“We are waiting for you at the immediate care center” two kilometers away, said a voice over the intercom, in front of the closed door of the Montauban emergency room. Disconcerted, the man turns back, with his sick brother and his handicapped son.
To avoid congestion in its emergency department, in lack of doctors, the Montauban hospital is one of the first in France to filter the entrance, night and day, thanks to two intercoms.
Green is reserved for patients who have obtained a prior telephone agreement for treatment. Via red, others can explain their case, before being allowed to enter. Or not.
25% fewer passes
This “filtering”, put in place since the beginning of July, aims to sort out so as to deal only with cases “really relevant” to emergencies, explains one of the heads of the service, Hélène Pizzut, 45 years old.
The new process results in an “average reduction of 25% in the number of passages” and “the refocusing on its core business” of the service, in order also to attract more emergency physicians, in insufficient numbers in France.
People showing up without an appointment are referred to other medical centers likely to treat them, such as this man in his forties, his brother pale with pain and his autistic son.
With more or less success: three hours later, he is there again, sent back by the center to which he had been referred. In front of the same closed door, he remains polite, but seems tired and angry.
A number of patients that has exploded in twenty years
In recent years, the number of patients coming to the emergency room has exploded. “We were twenty years ago at 20,000 admissions, we are currently at 40,000” per year, told AFP the other head of department, Dominique Coppin.
This growth coincides with a decline in the number of liberal generalists. In Tarn-et-Garonne, 10% of the population has no attending physician, recalls this 67-year-old emergency doctor.
Three patients in the waiting room
If the activity remains sustained, it is less intense than it would be without “filtering”, he underlines, pointing to the waiting room, where three patients are seated. “The twenty places would all be occupied. »
In a corridor, several empty stretchers. Without “regulation” at the entrance, they would all be taken too, continues Dominique Coppin. That evening, only an elderly woman was waiting there to be treated.
A little further on, two patients are bedridden, each in a room equipped with measuring devices. About fifteen people in total are at that time taken care of in the emergency room.
Work more peacefully
With rapid steps, doctors and nurses pass from one room to another, from one cubicle to another, stop in front of a screen to consult the patient’s files, talk to each other.
If they never stop, they do not seem particularly stressed. For Hélène Pizzut, since the installation of the intercoms, the staff can indeed work with more “serenity”.
Calls to the Samu up sharply
The choice made in Montauban corresponds, she admits, to the idea that the government has of access to emergencies.
To limit their congestion, the new Minister of Health, François Braun, urged to first contact “the 15th”, where the calls have at the same time increased.
Thus, in Montauban, the 25% drop in emergency room activity was accompanied by an increase of more than 50% in calls to the Samu.
“Emergencies can no longer be open bar! »
The Prime Minister, Elisabeth Borne, also wished at the beginning of July “that everyone could take the reflex of the 15th and not systematically come to the emergency room”.
She thus relayed more soberly the message of François Braun who had estimated, before taking office: “Emergencies can no longer be open bar! “.
Decades of “destruction of the public hospital”
But the president of the association of users of the Montauban hospital, Maurice Souleil, sees things differently.
According to him, it would be better to go back on decades of “policies of destruction of the public hospital”, cause of the saturation of emergencies and medical deserts.
He also denounces the limitation of entries into the faculty of medicine -numerus clausus abolished in 2018- or the financing of hospitals according to their level of activity.
In Montauban, users are also worried about the project to build a new hospital outside the city center, which would be less accessible to them.
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