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Even Doctors on Wheels

April 21, 2011

Tags: socialized medicine, French doctors, French socialized medicine, French medicine, American vs. French medicine, French social security benefits, French medical offices, medicine in France, cost of doctors in France, education in France, WHO, AARP

Doctors' names on apartment buildings

I’m sitting in my doctor’s office in Philadelphia, reading one of those medical magazines meant to keep patients happy while they’re waiting. On every page there is advertising for this vitamin and that drug, and for various doctors, both MDs and DOs, who are waiting for you—their next patient.

In one photo, a doctor stands in the middle of all the female help. He wears the proof of his medical degree--his stethoscope around his neck. Everyone else is dressed in colorful scrubs but carry no stethoscopes. And everyone is smiling. The ad lists the doctor’s address, phone numbers and the fact that he is board certified.

It’s a very typical ad for America and one that I’ve never seen in France, where medicines aren’t advertised on TV and doctors don’t solicit patients.

I know, I know, how much has been written about the perils of “socialized” medicine that threaten the American way of life. How people are suffering in Canada and England, and how they long to come here to be treated. I also know what I pay every month for health care insurance, even though I belong to a large group. The costs, despite a recession and new health care policies, keep going up.

I’ve also heard about terrible medical practices in all those other countries that have “fallen by the way” by adopting socialized medicine. I can’t speak about the health care system everywhere else, but I can describe my experiences in France.

For a long time in France, I paid my own fees as an outsider from the system. Now, of course, I’m connected to my husband’s social security benefits and pay little. I even have my own card with my unsmiling face (no happy expressions allowed), stamped on the front. Read the examples below and let me know what you think.

For the most part doctors’ offices are inside regular apartment buildings. There are few medical complexes. You take the elevator and enter an ordinary apartment, where the living room has become the waiting room. Ordinary chairs wait for you. Very little is color-coordinated. Everyone who enters says, "Bonjour," because that’s considered polite. Sometimes there’s a receptionist in a little alcove in the hall, sometimes not. The doctor often does his own scheduling.

The doctor comes out to greet you and you follow him/her into the office (one of the original bedrooms). If you’re a French citizen, you have a medical card that the doctor swipes in a computer terminal. All of your medical information is instantly available to him. The doctor types the reason for your visit that is instantly added to your history.

Then you’re examined, right there on a table that is usually in the same room as the office. The doctor doesn’t hop between patients. No assistants jump in to take your vitals. You are with only the doctor for the whole time.

My husband visited a cardiologist. As part of the exam, the doctor did an echocardiogram during the same visit. He showed my husband the screen and explained all the sign posts of healthy arteries. He even did a “Marie Antoinette,” as he called laughingly it, to produce a cross section of my husband’s carotid arteries.

“All clear,” he pronounced.

We didn’t have to make an additional appointment to see a radiologist and then wait a week (full of anxiety) for the doctor to call with the results.

One summer, my son visited us in France and complained of pain in his back. I did the normal Mother thing. Doctor’s appointment. Long conversation.

“I’d like to do an x-ray,” she explained.

“How long will that take?” I asked anxiously, remembering how things were at home.

“Just walk two blocks to this office,” she wrote down the name. “And I’ll call them for you. But there’s no emergency.”

We walked. We waited 20 minutes. He had the x-ray. Another 20 minutes. The radiologist invited us to see the film.

“Nothing to worry about. Just muscular,” the doctor explained, pointing to clean areas in his back. She gave me the films to take home.

The cost? 120 euros. For the doctors, the x-rays, the explanation. Over in one hour.

Then there was the summer when I grew more and more dizzy. I’d walk down the street with my head spinning, as though my equilibrium had been thrown away with the morning trash.

I was scared. Immediately that imagination of mine took over, conjuring up every dread disease known to man.

My husband called a specialist, an ENT doctor. “Let’s start there,” he insisted.

My appointment was scheduled for the next day. The doctor greeted me, went through my history, listened to my complaints. Then he led me to a small room fitted with audiology testing equipment.

No assistant appeared to run the test. For the next half hour, the doctor dialed the sounds as he formulated his diagnosis. Swelling in my inner ear was causing the dizziness. Ahhh, I breathed out.

His charge—60 euros.

My next stop was to the pharmacy where someone taught me to operate a breathing machine that would deliver medicine to my inner ear. 30 minutes. 75 euros to rent the machine, half of that only a security deposit.

A flu shot at the pharmacy in France? 4 Euros. Here at RiteAide--$30, even with health insurance.

If you need a doctor right away for an illness that doesn’t require the hospital ER, you simply call SOS Medicine and a doctor will arrive—most often on scooter. And there’s something wonderful about being treated in a polite atmosphere, where no one is rushed to see the next patient.

The French believe that everyone is entitled to health care. Yes, they pay high taxes—a sliding scale up to 50 %, for the rich, rich people, based on what people make. My husband says it’s not an exact science. Social security gives you 75% reimbursement for medical care, but if you have no money, the government pays everything. Some decide to buy an additional private policy for the rest. The French also get retirement, disability insurance, and free education for all their children—even to the Sorbonne, if the kid is smart enough to get in. Medical doctors are trained for FREE. They don’t leave medical school with more than a hundred thousand dollars of debt.

Finally, I just read an article in AARP magazine about expats living in foreign countries. They quoted WHO (World Health Organization) that listed the French system as the best in the world.

One person’s experiences. I have skilled, caring doctors here in Philadelphia. But I often wonder why we can’t be more like the French.