Journal dun médecin généraliste (Documents) (French Edition)

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La Presse Médicale - Journal - Elsevier

Researcher Academy Author Services Try out personalized alert features. Care refusal of the patient in palliative care in terminal phase at home by general practitioner: Is it a reality? Deuxiemes rencontres biennales de la Federation nationale des equipes ressources regionales de soins palliatifs pediatriques Lyon, octobre On 1 st January , half of foreign doctors were European, the highest numbers being Belgian, and a third were from a North African country, mainly Algeria.

While there was little change until , was marked by a sharp increase in the number of foreign physicians registering at the CNOM, the majority of them being females Figure 1. In , for the first time, there were more Romanian doctors registered than Belgian ones.

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Newly registered physicians of European and extra-European nationality per year since France. Not a brain drain between developing and developed countries but between centre and periphery into EU: The two countries also present widely different healthcare systems. Romanian healthcare system is a universal one. After the fall of Ceausescu in , a system of social insurance has been set up for paying doctors and reorganizing hospitals.

Finally, in hospitals, the number of beds remains in surplus and investment are insufficient to allow modernization and, therefore, the number and popularity of private hospitals have risen. For many young Romanian physicians, the preparation of an inter-university specialisation diploma DIS or the certification of specialised training AFS was a way to be recruited in France 4. This concerns respondents of our survey, of whom arrived before The number of Romanian physicians present in France had therefore already increased significantly in the early s.

However, the strongest wave arrived in The number of Romanian doctors registered by the CNOM increased sharply in the years following Romania's entry into the EU, rising from on 1 st January to on 1 st January However these earlier migrants played an initiating role in the arrival of those who came afterwards.

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Thus, social networks dynamics demonstrate their effectiveness: Conditions of migration of Romanian physicians in France before and after Romanian physicians are present across the whole country, with higher numbers in the North and Northeast, whose industrial shrinking cities are overall less popular with French doctors, as well as in the Paris region. University hospitals employ senior practitioners as well as trainee interns.

There are significant numbers of Romanian practitioners in these hospitals. This is the case in Parisian hospitals as well as in the different university hospitals were the survey has been carried out. Romanian practitioners are also numerous in hospitals located in small towns, where they alleviate the problems of recruiting staff and thereby help to ensure the survival of departments under threat of closure.

In university centre and largest hospitals, Romanian doctors are in high demand as they are of no concern for the recognition of qualifications unlike the practitioners with a diploma from outside the EU , and they are employed on temporary contracts with all the associated disadvantages, including restrictive on-call duties. In small and medium-sized towns, the use of foreign practitioners can ensure the survival of the hospital facing major recruitment difficulties.

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In rural areas, the long-awaited Romanian doctor can ensure the continuity of a medical practice following a departure, a planned retirement or work overload, and is then expected to be permanently available to meet the demands of local populations, like the country doctor of the past. Local newspapers, which announce these arrivals, emphasise the fact that these Romanian doctors can speak French, that their practices are similar to those of French doctors even going so far as to showing them holding a copy of the Vidal medical dictionary, which is the bible for all French doctors.

It looks like the provision of healthcare becomes a key part of politics. The issue of recruitment and retention of GPs in rural areas is complex Scott and al. Three extracts from newspapers testify to these expectations: After almost one year without a doctor, the village has finally found a replacement: Iulia Sandu, arriving straight from Romania.

Mayor Alain Buot is delighted at the prospect. After the departure of Isabelle Derycke, a doctor came to replace her in February but only stayed for three weeks.

It also had an impact on the activity of the pharmacy and other health care professionals. Aged 65, he has worked in Melrand for thirty-six years. This doctor tried in vain to find a successor. The municipal council signed an agreement with the agency XP-consultant, specialised in the recruitment of doctors, in an attempt to find a replacement.

The agency soon put forward a candidate, a female doctor aged 56, who lives in the region of Bucharest and speaks good French. The new doctor will arrive in the village mid-November " Ouest-France , 7 th October One year later, we are delighted to welcome Bogdan Coman to the health care centre". Dr Miniscloux who was struggling alone to cope with the workload also appreciates his arrival.

Bogdan Coman is a young doctor aged 36 who came straight from Romania " Sud-Ouest , 15 th October Romanian doctors do not necessarily set up practice where they are most needed.

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In their defence, it should be said that hospitals offer a professional environment more favourable to their integration. In the independent practice, they can be quite isolated and even encounter reactions bordering on intolerance. A Romanian female doctor working in a rural village of Brittany talked to us about the ostracism displayed by his colleague in the place. Stating that the new arrival had fewer qualifications than him, he advised patients against going to her.

Similar stories are regularly reported in the press: I spoke about it with my Romanian colleagues, who were undergoing the same kind of experience. Once arrived, local doctors would leave them very few patients. More clearly, in the question of the integration of Romanian physicians, the CNOM warns against the use of recruitment agencies: Romanian doctors are awaited to compensate for the shortage of doctors, to fill the gaps in certain specialties or certain locations, and therefore to go where French doctors are less inclined to practise and to care people disregarded by other doctors like insane or older patients with multiple pathologies.

In short, and more particularly in public hospitals, are they not seen as the reserve army of medical labour? The idea have been suggested by Raghuram speaking about the NHS in the post-war period: One may fear that this will continue in the current context of budgetary austerity and reduction in public spending. French health policies are consistent with the objectives of healthcare systems reforms, which tend towards financial sustainability and freedom of choice of healthcare for professionals and patients rather then the improvement of quality of care and even more the equal access to healthcare Palier, Once again, in April , the French Prime Minister, Manuel Valls, called for a special effort to reduce healthcare costs.

More than these financial motivations, there are those relating to healthcare conditions: According to some of them, the current healthcare system in Romania does not offer good working and treatment conditions and it is not possible to properly fulfil their obligations with regard to patients, confirming the observation already made in by Delautre et al and repeated by Boncea in Conversely, the French medical system is perceived as being able to offer greater job satisfaction with modern medical equipment and materials, ensuring medical procedures are safe and carried out within a well-financed healthcare system and a stimulating professional environment.

Therefore, Romanians physicians can believe they will be more able to fulfil the Hippocratic oath in migrating to France rather than continuing to serve Romanian population. In our survey, women particularly expressed this. The quest for a better quality of life and more specifically better education and training opportunities for their children were evoked as decisive factors in the migration of 99 of the doctors interviewed.

These figures suggest that the departures abroad are positive ruptures carried out in order to fulfil a life project. Although, according to Eurostat data, Romania is one of the countries in the EU where the gaps between men and women are smallest, Romania is also the EU country where average wages are the lowest, and a country where gender relationships are very demanding on women Boulineau and Bonerandi-Richard, Thus, migration can give rise to the creation of an area of empowerment for women Potot, Researcher Academy Author Services Try out personalized alert features.

Guillaume Giordano-Orsini Sophie Lefour Pierre Charles Boris Bienvenu Nicolas Chevalier Brigitte Delemer Most Cited Articles The most cited articles published since , extracted from Scopus. Odile Launay Luc Martinez The Plum Print next to each article shows the relative activity in each of these categories of metrics: Captures, Mentions, Social Media and Citations.

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