Registered Doctors in France
The role of the referring doctor in France: how to select and nominate a general practitioner or other specialist to be the family doctor…
Every person of 16 years and over living in France and benefiting from social security should nominate a medical doctor to be their attending medical practitioner (médecin traitant).
The attending practitioner or primary care physician is responsible for their patient’s direct care and all referrals to other medical practitioners and specialists.
While it is not obligatory to have a médecin traitant, medical consultations and treatments referred by the médecin traitant are reimbursed by social security at beneficial rate.
Note: It is not necessary to get a referral for visits to an ophthalmologist or for dental and gynaecological treatment.
Responsibility of the Attending Practitioner
The attending practitioner is the doctor usually a General Practitioner (GP) who is consulted first for any medical issue. They are responsible for maintaining the medical file of patient’s visits, diagnoses and examinations. They refer their patient to other care if necessary and collect and keep the information and results of consultations. They can coordinate medical follow-up.
All medical visits made by referral of the attending practitioner are reimbursed at the standard rate of 70 percent (or more, depending on the situation).
A patient is not obliged to go to the specialist referred by the médecin traitant and the médecin traitant cannot prohibit their patient from seeing a specialist of their choice.
However reimbursement may only be partial.
Choosing an Attending Practitioner
Any doctor can be nominated as the attending practitioner provided they agree to this role.
While it is recommended that a GP (généraliste) be named, this isn’t obligatory. They may be a GP, a specialist, in private practice or at a hospital or clinic, and need not be geographically close to the patient. The only stipulation is that an individual is named, not an entire group practice (cabinet de groupe).
Once a doctor has been asked and agreed, both the doctor and patient fill in the Cerfa form No S3704 Déclaration de Choix du Médecin Traitant (declaration of choice the attending practitioner) which they sign and stamp. The patient then sends this form to their CPAM (Caisse d’Assurance Maladie) office.
All members of a family are not obliged to nominate the same doctor. Any person 16 years or older may approach the doctor of their choice; a declaration by people under 18 years must be signed by a parent or guardian.
It is recommended that a médecin traitant be chosen taking the following into account:
• Their judgment is trustworthy
• Making visits to them is easy and convenient
Changing an Attending Practitioner
The patient may change their chosen médecin traitant at any time with no penalty and no questions asked. Simply complete a new Déclaration de Choix du Médecin Traitant form with the new doctor and submit it to the CPAM office. The new declaration will cancel the preceding choice.
• If a medecin traitant is away, consult the substitute appointed by them
• A patient who is away from their normal place of residence for holiday or business (or in the event of an emergency) is excused from getting a referral. Reimbursement is at the standard rate
• A patient who is following a sequence of treatment/consultation with a specialist need not see the attending doctor before each specialist visit
• Referrals for visits to specialists are not required for under 16s