie LEMARTHE, General practitioner at CH de Perpignan (66)
Vincent LAUTARD - Nurse and lawyer in health law, consultant in the health and social sector, Toulouse (31)
Dr François MAIGNEN - Pharmacist and statistician specializing in public health - Master of science - Chartered Statistician, London (England)
Pascale MATHIEU - Physiotherapist - President of the National Council of the Order of Physiotherapists, Paris (75)
Dr Christine MAYNIÉ-FRANÇOIS - General practitioner, Saint-Quentin-Fallavier (38)
Flora MEYRIEU - Tobacco dietitian specializing in addictive behavior, Toulouse (31)
Lise MANTISI - Advanced practice nurse - Pitié-Salpêtrière Hospital (APHP), Paris 75
Julien MARTINEZ - Mental and community health nurse - Master in organizational management - Student nurse in advanced practice, Lyon (69)
Lucien MIÈGE - Dietitian-nutritionist - Nursing student, Toulouse (31)
Marie MILLER - Physiotherapist, Lyon (69)
Julie NOS - Speech therapist, Canéjan (33)
Pr Nicolas PESCHANSKI - Emergency physician - Associate Professor of the Universities, Rennes (35)
Dr Nicolas PINSAULT - Physiotherapist - Senior Lecturer - Director of the Grenoble physiotherapy department - Vice-president of the Order of Masseurs-Kinesitherapists, Grenoble (38)
Dr Aurélie PLESSIER - Gastroenterologist - Coordinator of the reference center for rare diseases “vascular liver diseases” - Beaujon Hospital (APHP), Clichy (92)
Dr Gaëlle RANCHOU - Doctor - Head of department, Mobile Palliative Care Team and Palliative Care Unit - President of the Medical Commission for the Establishment of the CH de Périgueux (24)
Michel REISDORF - Physiotherapist, Freyming-Merlebach (57)
François RIPOLL - Physiotherapist - Center aquitain du dos, Pessac (33)
Arnaud ROBERT - Emergency nurse - Second year master's student in Public Health, Millau (12)
Cédric ROBERT - Physiotherapist, Inter-University Diploma in Pediatric Physiotherapy, Certificate of Complementary Studies in Sports Physiotherapy, Gournay sur Marne (93)
Laurent SALSAC - Advanced practice nurse - Vice-President CPTS O'Tours - President of the Order of Nurses 37-41, Joué-lès-Tours (37)
Claudine SCHALCK - Midwife and clinical psychologist - Associate researcher CNAM - CRTD, Paris (75)
Robin VERVAEKE - Physiotherapist - Master in Public Health, Mulhouse (68)
Dr Mathias WARGON - Emergency doctor - Head of the emergency department at Delafontaine hospital, Saint-Denis (93)
Dr Youri YORDANOV - Emergency physician - Saint-Antoine Hospital (APHP), University Lecturer, Paris (75)
Dr Florian ZORES - Liberal cardiologist, Strasbourg (67)