Introduction to the French doctor system
Doctors are one of the most respected and well-paid professions in the West. This is due to the brutal screening and long and rigorous training they undergo.
First of all, it is not difficult to enter medical school. All students who have obtained the Bachelor of Arts (Bac) in HK can register at the medical college. However, after one year, they must pass a rigorous screening qualifying examination before they can continue their studies. There are only 200 places available in this examination and up to 80% of students are eliminated. And a candidate can only take the exam a maximum of two times. Failure means that you will never have the chance to become a doctor again. So there are all kinds of remedial classes for medical students, and almost all of the students who have taken the exam have taken them.
After this hurdle, medical students need to go through at least six more years of training, including three years of basic medical education and three years of clinical practice, with a points-based curriculum and annual exams, which can be made up if you fail. At the end of their basic medical education, a more rigorous Internat (specialist qualification exam) awaits them, which they pass in order to become a Spécialiste, with priority given to those who score high enough to choose a specialty. Those who do not take the test or fail it become general practitioners (Généraliste), or general practitioners. Specialists have a relatively higher social status and are more expensive. In addition, they are able to increase their fees from those set by the state, which are not reimbursed by Sécuritésociale for patients.
Next, would-be generalists and specialists undergo a three- and five-year hospital internship, respectively, and then write a thesis, with the generalist student able to choose his or her own topic. That means a minimum of 9 years of study to become a generalist and 11 years for a specialist. In France, you can generally practice medicine with a medical school diploma. The medical association (L'ordre des médecins) is the body that decides whether or not a doctor is qualified to practice medicine and issues a license to do so. It takes into account the balanced distribution of doctors in each region and prevents doctors with a bad record from continuing to practise.
After graduating from medical school, medical students go to work in hospitals as internes, a position comparable to that of a teaching assistant in a medical school, and the nature of the work is training. After two years of work, a thesis is written and passed before the resident is promoted to attending physician (chef de clinique), equivalent to a lecturer. The maximum length of a residency is four years, and the department of service and the professors who follow it change every six months, avoiding "inbreeding" in the academic world.
From the doctor's point of view, practicing in a private hospital (Clinique) or clinic has a high net income, but there are pressures from clientele, rent, and equipment investment. As a result, many doctors choose to affiliate with public hospitals, working a few days a week at the hospital and the rest of the time at their own clinics or private hospitals. Some even come to public hospitals only once a week for work or only for weekly meetings. The advantage is that critically ill patients requiring long-term treatment can be transferred from their own clinics to public hospitals to minimize cost pressure. In addition, since the investment in setting up one's own clinic or joining a private hospital is very high, specialists who are new to the profession usually choose to work as a top-up doctor first in order to build up a more regular network of patients, that is, a clientele. There are also two types of private hospitals, closed and open. Closed hospitals have a fixed number of doctors and will not recruit new people if there are no vacancies. Doctors who want to enter can pay for a vacant doctor's seat, but good hospitals are very expensive, a position can be up to one or two million euros. Open hospitals, on the other hand, allow doctors to bring in their own patients and then pay a fee to the hospital.
Medical students need to pass a rigorous exam to stay in medical school after graduation. The few people who end up becoming professors in medical schools are true authorities. Their social status is so high that they are usually re-elected only after their death. This corresponds to their generous remuneration, which generally consists of two parts, one from the medical school and one from the hospital.
French hospitals also have many external experts, scholars and foreign doctors, they are called pratician attaché, that is, "guest doctor", generally outstanding expertise, medical skills. Dr. Tong has been appointed as a visiting doctor of gastroenterology by Bichat Hospital and Bizet Private Hospital, which are among the top seven hospitals in Paris. He is particularly good at the world's most advanced liver and gallbladder lithotripsy and laparoscopic surgery. He believes that the French medical community has a very objective evaluation and high respect for the talents of good foreign doctors.
The profession of doctor is one that requires constant experience and updating of knowledge. In France, general practitioners have regular annual medical school training to keep up with the latest medical techniques and medications. Specialists are also required to attend regular meetings with their peers, and if they fail to speak at a meeting three times, they are considered to be professionally backward and will not be able to keep their positions.
How to choose a doctor and a hospital
When it comes to medical care in France, choosing a hospital is important, but choosing a doctor in a hospital is key. In particular, the new health care reform stipulates that from July 1 this year, you must first go through your own community doctor (Médecin traitant, also known as a family doctor or doctor in charge), and then he will recommend other specialists, otherwise you will not be able to get reimbursed at the maximum amount of the social security (except for specialties such as psychiatry).
Of course, everyone wants to find a doctor who has a good command of the language and a good command of the art. That's why you usually choose a Chinese person recommended by a friend or relative. This is certainly true, but we recommend that you also consider the following:
1) The clinic is close to your home address. After all, sick people don't want to spend a lot of time and energy to go to the doctor's office, and if you don't want to go to the doctor's office because it's too far away, you may experience delays or even serious consequences. If you don't have a language problem, you can also use the yellow pages of the phone (Pages jaunes) or go online to find a doctor near your home.
2. Doctors have plenty of free time for consultation sans rendez-vous. Some doctors are very famous, and because of this, you have to make an appointment one or two months in advance, which is very inconvenient for most patients. In fact, there are doctors in every community who have regular weekly slots (such as Tuesday and Friday afternoons) to receive patients who do not have an appointment in advance, and it's much more convenient to see them as they come in.
3, it is best to find a doctor who is familiar with your medical history. For example, some patients are allergic to certain medications, or take certain medications that produce large side effects and must be combined with other treatments. A doctor who is familiar with your medical history and constitution will be able to find the best solution to reduce unnecessary risks.
In the event of a sudden injury or emergency, you must be taken to a hospital. There are more than 100 public and private hospitals in the Paris region, and the Assistance publique is the largest medical aid organization, or the "health bureau" of Paris (www.aphp.fr for more information on hospitals), chaired by French President Jacques Chirac. The organization includes a number of public hospitals, with tens of thousands of beds in the city of Paris.
France focuses on medical economics, in order to avoid unnecessary waste, hospital emergency rooms are almost all open during the day, and the department is more complete. But specialty emergency rooms at night are only available in some hospitals. For example, according to Dr. Tong's introduction, Paris residents at night to see the best ophthalmology emergency next to Notre Dame Hospital HOTEL DIEU (1, place du Parvis Notre-Dame, 75004 PARIS), which is also specialized in police hospitals and criminal cases and injury identification hospitals; otorhinolaryngology and maxillofacial trauma to go to Europe's largest PITIE - SALPETRIERE Hospital, which is the largest in the world. SALPETRIERE Hospital (47-83, boulevard de l'Hopital, 75013), or the LARIBOISIERE Hospital (2, rue Ambroise-Paré, 75010 PARIS) near the Gare du Nord, in addition to the PITIE Hospital, which has vascular surgery, dentistry, and cardiac surgery. emergency night clinic. The BEAUJON HOSPITAL (100, boulevard du Général Leclerc 92110 CLICHY) in the suburbs of Paris has nighttime emergencies in vascular surgery, hand surgery for traumatology, and gastroenterology for liver, gallbladder, and pancreas; the AMBROISE-PARE HOSPITAL (92100 BOULOGNE- BILLANCOURT), close to the Bois de Boulogne forest to the west of Paris, also has a nighttime emergency for vascular surgery, hand surgery for traumatology, and gastroenterology. BILLANCOURT) also has an emergency night clinic for vascular surgery; for burns, go to the COCHIN hospital (27, rue du Faubourg Saint-Jacques 75014 PARIS); and for hand trauma, cardiac surgery, and especially infectious diseases, go to the BICHAT hospital attached to the University of Paris VII (46, rue Henri- Huchard, 75018 PARIS); HOPITAL EUROPEEN GEORGES POMPIDOU (20-40, rue Leblanc 75015 PARIS) also has a hand-surgery trauma and cardiac surgery emergency clinic. For pediatric emergencies, especially for kidney disease, it is best to go to the NECKER Pediatric Hospital (149, rue de Sèvres, 75015 PARIS); for hematology and dermatology emergencies, go to the SAINT-LOUIS HOSPITAL (1, avenue Claude-Vellefaux, 75010 PARIS); for oncology and liver transplants go to the PAUL-BROUSSE HOSPITAL (12, avenue Paul-Vaillant-Couturier, 94804 VILLEJUIF) in the southern suburbs of Paris; for intestinal diseases in gastrointestinal surgery go to SAINT-ANTOINE HOSPITAL (184, rue du Faubourg Saint-Antoine. 75012 PARIS); and so on. If you don't know which hospital to go to, you can call the emergency number 15 or 112 directly.
The hospitals described above are large public hospitals. Private hospitals, which cannot be described in detail here, are characterized by the following features: 80% of private hospitals are surgical hospitals, but only large private hospitals have service reanimation. Private hospitals have only attending physicians, which ensures a higher level of treatment and allows them to directly designate famous doctors to do the surgery and so on.
Misunderstandings and suggestions for Chinese people seeking medical treatment in France
In addition to this, the main problems or misunderstandings encountered by Chinese people seeking medical treatment in France may be:
1) Language barrier. If you are not fluent in French, it is best to find a friend or relative who speaks the language well enough to accompany you to the doctor. Otherwise, you can prepare a written note in French at home, describing the symptoms in detail, including the symptoms, the duration and frequency of attacks, the medicines you have taken, the foods you have eaten that may have had an impact on your condition, and so on. You should also keep a lightweight Chinese-French dictionary at home, such as the pocket-sized Foreign Language Teaching and Research Publishing House (FLTRP) Chinese-French Classification Vocabulary Handbook, which includes general everyday terms used to describe the illness.
2, not familiar with the French medical habits. In China, you go to the hospital directly, but in France, you go to the community doctor's clinic, and you need to make an appointment with the doctor by phone for non-emergency cases, and you go to the doctor in the general hospital, too, unless you are in the doctor's free consultation period.
3. The psychology of medical treatment is different from that of the French. Chinese people generally want to know more about their conditions and treatments, while French patients are used to listening to the doctor's arrangements. Dr. Tong gave an example of a French patient who went to the hospital to see a doctor, the doctor asked him to ask him what diseases he had in the past, he could not answer, so the doctor went to check the medical records or asked him to ask his past doctor. The doctor then asked for his opinion on whether or not to operate, and he had only one thing to say: "You should decide, because you are the doctor." This is common in France and harder to imagine in China. The same applies to signatures before surgery. In France, adults only need to sign their own consent before surgery, while children need their guardian to sign. In China, however, the patient's family and even the head of the organization are also required to sign. Before the Kouchner law came into effect in 2002, doctors in France had the right to not even explain treatments and medications to their patients. But now, all patients in France have the right to access their own medical records and all information about their treatment.
4. The desire to go directly to a specialist. In fact, patients often just guess which specialist they should see, but may not be accurate, leading to misdiagnosis or delayed treatment. In addition, some specialists in France (e.g. neurologists, endocrinologists, cardiologists, etc.) require patients to go to a general practitioner to complete a preliminary examination before treating them according to the specific situation. Therefore, it is important to go to your own community doctor as a first stop, for all kinds of medical information and transfers to hospitals. In addition, you can consult your community doctor or the social security administration for all information about the healthcare system. In France, for example, those with social insurance are entitled to a full medical checkup (including radiography, electrocardiography, blood tests, etc.) every five years, and women over 50 are entitled to a free mammogram every three years, and you can ask the insurance department for details of where to go for the checkup.
The main problems or misunderstandings that Chinese people encounter when seeking medical treatment in France include:
1. If you are not fluent in French, it is best to find a friend or relative who speaks the language well enough to accompany you to the doctor. Otherwise, you can prepare a written statement in French at home, describing the symptoms in detail, including the symptoms, the time and frequency of attacks, the medicines you have taken, the food you have eaten that may have an impact on your condition, and so on. You should also keep a lightweight Chinese-French dictionary at home, such as the pocket-sized Foreign Language Teaching and Research Publishing House (FLTRP) Chinese-French Classification Vocabulary Handbook, which includes general everyday terms used to describe the illness.
2. Not familiar with French medical habits. In China, you go to the hospital directly, but in France, you go to the community doctor's clinic, and you need to make an appointment with the doctor by phone for non-emergency cases, and you go to the doctor in the general hospital, unless it is during the doctor's free consultation time.
3. The psychology of medical treatment is different from that of the French. Chinese people generally want to know more about their conditions and treatments, while French patients are used to listening to their doctors. Dr. Tong gave an example of a French patient who went to the hospital to see a doctor, the doctor asked him to ask him what diseases he had in the past, he could not answer, so the doctor went to check the medical records or asked him to ask the past doctor. The doctor then asked for his opinion on whether or not to operate, and he had only one thing to say: "You should decide, because you are the doctor." This is common in France and harder to imagine in China. The same applies to signatures before surgery. In France, adults only need to sign their own consent before surgery, while children need their guardian to sign. In China, however, the patient's family and even the head of the organization are also required to sign. Before the Kouchner law came into effect in 2002, doctors in France had the right to not even explain treatments and medications to their patients. But now, all patients in France have the right to access their own medical records and all information about their treatment.
4. The desire to go directly to a specialist. In fact, patients often just guess which specialist they should see, but may not be accurate, leading to misdiagnosis or delayed treatment. In addition, some specialists in France (e.g. neurologists, endocrinologists, cardiologists, etc.) require patients to go to a general practitioner to complete a preliminary examination before treating them according to the specific situation. Therefore, it is important to go to your own community doctor as the first stop, and to consult them for all kinds of medical information and transfers to hospitals. In addition, you can consult your community doctor or the social security administration for all information about the healthcare system. For example, in France, social insurance holders are entitled to a comprehensive medical examination (including imaging, electrocardiogram, blood test, etc.) every five years, and women over 50 years of age are entitled to a free mammogram once every three years, the specific location of which can be found by contacting the insurance department.