exile
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Massif Central
Posts: 2,685
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Post by exile on Jan 21, 2022 22:24:18 GMT 1
That last comment is utter tosh. No it isn't. In my reasonably wide circle of friends, there are quite a few nurses and teachers, and one doctor. OK...not exactly a mori poll They're all of the same opinion, though, that the medical and teaching professions as they stand today have changed. The career structures have changed. The self-perception of the people employed in those professions has changed. The thing that proves beyond a shadow of a doubt how little vocation counts, at least among MTs, is the medical desertification in rural France. Despite generous government incentives and Maires bending over backwards to provide facilities, young doctors simply don't want to know. We're now in a situation where A&E departments in main hospitals are closing between 20h and 8h during holiday periods, because there are no urgentists. I'm sure there are still individuals in all three professions that do still have a vocation, but I stand by my opinion that there are many, many more that put that quality way down on their priorities after money, career prospects, personal life and status. But isn't there an alternative view of that situation? Despite the monetary incentives these MTs are so vocationally dedicated to their current situation, that they are not prepared to accept the bribes. (my words). Is it better to be vocationally dedicated to 20,000 clientele who you already know and whose needs you understand, or to move to somewhere you don't know and care for 10,000 people?
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Post by houpla on Jan 22, 2022 6:26:31 GMT 1
Unfortunately, that's not quite the situation, exile. We're talking about newly-qualified doctors looking to set up a practice or replace retiring MTs. A) They're less interested in general practice with it's long, sometimes unsociable hours, than hospital work in the big towns and cities. B) They're quoted as citing 'isolation' as being one of the reasons for not taking up rural practices, yet a lot of communes are investing heavily in pôles de santé to address that problem. Maisons de santé, where they'd be working with other MTs, nurses, physios etc etc. It's not working. I don't know how the French system of remunerating MTs works, since the introduction of the Carte Vitale, but presumably, the level of pay is higher in a city hospital? As someone said in another thread, there's also the need for some of them to fit in with their partner's job. The answer, at least round here, is trying to fill gaps with Portugese, Romanians, any nationality you'd care to name..... That's not working either, as the candidates are often rejected by the governing body due to lack of language skills.
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Post by houpla on Jan 22, 2022 6:32:48 GMT 1
No it isn't. In my reasonably wide circle of friends, there are quite a few nurses and teachers, and one doctor. OK...not exactly a mori poll They're all of the same opinion, though, that the medical and teaching professions as they stand today have changed. The career structures have changed. The self-perception of the people employed in those professions has changed. The thing that proves beyond a shadow of a doubt how little vocation counts, at least among MTs, is the medical desertification in rural France. Despite generous government incentives and Maires bending over backwards to provide facilities, young doctors simply don't want to know. We're now in a situation where A&E departments in main hospitals are closing between 20h and 8h during holiday periods, because there are no urgentists. I'm sure there are still individuals in all three professions that do still have a vocation, but I stand by my opinion that there are many, many more that put that quality way down on their priorities after money, career prospects, personal life and status. Well, that's a comprehensive study to back up your earlier assertion. For myself I can merely offer a career in medicine so only meeting many hundreds of health professionals the majority of whom continued to undertake their vocation in spite of encountering the sort of total bollocks above, But I'm retired now and have no skin in the game so why I've even bothered to reply to someone whose depth of understanding and experience clearly exceeds mine, I've no idea. Me neither. As you don't seem to be able to put forward your point of view without resorting to high-handed abuse, it's of very little interest.
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Post by ForumUser2 on Jan 22, 2022 7:48:58 GMT 1
Well, that's a comprehensive study to back up your earlier assertion. For myself I can merely offer a career in medicine so only meeting many hundreds of health professionals the majority of whom continued to undertake their vocation in spite of encountering the sort of total bollocks above, But I'm retired now and have no skin in the game so why I've even bothered to reply to someone whose depth of understanding and experience clearly exceeds mine, I've no idea. Me neither. As you don't seem to be able to put forward your point of view without resorting to high-handed abuse, it's of very little interest. Im sure it is. You make a silly, unsupported, high-handed statement that there is no vocational pull to young professionals any more without having the first idea of what drives people to join these professions, That sort of prejudice and ignorance needs challenged.
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FFS
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As usual, in front of my laptop when I'm here
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Post by FFS on Jan 22, 2022 11:09:51 GMT 1
There was an item on the news the other day about a Maison de Santé, somewhere in the Hauts de France, which has recently opened with 5 or 6 MTs. Previously there were 2 MTs for 10.000 inhabitants, now there is the Maison de Santé with 5 or 6, all employed and paid by the département. I think that sort of arrangement could work elsewhere.
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Post by ForumUser2 on Jan 22, 2022 11:59:13 GMT 1
There was an item on the news the other day about a Maison de Santé, somewhere in the Hauts de France, which has recently opened with 5 or 6 MTs. Previously there were 2 MTs for 10.000 inhabitants, now there is the Maison de Santé with 5 or 6, all employed and paid by the département. I think that sort of arrangement could work elsewhere. It's becoming increasingly difficult to practise as a lone GP largely because of the complexity of modern medicine but also the administrative burden of modern practice. Small regional Maisons de Sante such as you describe have many advantages: clinical cover, broader interests and experience, centralised admin, reduced costs per practitioner, shared knowledge and so forth. I would even go so far as to say that anyone considering solo practice is placing themselves in professional and financial jeopardy while being unable fully to support their patients.
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Deleted
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Post by Deleted on Jan 22, 2022 12:07:57 GMT 1
If there was a lack of vocation,do you seriously think that health services would still be running after the last two years?
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FFS
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As usual, in front of my laptop when I'm here
Posts: 2,797
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Post by FFS on Jan 22, 2022 12:17:02 GMT 1
It's becoming increasingly difficult to practise as a lone GP largely because of the complexity of modern medicine but also the administrative burden of modern practice. Small regional Maisons de Sante such as you describe have many advantages: clinical cover, broader interests and experience, centralised admin, reduced costs per practitioner, shared knowledge and so forth. I think that's precisely why multi-practitioner arrangements are the solution; someone starting a professional career is enormously helped by the opportunity to share, be it experiences, expenses, or patients.
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Post by ajm on Jan 22, 2022 12:29:03 GMT 1
When our MT told us he was going to retire we were a bit worried, but we got a new practice with 3 young doctors which is brilliant.
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Post by mangetout on Jan 22, 2022 14:22:40 GMT 1
Here's 2 instances of dedication beyond the call. Our MT told his patients he needed to retire on health grounds, he worked the 2 week notice period with his usual dedication and made sure we would be ok, even sorting out new MT's for those of us with serious health problems. He held our hands, told us not to worry, that we would be well cared for. He died 2 days later. He had advanced cancer.
And today I went to the pharmacy, obviously distraught because my husband was crying with pain that is too much for his current meds. The pharmacist spent 30 minutes ringing round, got an ordonnance from the cancer clinic and gave me enough morphine for 10 days. I didn't even have a carte vitale with me, but she waived the need.
People like that have something special which no amount of money generates.
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Deleted
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Post by Deleted on Jan 22, 2022 14:27:51 GMT 1
I feel awful liking the above because poor Mangetout husband is suffering,I like the point she makes
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Post by lindalovely on Jan 22, 2022 15:30:06 GMT 1
I can't say I've noticed any lack of vocation in the healthcare professionals I teach. In deed many of them have given up lucrative jobs in other fields to retrain, for the desire to work in a more meaningful job. Of course that comes with other complications..being older they may have young families to support and partners who have full time jobs to consider, which limits their choices for jobs.
In France setting up as a professional liberale is quite a step and younger professionals prefer to be employed for a while before committing to one area. I can completely understand that. I did the same when I was younger..changing jobs every year or so..
My nephew's girlfriend is training to be a gastroenterologist. She worked as a doctor on the medical wards in London throughout the pandemic. It was horribly stressful, like working in a war zone.. but even that and the fact that now it seems to have become fashionable to give doctors a hard time, she is still committed to her choice of career. The problem is in the not too distant future her and my nephew will want to be able to buy their own place and that is not remotely possible at the moment. They have already decided not to have children because they can't afford it and medical training is not conducive to family life.
Looking at the conditions they work in, compared to what it was like when I worked on the coalface, I can't imagine how they do remain positive, but they are young and resilient and so they do.
And yes every year on the course I teach on, there are 2 or 3 students that appear to have made the wrong career choice. Most realise before the end and change tack..some stick it out and qualify but don't stay long. This isn't a new thing. One of my flatmates at college finished the course and did one job, before she left and became a secretary.
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ibis
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Post by ibis on Jan 22, 2022 16:22:42 GMT 1
Spain has the same system as France seems to be implementing - a local health center. Many doctors, departments all in one building in the "neighborhood". Hospital for blood tests or specialized treatment... I think it works much better than the old French system. There are also many good to excellent private hospitals and clinics here which thru medical insurance come out cheaper per month than " paying into the system".
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