Using the services of a doctor via interposed screens has almost become common practice. Since the health crisis, the number of teleconsultations has exploded, from 80,000 in 2019 to nearly 9,400,000 in 2021, according to figures from the Ministry of Health. A boost such as getting a medical videoconference is sometimes as complicated as getting an appointment in the office. Especially since with the shortage of doctors, the waiting times for obtaining a consultation are constantly getting longer, especially with specialist practitioners. Neither one nor two companies have seized the opportunity to develop a new offer: a subscription teleconsultation system supposed to offer privileged access to white coats. In exchange for ten euros per month, customers can exchange without delay and all costs included with a general practitioner or specialist. A novelty that makes many cringe.
€11.99 per month to be able to consult a doctor 24 hours a day, 7 days a week, at no additional cost and “whenever you need it”. The offer of Ramsay Health, Australian giant of private clinics, has something to catch the eye. And the company prides itself on a state-of-the-art service: “No filters or middlemen, no waiting times or appointments to schedule, you are directly and immediately put in touch with the doctor or healthcare professional” , by phone or computer. A boon for the patient therefore, especially since there would be “no consultation cost”.
Once the subscription is paid, there is no longer any need to put your hand in your wallet. And even if all the practitioners are “registered with the National Council of the Order of Doctors and qualified in France”, Ramsay takes care to specify that “this service does not replace monitoring by a general practitioner”. The online consultation can nevertheless lead to the issuance of orders, but not work stoppages. But beware of those who would abuse the call to the doctor at the slightest harm, impossible to “exceed a reasonable number of calls estimated at twenty (20) calls per year”. A limitation that has not failed to be the target of criticism.
Ramsay is not, however, the only company to have set up this subscription-based teleconsultation system. “It is widely offered by mutuals or health insurance companies which include it in their offer”, defends the company in a press release. Companies have positioned themselves in specific medicines, such as paediatrics. The May mobile application thus proposes to support parents “from pregnancy to the start of school for their child” via a network of pediatricians, midwives and pediatric nurses. For 9.9 euros per month, patients can chat with specialists every day, from 8 a.m. to 10 p.m. Nearly 300,000 people would use this application, created in 2018.
Same positioning on the side of Biloba, which offers an unlimited offer at €14.90 per month. Benjamin Hardy, founder and CEO of this medical messaging service for parents, explained to L’Express the reasons for the proliferation of teleconsultations by subscription: “In a health system where you have to wait an average of 6 days to get an appointment with a general practitioner and 22 days for a paediatrician, the need to offer a health relay upstream of the care pathway is essential”.
An opinion rejected en bloc by the National Council of the College of Physicians. In a press release, the organization blasted the offer launched by the Ramsay group, “contrary to medical ethics”. From an economic and geographical point of view, “these teleconsultations threaten the healthcare system and its model organized around doctors who meet the needs of the population in their region” and “question the French health model based on solidarity and free healthcare. “This type of subscription makes medicine a trade and discredits the profession”, tackles the National Council of the Order of Physicians.
The organization is therefore calling for an investigation from the Minister of Health in order to strengthen the regulation of telemedicine. However, its vice-president, Dr Jean-Marcel Mourgues, acknowledged at the microphone of France Info that this service met a real need of the French population, in need of quick appointments. “This is not to say that telemedicine has no place”, but that it is “a false good solution”, risking accentuating a “two-speed medicine”.
“We saw this “low-cost Netflix offer”. No follow-up, no coordination, no physical consultation, this is the worst of what we can see as a care offer, ”denounced Agnes Giannotti, president of the main French general practitioner union MG France.
For its part, Ramsay Santé argues that its offer – launched publicly since last January – is only intended to meet needs that the conventional system does not meet. “The virtuous course of care is the (physical) consultation of the attending physician and possibly then specialists”, but “there are 10% of people who are not lucky enough to be able to benefit from this ideal course”, said Francois Demesmay, Ramsay’s director of medical innovation.
