Why do prevention aimed at 25, 45 and 65 year olds?

It was a campaign promise from candidate Emmanuel Macron in 2022 and a measure that some doctors have been calling for for years. The Minister of Health, François Braun, announced in The Sunday newspaper September 18, the setting up of free consultations for people aged 25, 45 and 65 who must emphasize prevention in terms of health.

For Agnès Giannotti, president of General Practitioners of France (MGF) and contacted by 20 minutes, this measure is welcomed in view of the “interested delay” on the issue of prevention in our country. “It seems important to us to have dedicated consultations,” she adds enthusiastically. “Our country is not good in terms of prevention”, but “we have decided to act”, conceded the minister on France between Monday morning.

A delay in prevention

François Braun insisted on this point in the JDD : “We are entering the era of prevention”. Today, it is considered “insufficient” compared to what other countries are doing. “We are very late because we only reimburse the treatment”, confirms Agnès Giannotti.

However, there is a real need to counter social inequalities in health and to encourage the most disadvantaged to go to the doctor for regular check-ups. Those who are the furthest from care are those who are most affected by these inequalities. Will this free be enough? “It breaks a certain financial barrier, and that’s already something,” replies the general practitioner. For her, we see this delay taken “in the whole society”, not the increase in chronic diseases, obesity or diabetes.

This free measure should also encourage categories of people, in particular those aged 25 who do not have chronic problems and therefore visit the doctor less often, to consult and be educated about their health. It should be accompanied by a global public health prevention campaign. “It will be part of a whole,” hopes Agnès Giannotti. According to the minister, “we are going to take better care of the children, who benefit from 20 examinations up to the age of 16, but also follow these generations during their lives”. “We are going to have this logic of going to the people furthest from care”, he added on France Inter.

Why choose these ages?

The ages chosen by the Minister are not insignificant. “These are pivotal moments in the lives of adults, confirms Agnès Giannotti. At 25, it is the entry into adulthood, into working life, it is also necessary to prevent the risks of violence, those linked to sexual infections, to addiction of any kind, to obesity or diabetes, and it’s an age at which you don’t fall seriously ill while it is still important to go see your doctor”. It is also the age of vaccine reminders which are not always up to date. Nevertheless, these ages remain “indicative”, specified the minister.

People aged 45 will be made more aware of chronic diseases and encouraged to screen for several cancers (breast, colon or prostate) because “if it is from the age of 50 that we will insist on the screening, it’s important to explain to them beforehand,” said the general practitioner. Here too, questions about the work environment and the private environment will be able to be induced, and always the risks associated with sexual relations. “It’s not useless to put on a layer for people who change partners or divorce,” she adds.

Finally, at age 65, the doctor will address issues related to retirement, change of living environment and begin prevention of loss of autonomy. “To review every 20 years, that seems important to me”, abounds Agnès Giannotti.

What concrete implementation?

This measure should be put in place from 2023, but it has not been the subject of consultation with the various doctors’ unions, protests for his part Jean-Paul Hamon, general practitioner and Honorary President of the Federation of doctors from France, contacted by 20 minutes. “He decided that all alone in his corner without a representative union,” he regrets.

And how to concretely set up these consultations when the country is affected by “a shortage of doctors, he wonders. If it is to carry out a consultation without means of action on what we want to imply, it is not very useful”. Remember that nearly 7.5 million French people have “limited access” to a general practitioner, according to figures from the Association of Mayors of France (AMF).

DELETE

“There are a large number of people who will benefit from this consultation when they do not need it”, agrees Jean-Paul Hamon. According to him, doctors need time, a long and complete consultation in order to provide support, as for overweight people. The doctor then pleads more for dedicated consultations by disease or complication, such as for obesity or addiction. “That would make more sense,” he says. Prevention, we already do it every day with our patients, whether it is a reminder of vaccines or cancer screening. This shows that the minister does not know what the profession of general practitioner is. The measure proposed by François Braun will be included in the next social security financing bill, submitted to parliament.

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