Sometimes victims of prejudice, “CMUs” patients can be discriminated against by private doctors.
This is what is called being the victim of double punishment. The Defender of Rights released this Tuesday a study on “Medical and dental practices, between differentiation and discrimination”.
Carried out under the direction of Caroline Despres and Pierre Lombrail, this work aims to collect the point of view of liberal practitioners on the care of patients living in precarious conditions.
The study was based on an analysis of speech from a total of 50 health professionals including dentists, general practitioners and specialists. And the results collected are proof of a drift on the part of certain professionals.
Refusal of care
The study first shows that the category of “CMUs” patients is widely used in speeches by practitioners. According to the authors of the report, it has even become another way of naming people in precarious situations …
The group of “CMUs” can also be associated by doctors with prejudices. And not the least: suspicion of fraud, overconsumption of care, absenteeism, frequent delays … The list goes on!
More generally, precarious people are seen as patients “by nature” difficult to treat. These “expected” behaviors are viewed negatively by practitioners and are sometimes used to justify refusals of care.
And serious discrimination
However, they constitute situations of discrimination prohibited by law. Article L. 1110-3 of the public health code indeed qualifies the illegal nature of such refusals: “no person may be discriminated against in access to prevention or treatment”.
Concretely, discrimination can take the form of a permanent or occasional refusal. They can also be expressed in a more insidious way: systematic reorientation of a patient to another practitioner or to the hospital, abnormally long waiting times, agreement between practitioners not to address beneficiaries either of the CMU – C, or assistance for the payment of complementary health insurance (ACS) orstate medical aid (AME).
In response, the Defender of Rights opened several inquiries in December 2016 following information mentioned on websites concerning the practices of certain doctors not accepting CMU or AME beneficiaries. In the process, the National Council of the Order of Physicians (CNOM) announced that it would seize its disciplinary chambers. The noose is tightening on these illegal doctors …
The institution’s recommendations
In the remainder of the Institution’s work on refusals of care and with regard to referrals and the results of the study, the Defender of Rights recommends:
– to legally define refusals of care by supplementing Article L. 1110-3 of the Public Health Code with a typology of the main situations characterizing an illegal refusal of care;
– ask the CNAMTS to identify practitioners who impose excess fees on beneficiaries of CMU-C or ACS social protection;
– to carry out a national situation test by the “refusal of care” commissions;
– to include refusals of care in the framework of regional programs relating to access to prevention and care for the most deprived people (PRAPS) of regional health agencies.
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