Problems with Doctolib

Health Care & Carte Vitale
21

I think he means having made and appointment for a rdv in person rather than télé-consultation!

But for our GP we can just walk in and book at the accueil as it is a staffed medical centre. Other doctors have individual cabinets so no way of doing so.

Sadly big shortage of medical generalists and specialists, so if they left their lists and appointment systems open they would be quickly booked to 2025. Which is why the doctolib merry-go-round. I have appointments booked with my specialist all the way through 2024. The advantage of doctolib and equivalent is that if I don’t need one of them I can cancel it easily.

However, does your medical centre have a walk-in nurse’s clinic? If so might be worth popping in as they can sometimes escalate your case if they think necessary.

22

Thoroughly agree. We are now part of a group practice with a receptionist. I’ve taken OH in at 8am on a couple of occasions and thrust an open wound under a passing doctor’s nose as they’ve started their day. We were grumped at, but seen immediately, had the wound cleaned and given an ordnance for a nurse to clean and dress it daily. The French system is brilliant.

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23

Our doctor came off Docto Lib because people were making appointments and not turning up.
Pascale who helps me in the house, has a daughter who is a kine and she had e actly the same problem, with the same outcome.
I now wait until the afternoon to make a non urgent appointment.

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24

I bypassed everyone to start with and rang a foot surgeon direct (his secretary obviously) out of several listed. Appt made there and then for consultation, needed to get xray ordnance from a doctor and take them to the consultation so got one locally within a couple of days and now surgery in five weeks time followed by the second surgery two weeks after that. Ordnances for all equipment,medication,anaesthesie visit and nurse visits for a month given at consultation - very impressed and I could choose when to have the surgery but decided the sooner the better so I would not fret nor sweat. Anaesthesie booked for the week prior. No doctolib or similar involved at all.

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25

The analysis of medical appointment systems shows that the online systems are much better for doctors In terms of cancellations. If someone has to wait half an hour on the phone to cancel an appointment they won’t.

I wonder whether this was a while ago when these IT systems were in their infancy? These days you gets so many reminders and requests to press button X if you want to cancel or change you appointment that it would surprise me that this was a big issue.

Presumably a hospital based surgeond? No need to go via an intermediary then - and would probably slow it down.

26

I’ve said this before (rather a lot of times unfortunately) but not every doctor or consultant uses Doctolib. In our area, a lot of the GPs use Maiia, not Doctolib, and quite a few don’t use any on-line booking mechanism.

I know this is probably too far for @captainendeavour but when a member of our conversation group wanted a dermatologist, she was recommended one in Coutances and we drove her there. She went into the cabinet and booked an appointment with the secretary (I think the wait was about 3 weeks). I can get the details from her if needed…

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27

@AngelaR . Coutance too far? Not at all. I have a lesion which bleeds and weeps and is getting bigger. It needs seeing to, chop-chop. I have my M.T.'s letter that says so.

Miles in the car is nothing compared to having an RdV. So I’ll take anything that’s available, asap, please.

“We are now part of a group practice with a receptionist”

@SuePJ you are very fortunate.

My M.T. [one of two docs] is in a building with various medical professionals, including 3 nurses who never seem to be there - out on call, I s’pose - but it is not a health centre with a general reception. They all just rent the rooms, I guess.

When my M.T. told me to get a blood test from one of the nurses downstairs I had to make an RdV. At the time I was living only 10 mins away. Now 40 mins.

I wondered if going to ‘Urgence’ somewhere like the massive hospital at St. Lo or at Caen might do it? I can’t imagine anyone looking at what I’ve got and not referring me on.

Quite a number of the dermatologists on the Amelie list [Stella’s link] are on Doctolib, of course. This means that a phone call will have the same result as I described above. No answer from a human. Instructions to book on Doctolib. Booking link on Doctolib …

WhatsApp Image 2023-08-15 at 11.22.23

Every single one on D/lib produced this result.

Clinically, this may be true. But administratively, only if your local set-up makes it that way. As I mentioned, Torigni has a building with a selection of health professionals, from nurses to psychiatrist - a dentist, even! - but no receptionist.

"But for our GP we can just walk in and book at the accueil as it is a staffed medical centre. Other doctors have individual cabinets so no way of doing so."

Quite so.

My M.T.'s sec and I have exchanged emails in the past. Now her email rejects incoming messages. :angry:

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28

Its a Mutuelle clinic specialising in orthopaedic work.

29

Go back to your GP and ask for help. GPs have the ability to bypass dragons who guard the specialists, and find appointments where none seemingly exist. Mine has in the past got me a next day MRI, and a cardiology appointment within days.

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30

Sort of, what I meant was that having made a RdV with my MT or consultants secretary they then pop into Doctolib which the must be using for scheduling. Since Im posted that however, I’ve also used it for a “cold call” (ie self referred) appointment for a consultant Ophthalmologist.

If I had you condition @captainendeavour I think I would be popping into ED. Sooner fixed the better.

31

What that? Emergency Dept?

32

Yes, I’d prefer to have their view and if it’s a larger hospital they may have a dermatologist on duty, or at least refer you to one with the appropriate level of urgency. If they’re not too bothered it would al least put your mind at ease.

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33

This may work. I will try. But the question is - why not in the first instance?

It’s all this variations on a kalaidascopic variation in the level of charges and refunds by Amelie and mute [or not]. The M.T. leaves that decision to the patient, asit’s a matter of the patient’s resources, but the clinical aspect may well suffer, as it certainly has in my case.

This is one of the reasons I don’t rave over the FR system, as many others do.

When it comes to health issues, get the patient eyeball/eyeball with a medic and the funding take the hindmost. This was my experience in Spain as well as UK [waiting lists permitting]

I would imagine that a lesion that bleeds and weeps would never come under ‘not too bothered’.

Thanks to my mum being a QA theatre sister I am competently dressing this lesion 2 x 24. [By the way, the dressings that the M.T. precribed cost €45 for a box of 10 :grimacing:]

However, whoever else might be ‘not too bothered’, I am…

34

I really don’t understand that. How you personally pay for your healthcare has absolutely nothing to do with the prescribed treatment. If for one reason or another you choose not to follow a treatment plan then yes that’s down to you. But there are safety nets for people on low income so that no-one should be denied care.

Can you give an example of how your clinical treatments has suffered because of the way the costs are allocated?

My experience here is precisely as you say, one-to-one appointments with doctors leading to a treatment plan. The funding of that treatment plan is peripheral. I am in fact being prescribed a drug I was not allowed in the UK on cost grounds, and even more am being kept on the original version not a similar (ie cheaper, like a generic) at my doctor’s request. No doctor in France has ever denied me anything on cost grounds.

Perhaps I am wrong, but I do think quite a few of the issues you encounter are due to communication problems in French.

A lot of medical professionals who are profession libérale work that way. They rent an office in a serviced building (serviced as in cleaned and maintained) and will organise their administration separately. A lot will have a secretarial/receptionist service off site , but that number may be listed on the online booking systems, or may not. Depends how overloaded they are.

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35

I’d try ED earlyish on a Tueaday or Wedneday( but not delay just to get those days)… it’s August so choosing day might help…just a chance. And meanwhile I hope Coutances can work out. And contact GP to ask help as Jane suggests - Doctolib can send messages if other means not working.

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36

This is why you need either a mutuelle or state funded top up insurance if you qualify .

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37

And just another thought, if these are the special expensive dressings for eg open weeping wounds (like ulcers) are you sure you are supposed to change them twice a day? There are generally designed to stay in place for a while as this gives the wound a chance to heal.

38

Correct. But you have misunderstood my point.

Treatment - the actual clinical intervention by the health professional with the patient - indeed has nothing to do with finance. Except, perhaps, in timing. If one goes 100% private, RdVs can be had instanter.

The point I was making is that the patient, not the doctor, is the one choosing/finding/making an RdV with a specialist because the choice has financial implications.

For example -

C.V. or no C.V. ? I was warned off ‘No C.V.’ in no uncertain terms by AngelaR until someone pointed out that reimbursement happens by a different m.o. than via a C.V. , at which point Angela wrote, in effect, “That’s all right then”

But C.V. or no C.V. is one of the Amelie options to choose when looking for a doc. There is even an icon on a doc’s page to indicate this.
image

As is the level of charging of the doc. - The € icon is not an indication of the doctor’s clinical competence …

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'Sélectionner un type d’honoraire’ is not a clinical issue. It is a choice to be made by the patient because it has financial implications.

I have never criticised the French health system on grounds of clinical intervention.

39

These days it is the patient who generally makes the RDVs because that is the system (although many times my MT has picked up phone and made appointments for me). All doctors are qualified under the same system, and whether in a clinic or public hospital, health centre or cabinet de ville their competency should be up to the mark. There are no financial implications beyond the normal contributions unless you choose to select something extra.

Yes you can select someone where you don’t have to pay and reclaim, or pay to get a faster appointment (sometimes) or select a doctor with much greater experience that may charge more but if you don’t decide to do that your clinical care should not be compromised. And if it is then a matter of complaint.

Would you want a system where you were sent to someone without your advance agreement that it will cost you €50 more?

You cannot expect the French health service to be like Spain’s or the UK. It is French. It is overly intricate at times and needs rationalisation, but it is what it is. And there is a shortage of professionals.

But if you take the time to understand the system there is nothing complex about it and it is quite easy to navigate.

40

My new MT now has come to terms that I don’t have a ‘normal’ body, ie I am on the extreme end of the scale for sensivity.
Mind you she looked stumped when I told her that my specialist thinks that the nodules in my lungs are Pulmonary Carcinoid Tumourlets.
They are not cancerous, but are extremely rare.
If she had told me sooner that that was she suspected and that there is medication for them, I would have agreed to the biopsy sooner.
I am going to have it done in a specialist thoracic hospital in Lyon in October.
I could have had it done sooner, but chose to wait until after the summer because of the family coming.

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