Mayor Rouchon (second from right) and Jardel during the opening ceremony of the new practice in the village of Ajain, in central France. Photo: Thomas Marty/Ajain municipality/dpa
When the last family doctor in the village of Ajain in central France retired two years ago and no successor was found, the community of 1,150 inhabitants did not give up.
Using signs at the village entrance and a video call in regional and national media, Ajain looked for a new doctor, initially without success, amid a growing nationwide shortage of rural practitioners.
But then the young doctor Martial Jardel came to the mayor's office with an unusual plan. Suddenly Ajain had 40 available doctors under a simple scheme, whereby for a week at a time, a practitioner from somewhere in France comes and fills in.
"I was approached almost daily by people asking, 'have you found a doctor, because I'll be dead before we get one again?'" Mayor Guy Rouchon told the France bleu radio station. "We did what we could."
Ajain's appeal for help touched a nerve for the newly qualified Jardel, who had just spent six months travelling around France as a locum doctor in a camper van.
With the support of the national health authorities and the doctors' collective Médecins Solidaires, which he co-founded to implement his idea, it was launched last autumn.
"It can be scary when a different doctor comes every week," Jardel said at the recent opening of the new practice in Ajain. However, he added, this is still better than relying on a single doctor who sets up shop but may then leave again.
"As general practitioners, we want to offer a solution to a collective problem."
Like many rural areas across Europe, the village of Ajain is suffering from a shortage of doctors. Photo: Thomas Marty/Gemeinde Ajain/dpa
And that problem is deepening in France's rural communities, which currently lack around 6,000 GPs, according to a study conducted among mayors last year.
In the whole country, by some estimates, as many as 22 million people live in an underserved region, of whom six million don't have a permanent GP. The situation became so acute that President Emmanuel Macron last year proposed a scheme to encourage retiring doctors to stay in practice.
Reportedly, around 10% of French doctors are currently working in retirement.In search of a solution, the city of Nevers in central France made headlines by flying in doctors in a small plane from Dijon, 150km away.
The next generation of doctors may offer a less extreme remedy. Since qualifying in 2021, Jardel went on a mission to explore France's so-called medical deserts – places like Ajain that lack basic healthcare – and realised he could make a difference.
"It was a win-win situation. Doctors in isolated places were able to take time off and I was able to increase my experience," he told the What's Up Doc journal for young practitioners.
"And to take advantage of the fact that in our profession we can practice anywhere."Even in sparsely populated regions there are solutions if you look for them together, says Jardel, who sees much broader application of the scheme: "We are creating a collective movement, a new community."
But the first step, he believes, is to break away from the attitude that nothing works anyway and nothing can be done.
Médecins Solidaires, which translates as Doctors in Solidarity, is now promoting the idea of copying the model in other municipalities in France and is looking for 300 committed doctors as a first step. Within five years, 150 medical practices like the one in Ajain are hoped to be established.
The community's new practice was set up in a rented container building as a temporary solution, while the guest doctors will be accommodated in a country house.
Patients have to get used to the idea of a different doctor at every visit, but Mayor Rouchon thinks it will work, as the new healthcare centre has permanent receptionists and patient files.
"People are surprised that they and their little aches and pains are taken care of, they are very satisfied," he said.
Encouraged by the new clinic's success, the mayor is now looking at ways of preserving other facets of local life. Since the village post office cut back its opening hours, he has set up a combined Biblioposte post office agency and library, which should be sustainable because of its dual function. – dpa
