Health is no longer the exclusive domain of physicians. In some cases, midwives, pharmacists, nurses and opticians can relay. But not always.
Broken to self-medication, the French are becoming better informed about the disease. They are able to perform testing at home, to read and react.
Without sufficient practitioners, time for an appointment is longer, the distance too, while the cost of experts' fees remain a barrier in accessing health of the poorest populations.
For these reasons, some medical acts are progressively delegated to pharmacists, midwives, nurses and opticians.
Influenza screening tests to the pharmacist
By pushing the door of a pharmacy, you can now get information on the nature of your cold or your angina. Hitherto reserved for general practitioners, paediatricians or ENT, rapid screening tests can be performed by pharmacists.
This is a diagnostic orientation to the doctor for screening tonsillitis, flu but also diabetes For these tests, pharmacists must provide a confidential place.
For tonsillitis strep A, oropharyngeal test gives in 7 minutes causing sore throat. If the test is negative, you will save a consultation.
The pharmacist can then deliver you directly, for example, an anti-inflammatory or analgesic to relieve pain. It was only in the presence of a bacterial sore throat you consult a doctor for a prescription for antibiotics.
If you feel the flu, pharmacist practiced nasopharyngeal test, until now reserved to the doctor. Again, you will get the answer in less than 10 minutes. You will leave with appropriate medication if it is a virus and your condition does not inspire anxiety.
If you have the flu, fever and respiratory congestion, this may require a doctor's intervention and work stoppage. Especially a flu-like illness can hide an acute pneumonia or meningitis that the test does not mark.
Under the same conditions, the doctor may perform a blood glucose evaluation test for the identification of a hypoglycaemia or diabetes.
How much does it cost ? If the tests courtesy of the Health Insurance Sentinels of doctors monitoring network - which includes 1300 physicians since 1984 - it is not yet the case for pharmacists.
The price of the test is currently being negotiated by the National Collective of associations of pharmacists and the remuneration of the time you will spend the pharmacist.
Live glasses to the optician
Hard to get an appointment within a reasonable time to his ophthalmologist. The profession is losing about 200 specialists per year and the average waiting time, depending on the region ranges from 6 months to 1 year.
If you are over 16 and a prescription under 3 years old, your optician can renew, with or without modification, your glasses. In the future, this act could become possible in 5 years, but only on presentation of the order.
However, the ophthalmologist must not have shown his opposition to the ordinance "with renewed adaptation" by the optician, what to do when monitors besides your vision, glaucoma, cataract, consequences of diabetes or risk of macular degeneration.
How much does it cost ? Renewal or adaptation of lenses and frames is usually not charged, although a price is displayed to the optician, if followed by the purchase of glasses.
You will pay the mount and new glasses and will normally be paid at the rate of one pair per year.
The midwife rather than the gynecologist
Nearly half of Midwives provide follow-contraception, pregnancy and post-childbirth.
Since the 2009 law, liberal midwives fly any contraception healthy women: prescription contraceptives, IUD or implant, practice of Pap screening.
How much does it cost ? Consultation is charged € 23, refunded 70%, a rate equivalent to that of a general practitioner sector 1, significantly lower than those of gynecologists.
A liberal nurse for Vaccines
The liberal nurses working with general practitioners and pharmacists in interprofessional coordination or the extension of certain provisions. This is particularly true for a vaccine against influenza.
Following an initial vaccination performed by a doctor, nurses practicing in a second. They may also renew a contraceptive treatment or prescribe compression stockings which are thus reimbursed.
How much does it cost ? No consultation rates for nurses, but of codification instruments. Vaccination against influenza, for example, is charged € 6.30 refunded 60% by Medicare, against € 23 to 70% in the general refunded.
Products for in-store lenses
To better play competition, Hamon Act provides that the use of lens care products will, in 2014, sold in stores, not only in pharmacies or opticians.
Some pharmacists argue that competition is already exercises with a price range between € 5.90 and € 16.90 for a month maintenance.
Christian Roméas, president of the Union of entrepreneurs opticians believes that the current monopoly control allows a minimum of cleaning products, their origin and composition.
Self-tests the counter
Pregnancy tests, far sold in pharmacies, will soon be available in supermarkets. Objective: to lower their prices.
For Marie-Pierre Martinet, Secretary General of Family Planning, this accessibility is involved in women's autonomy in controlling their fertility. "
However, they can not benefit from the advice of a pharmacist.
Also new, the HIV self-tests, already authorized the United States and the United Kingdom, could, early 2014, to be available in pharmacies. In France 30 000 of 40 000 people would be infected without knowing it.
This direct access will be anonymous and the dual advantage of providing early care and reduce the risks of contamination, "argues the Aids association.
Warning: the self-test will be the responsibility of the user while the screening center or mobile unit is free.