2023-09-27 07:49:00
In the industry, we call them “triple 0s”. Not flattering. However, they are indeed doctors, qualified by their State, competent to practice their art. Triple 0 doctors have an Inami number ending in “000”. Each doctor has an Inami number. This is made up of eleven digits and the last three specify the specialization of its holder. The triple 0 means that the doctor has no specialization and does not follow any training. He is also not a generalist.
“There are currently 2,440 doctors with a competence code 000, of which 1,025 have a foreign basic diploma and 1,415, a Belgian basic diploma, details the Federal Minister of Health, Frank Vandenbroucke (Vooruit), in a parliamentary response written addressed to MP Frieda Gijbels (N-VA). According to the data we have, only 324 doctors certified at least one service during the year 2021.”
Among these services, the three most common were consultations in a general practice, advice regarding continuity of care, and monitoring of a hospitalized person.
The UCLouvain Health Network explains that, in general, these doctors without specialization can prescribe medications, various examinations or physiotherapy services, for example. They can also provide routine care, monitor hospitalized people or lend a hand in an operating room, among other things. But certain acts are forbidden to them. As a result, they are paid less than their colleagues.
Young people waiting for training
Triple 0 doctors sometimes work in the private sector, particularly in the pharmaceutical sector, or in public health organizations. But they are more generally young graduates who either did not obtain the internship in the desired specialization (the number of places per specialization is limited) and decide to wait a year to try their luck again, or have finished their training (including specialization) and are waiting to receive their final approval, which can take two or three months. In the meantime, they work – often in hospitals – within the limits of the skills authorized by code 000. Finally, some triple 0s are satisfied with this status in their nursing activity.
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Triple 0 doctors complain of being hired by hospitals to fill frames and carry out dirty work.
“My concern is that these doctors are exploited by hospitals or healthcare institutions, or even find themselves in situations of fraud by providing services in the name of other doctors,” comments Gilbert Bejjani, vice-president of the Absym, the main doctors’ union. I ask for transparency about their situation: that we protect them and ensure that there is no fraud.”
“Absym is right,” says Paul De Munck, president of the GBO, another doctors’ union. There is a risk that triple 0s will be used as cheap labor in hospitals. There can be no question of using these doctors to replace general practitioners and fill what hospitals cannot find.”
Future hospital general practitioners?
“It’s true that it’s a risk,” reacts Manfredi Ventura, medical director of the Grand Hôpital de Charleroi and president of the French-speaking Association of Chief Physicians. I hear that triple 0 doctors complain about being hired by hospitals to fill frames and do the dirty work.”
Manfredi Ventura, medical director of the Grand Hôpital de Charleroi and president of the French-speaking Association of Chief Physicians. ©Jean Luc Flemal
At the Grand Hôpital de Charleroi, “we are currently thinking about determining reasonable scales”, whether for young people waiting to start a specialization or for doctors who are satisfied with their triple 0 status. The latter “ could for example become hospital general practitioners,” imagines Dr Ventura.
“It would be worth getting back to the table with the minister to find out what a triple 0 doctor can do and his level of remuneration,” concludes Paul De Munck. In any case, we are opposed to taking away their ability to provide and consult.”
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