[van_suso]

Hello!

I'd like to ask two questions regarding doctors that're available online, e.g. on doctolib or mondocteur.

1) What do you do when you need to consult a specialized doctor (not GP) in a few days, and all the corresponding doctors seem to be booked for at least a month? For example, I need to visit a dermatologue soon but the earliest appointment I got was August 18th. Is there any hospital you can definitely go to (if possible, walk into?), that accepts carte vitale? P.S. I noticed GP's are free almost always in 2-3 days, even in July. On the other hand, speclialized doctors are always booked till late.

2) When I try to search for a specialty, say dermatologue, certain doctors' names show up, but when I take the appointment (rdv), I notice often that someone else is replacing the doctor (I see 'collaborateur du' or 'remplaçant du' + the doctor whose name is on the website) that was originally mentioned on the website(s) like doctolib. Now, I've consulted one of such replacement doctors, and apparently her name was not enlisted on website. Why is this the case? Does it mean these replacement doctors are not well-qualified or registered with the site(s) (I'd guess no)? I asked my previous doctor whether she's an intern, but she was an actual dermatologue. Somewhat frustrating though, the doctor whose name was on doctolib speaks English as per doctolib, but the replacement doesn't!

 

[DejW]

Try asking your médicin traitant for help, they know the details!

Also, it's France and the time of les grandes vacances.....expect closures, non availability and stand i s.


DejW

 

[van_suso]

Reply

Thanks, so are you saying that I can ask my medicin traitant about seeing other dermatologues (or referring to them?) or the question 1?


I know August is the tilme of les grandes vanaces, but even before I nopticed ther samel patterns-GP's are available quickly, but not specialized doctors, the waiting time for the later is always long!

Try asking your médicin traitant for help, they know the details!

Also, it's France and the time of les grandes vacances.....expect closures, non availability and stand i s.


DejW

 

[Bevdeforges]

The issue with specialists is pretty much the same as anywhere else - there simply aren't enough of them in a given area and they are simply booked solid well into the future. And to be honest, if you are limiting yourself to specialists available on one of those appointment booking sites, you're going to have even more difficulty. I don't know what percentage of doctors or specialists are registered with those booking sites, but it is by no means all of them, and possibly only a rather small percentage at this point.

As far as the GPs go, there are still some who have open office hours - where you don't need an appointment, just wait your turn. Even so, GPs are generally used for somewhat short appointments within the next day or so and serve to some extent as a sort of "triage" system to refer you to a specialist if you need one. You're far more likely to actually receive a procedure or treatment at a specialist's office and all that takes time.

As far as the substitutes go, they are fully qualified practitioners who fill in for a doctor when the doctor is on vacation or otherwise unavailable. Very often it will be a doctor who, for whatever reason, prefers practicing on a part-time basis. I know my GP had a locum one day a week because she is starting to cut back her own hours as she approaches retirement. My husband's daughter in law does something similar since the births of her children so that she isn't committed to a full time practice and can control her hours while still having access to the "main" doctor's patient records.
Cheers,
Bev

 

[van_suso]

Thanks Bev for the explanation, and particularly for mentioning the fact that only a small percentage of doctors ara available on the websites!

From what you wrote, it seems that I need to just google something like "doctors with specialty (*) in Paris", call them up and book an appointment, if I prefer not to wait for the appontment obtained from the site(s)?

Speaking about the "triage" system you mentioned, if I just ask my GP (médicin traitant) to refer me to some doctors with the specialty I need, will that help me get a quicker appointment with the specialist, because the GP and the specialist probably knows each other?

 

[DejW]

I think it works like this......the med traitant will give you a letter to see the specialist ( not needed for optho and gynie). I think you are free to go to any specialist.....but the MT may recommend one...for a variety of professional and perhaps "friend" reasons. If you ask the MT may help you by recommending one with shorter waiting list. Some MT are more helpful / time pressed than others. If it's really urgent the MT may use his power and telephone for you,but this varies a lot, I've found.

....don't expect to find English speaking doctors in France.....just learn the key words and take a dictionary with you. Some Fr doctors are good at reading English because they read Eng lang journals. However, few are good at "consulting room" discussions. I've spent too much time in hospital beds over recent years. Some doctors/nurses etc wanted to improve their English by speaking it with me. I tried to avoid this, as it's essential the learn the Fr words...the next doctor you see may not understand the English technical words you learnt from the previous one.

DejW

I've found that some medical professionals only accept internet bookings(for example my osteopath), others not at all....and some in between the two!

 

[Carlene]

Thanks Bev for the explanation, and particularly for mentioning the fact that only a small percentage of doctors ara available on the websites!

From what you wrote, it seems that I need to just google something like "doctors with specialty (*) in Paris", call them up and book an appointment, if I prefer not to wait for the appontment obtained from the site(s)?

Speaking about the "triage" system you mentioned, if I just ask my GP (médicin traitant) to refer me to some doctors with the specialty I need, will that help me get a quicker appointment with the specialist, because the GP and the specialist probably knows each other?

My dr referred me to a dermatologue and that did not make my appointment faster. I still had to take whatever was available and in my case I had to wait four weeks (this was in May by the way). I called the dr's directly though and did not try to book online, because sometimes you get luckier that way.

 

[van_suso]

Reply

I think it works like this......the med traitant will give you a letter to see the specialist ( not needed for optho and gynie). I think you are free to go to any specialist.....but the MT may recommend one...for a variety of professional and perhaps "friend" reasons. If you ask the MT may help you by recommending one with shorter waiting list. Some MT are more helpful / time pressed than others. If it's really urgent the MT may use his power and telephone for you,but this varies a lot, I've found.

Thank you for the detailed account! Yes, I was also thinking along the line of the "friend reasons" that you mentioned, but it's understandable that making the whole process faster depends on the individual MT and his "friendship" with the specialized doctor.

....don't expect to find English speaking doctors in France.....just learn the key words and take a dictionary with you. Some Fr doctors are good at reading English because they read Eng lang journals. However, few are good at "consulting room" discussions. I've spent too much time in hospital beds over recent years. Some doctors/nurses etc wanted to improve their English by speaking it with me. I tried to avoid this, as it's essential the learn the Fr words...the next doctor you see may not understand the English technical words you learnt from the previous one.


Yes that's indeed a great point!
DejW

I've found that some medical professionals only accept internet bookings(for example my osteopath), others not at all....and some in between the two!

Okay I'll keep that in mind too.

 

[van_suso]

My dr referred me to a dermatologue and that did not make my appointment faster. I still had to take whatever was available and in my case I had to wait four weeks (this was in May by the way). I called the dr's directly though and did not try to book online, because sometimes you get luckier that way.

Thanks for sharing your experience, yes I also had almost a month's wait to visit a specialized doctor. But calling them directly never hurts I guess!

 

[Bevdeforges]

Thanks for sharing your experience, yes I also had almost a month's wait to visit a specialized doctor. But calling them directly never hurts I guess!

A month wait for a specialist really isn't too bad. If it's something urgent, your GP may contact the specialist they recommend on your behalf to see if you can be worked into the schedule on an "urgent" basis, but other than that, expect a wait of 3 to 6 weeks minimum to see most specialists. Certain specialists, particularly opthalmologists, can be 2 to 3 months, and the ophthalmo my husband sees takes appointments 8 to 12 months in advance.

Recently heard from a friend who is well connected within the medical establishment here that certain parts of the Ile de France (Paris region) are, in fact, "medical deserts" - meaning that there aren't nearly enough specialists available for the number of people who live in the area. It's far more common for areas out in the countryside to be declared "medical deserts" and apparently the authorities have been hesitant to declare parts of the Paris region but evidently we meet the criteria and may well be officially declared sometime after the Rentrée.
Cheers,
Bev

 

[95995]

You would be surprised how many areas, not just in the countryside, are at least technically medical deserts. This has not been helped by the number of doctors who have recently or will very soon retire. I think you can expect to see many more areas officially declared over coming months (and possibly coming years). Specialists are no exception. There is a significant problem here in Pau, for example - although at least nearly everyone is aware of it here.

 

[ToulouseRob]

When I consult my GP and she refers me to a specialist I always ask if she can recommend one, and always make a point of starting my conversation with the specialist/specialist's secretary "I was recommended by Dr XXX to consult you about ... ". But I have no idea if it does any good! I also ask my GP how urgent it needs to be.

My OH did this once, and the GP herself phoned the specialist there and then and asked "Hi XXX, how soon can you see a patient of mine ... ". She was booked in for a day or two later. So in that case the GP was very helpful indeed.

While I'm here I'll pose this question: Bev hinted above that you might need a letter referring you to a specialist otherwise you might not get an appointment at all, but is it the case that the CPAM (and hence the mutuelle if you have one) will only reimburse you if the GP refers you to a specialist?

 

[95995]

When I consult my GP and she refers me to a specialist I always ask if she can recommend one, and always make a point of starting my conversation with the specialist/specialist's secretary "I was recommended by Dr XXX to consult you about ... ". But I have no idea if it does any good! I also ask my GP how urgent it needs to be.

My OH did this once, and the GP herself phoned the specialist there and then and asked "Hi XXX, how soon can you see a patient of mine ... ". She was booked in for a day or two later. So in that case the GP was very helpful indeed.

While I'm here I'll pose this question: Bev hinted above that you might need a letter referring you to a specialist otherwise you might not get an appointment at all, but is it the case that the CPAM (and hence the mutuelle if you have one) will only reimburse you if the GP refers you to a specialist?

You a need a referral, except for eg. gynae, eye specialist, in order to be reimbursed by both CPAM and your mutuelle..

 

[Bevdeforges]

You a need a referral, except for eg. gynae, eye specialist, in order to be reimbursed by both CPAM and your mutuelle..

That said, I don't know precisely how the information about the referral is transferred to the CPAM (and hence on to the mutuelle). Every time I've had a referral, the doctor has given me a handwritten letter in an envelope (which I usually open and read for myself) to give to the specialist, who keeps the letter. Not sure if the specialist notes in their system the name of the referring doctor or how that works, but it seems to all happen through the computer system.

If the specialist were to give you a feuille de soin, I don't know if you would/should include a copy of the letter when sending that in to CPAM. Never done anything like that, which is why I assume it is somehow handled through the doctor's system.
Cheers,
Bev

 

[DejW]

On one occasion my wife lost the letter....she went ahead with the appointment...cardio I think. The specialist didn't seem to mind at all. Clearly there are cases when a letter is essential, two that come to mind are A.. patient doesn't understand, B. there are special other factors that the specialist should bear in mind.(this English male patient is stupid and tells terrible jokes)...in my case.

DejW

 

[van_suso]

Reply

You a need a referral, except for eg. gynae, eye specialist, in order to be reimbursed by both CPAM and your mutuelle..

Okay, so I saw a dermatologue today, and he asked for my GP's name while putting in my Carte Vitale. Doesthis automatically translate to being referred by my GP for better reimbursement? Thanks for answering!

 

[van_suso]

Reply

That said, I don't know precisely how the information about the referral is transferred to the CPAM (and hence on to the mutuelle). Every time I've had a referral, the doctor has given me a handwritten letter in an envelope (which I usually open and read for myself) to give to the specialist, who keeps the letter. Not sure if the specialist notes in their system the name of the referring doctor or how that works, but it seems to all happen through the computer system.

If the specialist were to give you a feuille de soin, I don't know if you would/should include a copy of the letter when sending that in to CPAM. Never done anything like that, which is why I assume it is somehow handled through the doctor's system.
Cheers,
Bev

Thanks for the info. So I visited a specialist today, and he put in my carte vitale and asked for mt GP's name. My GP didn't refer to him. But does this mean I'm going to get at least 70% reimbursement for seeing this specialist? The specialist didn't give any feuille de soin or any document.

 

[van_suso]

Reply

When I consult my GP and she refers me to a specialist I always ask if she can recommend one, and always make a point of starting my conversation with the specialist/specialist's secretary "I was recommended by Dr XXX to consult you about ... ". But I have no idea if it does any good! I also ask my GP how urgent it needs to be.

My OH did this once, and the GP herself phoned the specialist there and then and asked "Hi XXX, how soon can you see a patient of mine ... ". She was booked in for a day or two later. So in that case the GP was very helpful indeed.

While I'm here I'll pose this question: Bev hinted above that you might need a letter referring you to a specialist otherwise you might not get an appointment at all, but is it the case that the CPAM (and hence the mutuelle if you have one) will only reimburse you if the GP refers you to a specialist?

I actually asked a related question today. I saw a specialist not referred by m GP. The specialist did out my carte vitale in the machine and ask for my GP's name. If CPAM wouldn't have reimbursed me at all, then I wonder what's the point of doing so? Also, long before I saw another specialist not referred by anyone, and then I didn't even have the carte vitale. But this specialist did give me the reimbursement to claim the doctor's fee from CPAM. This isn't helpful, but just noting down.

 

[95995]

Okay, so I saw a dermatologue today, and he asked for my GP's name while putting in my Carte Vitale. Doesthis automatically translate to being referred by my GP for better reimbursement? Thanks for answering!

But did you not have an ordonnance from your GP? It doesn't have to be to the specific specialist you see. It sounds like you didn't, but the specialist may just check with your GP, although he needs at least the GP's name anyway.

 

[van_suso]

Reply

But did you not have an ordonnance from your GP? It doesn't have to be to the specific specialist you see. It sounds like you didn't, but the specialist may just check with your GP, although he needs at least the GP's name anyway.

I had nothing from my GP-I made an appointment independently on doctolib. But will I get the reimbursement from CPAM? I'd hope so. Otherwise, why would he put my carte vitale in his machine?