France’s healthcare and social security systems are among the best in the world, but the bureaucracy associated with them can be a nightmare to navigate even while searching something as simple as finding a doctor. This guide will help readers with understanding unfamiliar terminology, varying prices, and coping with cultural curve balls like oddly relaxed home offices and canine companions.
Though their numbers fell in 2017, there are still more than 196,000 doctors in France, which means there’s plenty of choices. Since 2006, anyone who qualifies for French social security (typically those in some kind of employment) is required to select a general practitioner or médecin traitant. Each qualified person gets to choose the doctor totally independent of postcode, and it’s considered normal to shop around before settling on the right one. However, seeing multiple doctors in a short space of time before deciding on one with whom to pursue a course of treatment can incur quite a lot of upfront costs.
All general practitioners and non-hospital specialists in France are self-employed, however, and are forbidden by law from advertising their services. In the past, finding a doctor used to involve a laborious trawl through the Pages Jaunes but most are thankfully now listed on Doctolib. This helpful website provides a database of doctors (GPs and specialists) in any given city, their price lists, and their availability. Make appointments with the click of a mouse, receive confirmation and reminders via email and text, and, in some cases, amend or cancel an appointment online.
Unfortunately, it’s not possible to use Doctolib to search for English-speaking doctors yet, but there are lists of them through the American Hospital of Paris, the British Hospital, and the embassies of Anglophone countries. Phone them directly or search for them on Doctolib.
Those plugged into the French system will have been issued a Carte Vitale. Bring this to every medical appointment (and a trip to the pharmacy) as it is needed for the payment and refund process. Check in advance what payment methods a particular doctor accepts because not everyone accepts cards and some even request change.
Nevertheless, in all cases, the payment is made to the doctor and then the French state calculates what percentage of the consultation it will cover and how much it will refund the patient. For example, 70 percent of a standard medical consultation will be refunded. Unusually for most non-French people, the patient will pay the doctor directly as often there isn’t an administrative assistant to take care of this side of things.
The Secteur that a doctor is registered under will affect the fees that they can charge. Under Secteur 1, the rate for a consultation is between €23 and €25 ($27.03 and $29.38). If classified under Secteur 2, the doctor can charge higher fees—albeit within legal limits—with a standard consultation costing somewhere in the region of €70 ($82.28). Don’t be surprised to find English-speaking doctors well represented in this second category. Specialist doctors may charge even more depending on the services required.
Whether the doctor is conventionné, meaning their services are refunded by the social security system and their fees regulated and capped, or non-conventionné will also impact the final bill.
Those who are just visiting France and don’t have a Carte Vitale but intend to seek reimbursement from an insurance provider, be sure to ask the doctor for a feuille de soins that will detail the amounts paid. A similar refund form will also be given for prescribed medications.
The biggest culture shock people will experience at their first French medical appointment likely won’t be the language but the insane informality of the setting. Sterilised clinics and surgeries are in the minority, and most doctors work out of their apartments. Some of these maintain a half-hearted home office vibe while others are simply family living rooms with a desk and an examination table shoved awkwardly in a corner. Keep an eye out for diplomas on the wall, but it’s not by any means an expectation that they’ll be displayed.
As with most professions in France, doctors also tend to be way more casually dressed than their British or American counterparts. Those hoping for a white coat will be disappointed: the standard outfit seems to be jeans and a bobbly, ill-fitting jumper.
Finally, every day is Take Your Dog to Work Day for many French doctors. Not only will these furry friends casually trot into the room mid-examination demanding their fair share of the attention, but some will even perch on the doctors’ laps while they carry out their questioning and take a patient’s blood pressure (depending on one’s aversion to canines, the reading might not be all that accurate).
Relax and go with it as visitors are presumably trying to integrate into another culture after all. Those who can’t handle the laid-back approach to medicine or draw the line at a pooch in the examination room, it shouldn’t be too difficult to find an expat doctor who adheres to the standards expected back home.
Most doctors don’t have the space or staff to offer services like blood tests or X-rays. They will instead ask their patients to visit their choice of laboratoire d’analyses médicales or cabinet d’imagerie et de radiologie they wish to follow up with, but there are a few keys points to note: most—but not all—of these operate on a walk-in, first-come-first-served basis, so arriving early in the day (usually well before the advertised opening time) is advised as the lines get very long very fast.
Most are able to pick up the results or scans on the same or next day, or possibly have them emailed when they come in. However, it is the patient’s responsibility to transfer them to the doctor. Despite the frequency of referrals for a whole host of medical services in France, there is next-to-no infrastructure for communicating patient information between healthcare providers. Patients are also expected to be in charge of their own medical records.
The pricing for additional services will depend on the tests being carried out, but the refund procedure and paperwork are the same as for a doctor.
Many doctors in France still conduct home visits, though there will likely be an additional fee of between €10 and €40 ($11.75-47.01) depending on the nature of the consultation. SOS Médecins is a useful service that can connect someone needing medical care with a 24-hour doctor.
All major hospitals will also have general practitioners and some other specialists who can be reached at all hours of the day and night.
Those who require an ambulance, dial the SAMU on 15. If paramedical treatment is needed, the fire service (sapeurs-pompiers) should be called on 18. A full list of emergency numbers can be found here.