French doctors want tough measures to stop patients missing booked appointments

SEPTEMBER 29, 2022: French doctors calling for tougher measures for patients who miss appointments – including online where patients are often booking on multiple platforms and keeping only the earliest appointment they get – and sometimes not even that.

The French Union of Health Professionals (URPS) has sent a letter of complaint to Francois Braun, France’s new health minister, alleging there is an epidemic of patients who are failing to alert doctors that they cannot attend booked appointments. So far Braun hasn’t responded but if large numbers of people fail to meet commitments and jam up the healthcare system, penalties should be imposed, the doctors say.

Currently medical appointment penalty fees are illegal in France on the grounds that doctors should only be paid if their services are carried out. Initially URPS favours a publicity campaign to counter the problem, but individual doctors quoted in the media are demanding financial penalties now.

In a URPS survey, 79 per cent of 2,000 doctor respondents complained that two to five patients a day had missed appointments without cancelations. In France, nationwide, one appointment not honoured per day per doctor represents 27 million annual consultations, equivalent to the working time of 4,000 doctors, URPS estimates.

Other patients are deprived of care, complains URPS which represents 20,800 “liberal” (self-employed) doctors in Paris and the rest of Ile-de-France. Of these doctors within the area of some 13 million people, 12,300 are specialist consultants and 8,500 GPs.

A growing number of appointments are made online via platforms such as Doctolib. A URPS spokesman said numerous patients were making multiple appointments on platforms. A large number either failed to turn up at the doctors’ practices or kept a chosen appointment but neglected to cancel others. Doctors complained that the errant patients were treating the medical platforms as “shopping sites” for consumers.

“URPS isn’t blaming the platforms for the unacceptable behaviour of these people who jam up the health system and cause unfair losses for doctors,” the spokesman said. “But we are asking whether Doctolib and other platforms can change their software or use staff to query or cancel multiple appointments.”

He added that the platforms could possibly find ways to alert their doctor subscribers that appointments had been cancelled or possibly block the errant patient from making appointments again.

Executives of Doctolib, which boasts on its website 70 million patient and 300,000 health professional users in France and Germany, neither responded to calls nor emails. However, officials indicated in the French publication, Capital that they were aware of the problem and were considering a campaign to alert the public on the potential dangers for the health service and patients. Doctors’ unions suggested that a warning email could be sent to patients who did not honour their appointments. Capital reported that the platforms have an interface that could identify the patients that make multiple appointments and failed to cancel the ones that they didn’t need.

UK’s proposed policy

During the UK leadership campaign, PM Rishi Sunak proposed a £10 (€11) fine for patients who missed a NHS appointment. Private UK consultants demand a sizeable kill fee if patients fail to turn up. A leading British dermatologist demands a full consultation payment deposit when an appointment is made. It is returned if 24 hours notice is given.

© Copyright Neil Behrmann

First published in Healthcare Business International

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