2023-06-12 08:00:02
Emmanuel Vigneron, geographer and historian specializing in health, discusses the emergence of the problem of the distribution of doctors on the territory. “In the early 2000s, the number of doctors only increased marginally, it even decreased in the ranks of general practitioners”he describes, while in parallel “the needs are constantly increasing, with an aging population and an increasing demand for care”. This is when access to care becomes difficult, beyond the countryside and the suburbs, in many small towns.
Is the question of the distribution of doctors recent in the public debate?
The political world has begun to care about medical deserts twenty years ago. But they’ve been around a lot longer, that’s an old topic. It is possible to go back to the French Revolution, a period during which the question of the scarcity of supply arose in the deep countryside. In the 19the century, the growing suburbs suffered in turn from the lack of doctors. Public authorities invent health centers in an attempt to respond to this.
From the Liberation, it was believed that the problem of poor distribution would solve itself thanks to the increase in the number of doctors. It was the “glorious thirty”, the number of doctors exploded. Until the 1970s: with the oil shock and economic activity slowing down, health expenditure was then considered expensive and the public authorities put in place the constraint of the numerus clausus [un nombre d’étudiants autorisés à poursuivre en études de médecine]. A vice originally proposed at the start of the 1969 academic year by the faculties of medicine, who wanted to avoid the contamination of May 68 within them, the plethora of students, the devaluation of their profession… Over the years, the vice of tightened, to arrive at 3,500 places only in 1993. And at the end of the 1990s, we find ourselves mechanically with a progression of the medical population which slows down.
Why do medical deserts impose themselves as a central subject in terms of health?
At the beginning of the 2000s, the number of doctors only increased marginally, it even decreased in the ranks of general practitioners – these are the effects of the tightest numerus clausus of the previous decade. At the same time, needs are constantly increasing, with an aging population and rising demand for care. It was at this point that the problem of the distribution of doctors across the territory came to light.
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