MRIs in France

MRIs in France, or the lack of MRIs in France
A new survey reported in Quotidien du Medecin this week reveals that France has one of the lowest rates of access to MRIs in Europe. The chairman of the French Society of Radiology, Jean-Pierre Pruvo called the situation a “scandal” in an interview in November of 2009. There have been some discussions of how the new regional authorities, the Agences Regionale de Santé (ARS) will change that, but little has been done according to the annual survey by Imagerie Santé Avenir (ISA).

That survey showed France has 8.7 MRI units per million inhabitants (543 machines in January 2010) and waiting times for a scan average 35 days, the same wait as in 2004. In contrast, Germany had 20 per million, Norway 25, Iceland 19.3; and Italy, 18.6 per million. The Unites States has 26 per million, the most of any country.

The lack of MRI scanners is threatening to derail the French National Plan for Cancer which calls for a waiting time for scan of no less than 10 days. The waiting times vary widely by region with the Pays-de-la-Loire having the longest at 58 days. The shortest waits are in Picardie (22.3 days)

The arguments for expanding the supply of MRI units rests on the grounds of cost reductions. Dr. Pruvo cited several examples of more costly surgery and invasive procedures to resolve diagnoses and initiate treatment.

The concern in the US has been with the overuse of MRIs and CT scanners. A recent NEJM article (Michael S. Lauer, NEJM August 27, 2009) estimated that up to 4 million Americans were receiving doses of radiation that were likely to cause cancer.

Who's Striking Today

In France strikes are a regular thing. Sometimes causing misery but mostly it’s a focused group of raucous people chanting in front of some administration building making their claim for more money or more time off. What may seem unusual to an American is the regular participation of healthcare workers in strikes

This past month we’ve seen a variation on the theme as nurse anesthetists wearing full operating room garb sat on the railway tracks just outside the Gare Montparnasse, blocking all the trains headed west from Paris or into the city from Brittany. Their complaint was over proposed changes to the retirement age, from age 60 to 61 or 62. The vague proposal was part of President Sarkozy’s response to the need for fiscal belt-tightening.

Generalist physician announced their intent to close their offices on June 18 to “educate the local elected officials” about their need to raise their consultation fee from 22 to 23 euros. “We will not wait any longer,” said the secretary general of the Medecins Generalistes-France, Vincent Rebeille-Borgella.

Doctors going on strike is virtually unheard of in the United States and it is generally illegal with a few exceptions. But in France it is something of a tradition. For example, in January 2020 there was the “Day Without Doctors” where three-quarters of all office based physicians stayed home.