- To relieve emergencies, a new device is experienced in the Bas-Rhin.
- Called "A doctor 116,117", the service is open from Monday to Friday from 8am to 20h and intends to reorient patients if possible to medicine in the city.
We probably all knew that waiting, which seemed so endless, to the emergency department of the hospital. We also see each winter
alerts "saturated emergencies" during epidemics. Whereas the Court of Auditors
recently estimated that hospital emergencies are still "over-solicited", judging the current system "out of breath" and advocating the development of city medicine, an unprecedented experimental device was presented Monday in Strasbourg.
Called "A doctor 116 117", this service wants to relieve the urgencies of the Bas-Rhin thanks to the development in the city of the unprogrammed care offer. With the will, in passing, to encourage patients to change their behavior or habits. The idea: to convince them to visit a doctor's day in the city without an appointment in a short time rather than wait and overload emergencies.
Reorient patients to improve management
Thanks to a single telephone number, a good part of the problem can be solved according to the Regional Health Agency (ARS) and the Regional Union of Health Professionals-Private Practitioners (URPS-ML) of the East, instigators the project alongside Strasbourg University Hospitals (HUS).
How it works ? The 116 117 can be reached free from Monday to Friday from 8h to 20h. At the other end of the line, a liberal regulatory doctor will ask some questions to assess the urgency felt, establish a pre-diagnosis and seek a doctor (or switch the care to 15). Priority is given to the patient's treating physician, if he / she is part of the device, or to the nearest physician (depending on the location). The visit can be done in the office or, if necessary, at home. About twenty minutes are usually enough to guide the patient.
– A Doctor 116 117 (@unmedecin116117) March 18, 2019
"Patients do not know"
The project promoters insist: it is a question of this service of capturing the patients who go to the emergencies whereas they would not necessarily need it: "Nearly 40% of the passages should be taken care of elsewhere, figure Christophe Lannelongue, director general of the ARS. This produces an effect of saturation and disorganization which ultimately penalizes the real demands of urgency. The desire is to put patients back into the right care loop.
Dr. Guilaine Kieffer-Desgrippes, president of the URPS-ML, continues: "About 70% of the patients did not call anyone before going to the emergency room, the attending physician, or the Samu …" According to her, in the half of the cases, a simple medical advice is enough. "In the minds of parents, for example, if your child has a fever of 38.5 ° C, go to his doctor, but at 40 ° C go to the emergency room. We did it all. But people have to accept and trust other solutions, argues Dr. Fieffer-Desgrippes. It is not a question of prohibiting but of bringing another answer. Some go to emergencies because they do not know, we never learned. We are also doing educational work here. "
"A 116 117 doctor" has been tested since November in Strasbourg: now 60 doctors participate in the regulation of 116 117 and 130 subscribe to the information system for geolocalised medical visits. A point will be made in three months to know whether to extend this device to Saturday morning, the weekend period that is not concerned by the tables of the doctors' guards. What about emergencies at night? "There are very few," says Christophe Lannelongue. But the emergency services are saturated in the evening because of patients arrived in too many numbers during the day. That, he hopes, should improve.