A doctor's tour of France, a "medical desert" at the same time

LES PIEUX, France – On a sunny but cold June morning, Dr. Martial Jardel pulled his black motorbike out of his motorhome, put on his hel...


LES PIEUX, France – On a sunny but cold June morning, Dr. Martial Jardel pulled his black motorbike out of his motorhome, put on his helmet and started the engine. On his last day in Cotentin in Normandy, he was ready to hit the road along the English Channel to visit a patient.

Michel Piquot, 92, standing on his doorstep in blue slippers, waited impatiently.

“When was the last time you had a blood test?” Dr. Jardel asked after arriving at the one-story house, speaking louder for the hearing impaired Mr. Piquot, a former employee of an airline company. “I have no idea,” replied Mr. Piquot, looking at the young doctor with blank eyes. “I’m telling you, it’s hell to grow old.”

In March, a freshly graduated 30-year-old Dr Jardel decided to go on a five-month Tour de France trip. But unlike the prestigious cycle race, his journey took him to what the French call “medical deserts” – areas suffering from a severe shortage of doctors. There, Dr Jardel makes an irresistible offer to overworked doctors: he replaces them for two weeks while they go on vacation.

Over the past few months, Dr Jardel has driven over 2,800 miles in his camper van, sharing his experience on his website and with more than 1500 subscribers on Instagram, in the hope of changing the minds of young doctors who are often reluctant to settle in rural areas full of patients but which do not have the attractiveness of large cities.

Despite France’s world-renowned healthcare system, around seven million people live in areas where access to a doctor is limited, according to a recent study investigation published by Mutualité Française, a leading professional union of mutual health organizations. To make matters worse, officials are preparing for a great wave of retirements over the next decade in France, where the average age of doctors is now 49, according to the government.

Normandy is one of the regions hardest hit by the shortage of doctors, according to a recent report from the French Senate, especially in Cotentin, where 40% of doctors are already over 60 years old.

“We must act quickly,” said David Margueritte, the president of the authority which oversees the Cotentin. “A territory cannot be attractive in the long term if there is no possibility of seeking treatment.

For the sixth stage of his medical road trip, after stopping in the center, east and north of France, Dr Jardel replaced Mathieu Bansard, 32, general practitioner in Les Pieux, a town of 3,000 inhabitants. du Cotentin whose main street is a mishmash of stone cottages and modern shops, including a bakery, a creperie and a hairdressing salon.

“I wanted him to understand that even here we could have optimal working and living conditions,” said Dr Bansard. “It’s not because we’re in the countryside that it stinks!

More than 30 people, including midwives and psychologists, work at the health center where Dr Bansard works. Located a hundred kilometers from Omaha Beach, it is an exception in the Cotentin peninsula, which suffers from a shortage of specialists such as dentists – only 33 per 100,000 inhabitants. The Doctors of the Piles already have 1,800 to 2,200 patients each, while the national average is around 900, making it “impossible” for newcomers to find a treating physician.

“The waiting time is appalling”, confides a patient, Didier Duval, 62 years old. “To see an ophthalmologist, you have to wait at least six months, whereas when I lived in Paris, it took less than 48 hours to choose between several.

After a morning of home visits and consultations, Dr Jardel left with his motorbike for a local nursing home. After an eight-minute drive along the Normandy coast, he met Natacha Carlat, a nurse who took him to two elderly patients. The coronavirus pandemic has exacerbated staff issues, she said.

“We never stop,” Ms. Carlat said. “A lot of doctors come in and out because, like us, they’re chasing time. “

To address the shortage of doctors in some areas, the French government tried to increase the supply last year of remove a cap on the number of medical students. But the gap between metropolitan areas and rural areas has widened. According to the Senate report on medical deserts, Paris and the Côte d’Azur have around 400 general practitioners and specialists per 100,000 inhabitants, while the national average is around 340.

Local authorities are trying to attract young doctors to underserved rural areas with incentives such as covering the tuition fees of newly graduated physiotherapists.

“It’s a charm offensive,” said Mr. Margueritte, the head of Cotentin. “We hope they have a crush.”

For some, the charm seemed to operate.

Axel Guérin, 25, a doctor in training at the University of Caen who works at the Pieux health center, said he was considering staying in the region after his six-month internship.

“I love the mentality, the rural life, the living environment,” he said, contemplating the panoramic sea view from his office. Doctors and interns sometimes enjoy lunchtime surf sessions, Dr Bansard said.

But Dr Jardel, the traveling doctor, was not wowed, even after two weeks and a farewell gift from Dr Bansard – beer from a local brewery.

“You can come back anytime, and don’t forget to bring us some friends!” said Dr Bansard, saying goodbye.

“I’m going into rural life, but moving here for the next 30 years I can’t,” Dr. Jardel admitted.

He stowed his motorbike in his camper van and passed Mont Saint-Michel – the Norman island abbey that dominates the region – for the next leg of his trip, in Brittany.

Following in his father’s footsteps, Dr. Jardel studied medicine for nine grueling years. But he wanted to take a “breath of fresh air” after graduation, in the midst of the pandemic, by discovering the French countryside and its medical offices in small towns.

In Brittany, Dr Jardel replaced Dr Marion Molié, 33, the only doctor in Pleumeur-Gautier.

Originally from north-eastern France, Dr Molié fulfilled a dream by buying a stone house in this small town to live there with her husband and two children. Local authorities desperate for doctors paid Dr Molié’s secretary for a year and covered her office rent by around $ 600 for the first few months.

But after working there since September, she felt overwhelmed.

“Before, there were eight doctors,” said Dr Molié, who works in a care home founded by two doctors in 2014. They resigned less than a year later to open an office in a larger city.

“Now for the 8,000 inhabitants of the peninsula, there are only two of us,” she said.

Overloaded by the 1,800 patients she already treats, Dr Molié has said since March that she could not take new ones. The situation is becoming “more and more worrying,” she added, especially now that the doctor in a neighboring town is about to retire.

After visiting the retirement home and collecting the keys, Dr Jardel looked for a place to park his motorhome before sunset. Along the misty coastal landscape of Brittany, he settles alongside old fishermen.

Dr Jardel absorbed the salty sea breeze and observed the waves. He has already thought of a new project: creating an association to encourage other young doctors to discover underserved areas.

And would he embark on another Tour de France?

“It’s not impossible,” he said. “I saw 10 of the 101 departments in France. I still have 91 left.



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Newsrust - US Top News: A doctor's tour of France, a "medical desert" at the same time
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