Doctor’s orders…

Visiting a health centre can be daunting in a new country, so what can you expect in France? Lorraine Wylie explains

Few, regardless of where we live, relish the prospect of visiting the doctor. Stuffy old-fashioned waiting rooms may have been replaced by bright modern reception areas where the ping of an overhead electronic board announces who’s next in line but, whatever the technological improvements, there is no disguising the smell of an antiseptic surgery or the sight of a stethoscope.

In fact white coat’ syndrome, a condition that sends blood pressure soaring at the mere sight of a doctor, is a well-known phenomenon throughout medical circles.

France enjoys a reputation for having one of the best healthcare systems in the world. Shorter waiting times, shorter queues and prompt attention make for a precise diagnosis and early treatment. However, is a visit to the Continental surgery any

less stressful?

It is worth noting some of the cultural differences that influence attitudes and can lead to some surprises when visiting the doctor.

Choosing a doctor

For practical reasons, it makes sense to choose a doctor within the local area although, in many rural locations, the nearest GP can mean a 30-minute drive. For a routine visit, a half-hour journey is fine but in an emergency, it can seem an eternity. It is worth noting that, in France, doctors will still make house calls but it does entail an additional fee.

Another important factor to consider is the ability to communicate, which is a crucial component in the relationship between doctor and patient. Very often medical practitioners, particularly those based in towns or at hospitals, speak fluent English but language skills are not a feature of many country practices. Nevertheless, it is essential to find a doctor who, despite the difficulties, will try to ensure a good measure of understanding.

Undoubtedly, a valuable tool in the decision-making process is personal recommendation. Friends and neighbours will be happy to give advice. However, at the end of the day, the best thing to do is shop around. Visit two or three GP practices before deciding who will be your m�decin traitant.

Visiting the doctor

In most cases, a rendez-vous with the GP can be arranged within 24 hours. Sometimes an appointment will be offered the same day. It wasn’t so long ago that individuals could visit as many surgeries as they wished and had the right to go directly to a specialist without a GP referral but with so many medical practitioners involved in their patient’s care, doctors were unable to build a rapport and provide consistent treatment.

Specialists also found that, without medical input from their colleagues on the ground, patients were assessing their own need and many consultations were not only time-consuming but also unnecessary. In 2004, the Government decided to make it compulsory for everyone to choose a m�decin traitant and enjoy the benefits of regular healthcare from a specified practitioner.

It is still possible to exercise a wider freedom of choice and opt for medical variety or go straight for a hospital consultation, but such decisions come at a price. Charges for trips to an unspecified GP as well as specialist consultants incur a higher rate.

Although, when it comes to seeking expert advice, it may be some consolation to know that the services of gynaecologists, and ophthalmic surgeons, as well as psychiatric help for those under the age of 26, are not financially penalised.

First encounters: salle d’attente

Apart from a few modern touches, it seems that, when choosing d�cor, many city practices opt for functional rather than plush. Hard chairs, old magazines, noticeboards with advice on everything from diabetes to full jabs are all part and parcel of the waiting room d�cor. Colour schemes may vary but hushed silences are the common choice of ambience.

However, rural France is the exception to the rule. Seating may be just as uncomfortable, literature as outdated and noticeboards equally informative but the atmosphere is unique. In tiny villages where everyone knows their neighbour, a trip to the doctor’s is another opportunity to socialise.

Waiting for the GP to enter, shake hands and whisk you to his surgery can be an entertaining experience. As well as describing individual ailments, fellow patients love nothing more than a good debate on either politics or their favourite game of boules, both of which are guaranteed to inflame passions and set the heart racing!

Consulting room

When it comes to health, French doctors leave no stone unturned. Despite the informal, relaxed atmosphere, an initial visit usually involves a detailed account of the patient’s medical history.

This invariably includes a check on height, weight and blood pressure. Regardless of the nature of the complaint, the latter is a feature of every subsequent visit. Depending on whether the reading elicits an impeccable’ or an oh la la’, the patient will either receive an encouraging smile or an ordnance’ for medication.

French doctors tend to be proactive in their approach to preventing illness and will often prescribe a few lifestyle modifications before resorting to pharmaceutical alternatives. It has been known for individuals to receive a prescription giving them free access to the local swimming pool in an attempt to increase fitness levels and improve overall health.

Where possible, natural therapies like homeopathy are the preferred choice but when more orthodox treatment is needed, doctors are encouraged to choose generic brands as these are considered equally effective and less expensive.

The French medical system employs a regular screening programme for all patients and, depending on age and sex, individuals are invited to participate in a variety of medical investigations. From the age of 50, women are automatically referred for a mammogram while men are screened for prostate problems. Both sexes have the opportunity to be checked for cancer of the colon.

First visits are the longest, lasting anything from around 20 to 40 minutes but, in general, consultations take as long as the doctor feels necessary with no strict adherence to time. This aspect of care is certainly beneficial to the patient concerned but for those waiting it can mean a long time in la salle d’attente.

Diagnostic practices and treatment available may be reassuring but for many expats there is one aspect of a Continental consultation that can be surprising as well as embarrassing.

Patients used to covering their modesty during a physical examination, will find the lack of gown or discreetly placed sheet a little disconcerting. As with waiting room d�cor, French doctors tend to opt for the no-frills approach in the examination room, expecting patients to shed inhibitions along with their clothes.

While pouring resources into important areas like screening and alternative therapies is highly commendable, expecting patients to go au naturel without turning a hair might be taking things to the extreme!