Lilian and I both had annual checkups recently. Finding a primary care physician here in Lyon can be an exercise in futility and frustration. There’s a shortage of physicians, and just about everyone I found on Doctolib (the app we use for booking medical appointments) had a note saying that they’re not taking new patients. Everyone in France needs a “medicin traitant” (primary care doctor) for things like ordering tests and approving specialists. I won’t be using any of those services until I get all of my paperwork taken care of. But, I figured I should still find a doctor that I can stay with for the long haul.
I like Doctolib, but its filters leave a lot to be desired. There’s an option to filter for spoken languages, but “speaks English” is well and truly in the eye of the beholder. I saw a gynecologist over the summer and you could have knocked me over with a feather when she asked if I’d prefer to converse in English. Every other doctor’s appointment has been in French. Also, you can filter for “appointments available online,” but I must have clicked on 50 different profiles just to read that all appointments were reserved for existing patients.
I eventually gave up on finding a doctor in the city and booked something with a doctor out in the suburbs. It took me maybe 30-45 minutes to get there today on the bus. Which seems like an eternity by local standards (the office admin actually remarked about how far I’d come), but wouldn’t have been that bad back in Boston.
Getting an appointment for Lilian was comparatively easy. Most primary care doctors will still take children as new patients (even if they’re not accepting adults). We still spoke with her doctor in French, but at this point I’m getting better at conversing in French.
All of the doctors’ offices that we’ve been to here have been really bare bones. There’s an office admin, but no other staff besides the doctor. The admin today asked me what my height and weight were, and waved me over to a scale in the corner of her office when I didn’t actually know. She then sent me to wait in the waiting room, where I was the only patient. The doctor came right on time to collect me. I’m used to seeing a medical assistant or a nurse first, but every appointment here has begun directly with the doctor.
We went over some basic demographic information and health history. I had all of the results from the last round of bloodwork that I did in the US and she seemed struck by how many tests they’d run. She said all of my numbers were good, so she didn’t feel the need to order any. She did a brief exam (took my blood pressure, listened to my heart and lungs, etc) but mostly she took me at my word that I felt fine and didn’t have any health problems. I think she’ll order bloodwork next year when I have a Carte Vitale and won’t have to pay for everything myself.
I paid a whopping 30 euros out of pocket for the appointment.
One interesting difference: in France, you get a TDaP booster at set ages: 25, 45 and 65. They don’t do a booster every 10 years, until you’re in your 70s. I had the shot a couple of years ago, so I guess I don’t need another one until I’m almost retirement age? Twenty years between boosters seems like an awfully long time, but apparently they don’t do any tetanus boosters in the UK. Medicine is wild.
Fun fact: In France, if you don’t vaccinate your kids to the point where you’re deemed to have “endangered the health of [your] minor child,” you can be prosecuted for it. The punishment is 2 years in prison and a fine of at least €30,000.
(Good for France!)
Another interesting difference: Lilian’s doctor gave her a (paper) prescription for the vaccine that she needs. I thought I might have misunderstood her when she told me to pick up said vaccine at a pharmacy before her next appointment in a few months. But, no, a French friend confirmed that we should do just that. We also have the option of having the pharmacist administer the vaccination. I’ve spoken to some doctors in the US who told me that keeping vaccines in stock resulted in them losing money every time they administer a routine childhood vaccination, so I am thinking it probably help keep costs down that the medical offices here don’t have to store them.
Lilian’s doctor also included a topical numbing patch and some ibuprofen for when she gets her vaccine. Because they were prescribed by the doctor, I believe they should be free. I guess we’ll find out!
Most of my friends back in the US are getting their first colonoscopies, but in France they don’t do colorectal screening until the age of 50. They also test via stool sample. Every two years, you pick up a free testing kit at the pharmacy, collect the sample, and then mail it off to a lab. Colonoscopies are reserved for folks who have a positive result on their screening test, or if there is family/medical history that makes colorectal cancer more likely.
(I wonder if “spent the first 44 years of my life eating American fast food” qualifies as a family history?)
France and the US have the same general guidelines for Pap smears, but they don’t do mammograms until the age of 50 (in the US it’s 40). A doctor can still order a pap or a mammogram for a younger person if they think it’s necessary. Everything is covered by social security.
As an American who’s used to having all.the.tests, it can be a little unnerving to have a doctor say “well, it sounds like you’re fine. Carry on!” But, then again, for all of the smoking and drinking that they do, the French have some of the highest life expectancies in Europe. And their numbers put the US to shame.
I will say, it’s super nice to go to the doctor and not wait an extra hour for a rushed appointment.
