Médecine de Proximité

The so-called "Hubert Report" was released November 25. This is a study of the future of generalist medicine in France and was commissioned by Nicolas Sarkozy this summer. Hubert is Elisabeth Hubert, a former general practitioner and minister of health. She was essentially asked to come up with a plan to bolster generalist medicine and, indirectly, primary care.

The report focused on expanding he generalist workforce by instituting required clerkships in ambulatory settings. The idea is to involve more office based physicians in training with the hope that this will expose the medical students to the benefits of this form of practice.

There will also be an expansion of the number of slots for an internship year that prepares new doctors for general medicine. They'll still have the opportunity to move on to specialties after the internship, but, again the hope is that many will choose to stick with primary care and community based group practice in general medicine. There is also emphasis on the promotion of multispecialty group practice and the formation of networks of primary caregivers.

The report covers many issues related to the organization of health care in France and the place of independent practitioners (medecins liberaux). President Sarkozy, in his remarks on the release of the report, promised to propose extensive changes in how health care is paid for and structured. He tasked the new Minister of Health, Nora Berra, as well as former minister, Xavier Bertrand and education minister, Valerie Pecresse to forge ahead with reforms to strengthen generalist care and "médecine de proximité", which Google translates as "outreach medicine".

Yann Bourgeuil, head of IRDES, a research center in Paris that has been working on the evaluation of interdisciplinary care and networks of primary care practices commented on the report on France2, one of the main television networks in France. I'll post his interview when the URL is available.