Wednesday, May 16, 2012

Medically Speaking

There is a problem amongst the medical fraternity in France: no-one wants to be a country GP (médecin généraliste)any more.  Live in the country far, far from all amenities (aka, outside the Paris ring road, but we’ve been there in another post) where the nights are dark (been there too) and culture is lacking? Non, merci. The older GPs are retiring, or dying out, and it is increasingly difficult to convince any young up and comer that he or she could continue to come up whilst dwelling outside a major conurbation. 

It’s not as though there are many major conurbations to start with – there are only about five real cities in France – so it would actually be harder, statistically speaking, to work within a conurbation than outside of one, without being stacked one on top of the other. The idea of being the Big Fish in the small pond just doesn’t seem to translate. That, or the French think small ponds are over-rated. 

We used to have a small pond, and it was full of interesting life forms. 

In our old village, the GP was also the Maire. He was, and apparently still is, a chronic late-arriver. Appointments were blithely made by his secretariat for 9 am in the certain knowledge that he wouldn’t turn up before ten, when the waiting room would be packed and every single patient there would present with high blood pressure. It was possible to arrive to find the door locked, and we would all be sitting in our cars when he got there looking quite unabashed. I made the mistake of walking there once, and spent a good hour wandering up and down a plain and not very interesting housing estate road in the cold until he arrived. He never once apologised. 

The upside was that once you got in to see him, he would give you all the time you wanted – up to 45 minutes on occasion. The downside to that was that having waited to get into the building, you then also had to wait whilst everyone in the queue ahead of you grabbed their chance to discuss everything in minute detail for as long as they could. Your revenge was that the GP would be late for his lunch. His was that he would be even later for afternoon surgery. You couldn’t win. 

The previous owner of our last house used to be the district nurse. They still have them here, doing the rounds of country homes to take blood, or change dressings or visit new mothers, and they do an important job. They aren’t attached to the doctor’s surgery, but have their own offices and are self-employed.  One year when she was away, our friend employed as a locum a young lady from Paris. She looked like a city person. She dressed like a city person. She didn’t know what a farmyard was. She didn’t own a pair of wellingtons

One day she went to see an elderly gent who offered her coffee, and being polite, she accepted. So on went the pan of stiff coffee that had been lurking on the side, and he looked around for something in which to serve it. To her horror and consternation, he picked up a glass, took the false teeth out of it and popped them in his mouth, rinsed it under the tap, and poured the coffee into it and handed it to her. 

She was forever unavailable after that. 

Perhaps it is fear of that sort of experience that puts the newly qualified GPs off the idea of moving outside the city walls. If they can be so upset by the threat of a dirty farmyard, or an unsavoury glass of coffee, do you really want to be treated by such a person? Worse, would you want a home visit? However ill you were, you would spend the hour before the appointment cleaning and tidying both house and self. He’s a Parisian, you’d say, sneeringly – and you wouldn’t want him to be able to look down his patrician (and very clean) nose at you. 

What’s needed is a dose of reality. All medical students should have to do at least a year in a country practise before being allowed back into the city.I’ve never met a medical student yet whose digs weren’t a total tip. So maybe that’s the answer: just tell them it’ll be like going back to their university days. By the time they find out you lied, it will be too late. 

All they need to know is to bring their wellies and avoid the coffee. How hard can it be?
©lms 2012

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