France’s healthcare paradox: too few doctors, too many treatments

Every so often I am reminded that although I live in a medical desert, there is a jungle of well-meaning quacks on the doorstep to compensate.

When both my eyes recently co-opted the carmine shade of Madonna’s lips on her Blonde Ambition tour, blistered, blurred and perpetually pounded, there was no shortage of unsolicited diagnoses and treatment plans from friends, neighbours and one complete stranger.

When the situation deteriorated – prompting another pal to extol how she’d cured her own conjunctivas by administering organic lemon juice (“unbelievably painful but incredibly effective if you can overcome the fear of losing your sight”) – I panicked and took myself off to a real optician.

To the emergency room

“I’m not a doctor,” she immediately qualified, lest I be under any illusion I’d accidentally stumbled upon a clinical oasis amid the GP-starved dunes and sandstorm of pseudo-healers. But she helpfully (genuinely) suggested I’d developed an intolerance to some other eye meds I was on, and sent me straight to urgences.

That this A&E was an hour’s drive away is not really the nub. Most people can accept that if you move somewhere expressly for the green space and quiet, you can’t also complain that useful services, decent shops and, in this case, specialist ophthalmologists are a country mile away.

Besides, lots of departments have it far worse. GP Anaïs Werestchack, who recently published a book entitled Urgent ! Recherche médecin (Urgent! Doctor Wanted) about touring France’s medical deserts as a locum, reported that when she was in Aveyron, she was the only doctor for 652km².

For me, the more worrying aspect of French healthcare is the avalanche of interventions when you do finally land on it. Again, whole books (and plenty of column inches on The Connexion’s letters page) have been written about France’s culture of over-prescribing.

Back in 2012, one title made particular waves by claiming half of drugs prescribed here were useless and 5% actively harmful. The authors calculated that the state was haemorrhaging up to €10billion a year on social security reimbursements for medicines they said had either no value or were plain dangerous.

Politically, economically, this is clearly not good for the optics. Nor for my optics.

Too much medicine?

I left hospital with the standard pick ’n’ mix of potions, running the gamut from antibiotics, antihistamines and steroids to more benign eye washes and dry eye formulas.

The original meds – the underlying cause of the allergy – weren’t switched for another three days, when I complained the motley new cocktail wasn’t making the blindest (apposite word) bit of difference.

Most of these drops are now gathering dust in the medicine cabinet, for which we will soon need to seek planning permission, knock through into the garden and build a veritable pharma pantry, so loudly are its shelves groaning under the weight of expectorants and other quasi-treatments for ailments past.

The lesson for other medical desert-dwellers is this: when you’re stuck between an azithromycin-happy doc and a hard place, don’t be so quick to knock the hard place. French medicine is mostly superb, frequently profligate, and often frustrating. It can occasionally be safely bypassed via a good night’s sleep and a few days away from the work computer screen.

My eyes are gradually mending. My citric acid-advocating friend tells me she hasn’t had problems with her own for 15 years. It seems that when life gives you lemons, as it regularly does on the long waiting list for a médecin traitant, making lemonade isn’t your only option. But I’m not that desperate yet.