Lucenay-l’Évêque: the daily life of a country doctor

REPORT – In Saône-et-Loire, Dr Cécile Gogué-Meunier is the only general practitioner in a canton of 5,000 inhabitants. Grueling consultations, distant visits, the doctor draws his energy from his patients and his family. Without priesthood.

“Come and do your report on medical desertification whenever you want, anyway, I’m always overwhelmed! “If disrupting the schedule of doctors is sometimes difficult, with Dr. Cécile Gogué-Meunier, no problem. Even if going to his consultation will be a long journey in the beautiful countryside of Saône-et-Loire.

The first words exchanged with this general practitioner in the canton of Autun (71) in any case very quickly set the scene. That of the grueling daily life of a 44-year-old woman working in a medical desert. On the occasion of the film’s release on March 23, “Country doctor” by Thomas Lilti, Why actor went to this department where the shortage of doctors is becoming more and more worrying.

One general practitioner for 5,000 inhabitants

After an hour by TGV, an hour by bus, and 30 minutes by taxi, I finally arrived in Lucenay-l’Évêque. Despite a bucolic landscape with forests surrounded by rivers, the village of about 300 inhabitants does not look great. The town’s grocery store, hardware store and bar are a thing of the past. The Lucenois only seem to have a pharmacy and a brand new medical center. A midwife, two nurses, a physiotherapist and a general practitioner compose it.

The building also has a last desperately empty doctor’s office even though the rent is offered by the town hall. As a result, Dr Gogué-Meunier is very much alone on a daily basis. She is even the only general practitioner in a canton of 5,000 inhabitants, against three 14 years ago when she settled. On a daily basis, his pace of work impresses. 30 patients per day. Her archives list more than 1,300 patients for whom she is the attending physician. “Figures that do not count children,” she says.

The intern Nicolas Guyotat and Dr Cécile Gogué-Meunier, general practitioner in Lucenay-l’Évêque (71) – Martrette / Pourquoidocteur / TDR

“My happiness is them”

For Dr Cécile Gogué-Meunier, home visits remain “the salt” of his profession. It is for these isolated patients that this woman with a strong character has chosen to practice in a rural environment. “My happiness is them. I have always wanted to practice in the countryside. People are nicer there than in town, I think. We are in proximity, in personal stories. Finally, you feel very useful in a place where no one wants to go, ”she says.

For this country child, Lucenay-l’Evêque was therefore her first installation and the love affair with the patients has lasted for more than a decade. And it must be recognized that Dr. Gogué’s daily life is varied. His working days are punctuated with very funny moments. Best example, his first home visit, “chez Alice et Bébert”. Aged 76 and 85 respectively, this couple warmly welcomes us to their living room-kitchen just after lunch. “We were expecting you Doctor with your reporter, sit down and make yourself at home. We are delighted to welcome you ”. The accent and direct tone of these locals make the moment unforgettable.

The dated furniture and a tablecloth of yesteryear recall nostalgic memories of a peasant France, to which every French person remains attached. And seeing the amused eye of our practitioner during the consultation, we feel that it is also the authenticity of these people that attracts her to this profession. Through stories about children and grandchildren, the closeness she wanted with her patients is indeed there. With in addition the recognition of the sick. All of them punctuate the visit with several sincere “THANKS” to their Doctor. It is, in their view, “essential” and “reassuring”. On the way home, the feeling of duty accomplished is thus widely perceptible in our hero of the day … In short, everyone looks happy in the countryside.

The priesthood is over!

This overflowing relationship means that the inhabitants, often elderly of the canton, have incessant requests. To hold out, the doctor had to learn to be respected. In particular, by setting consultation hours on which it never compromises. His office is open Monday, Tuesday, Thursday and Friday, by appointment only from 8:30 a.m. to 12:15 p.m. and from 4 p.m. to 6:15 p.m., time of the last appointment. His patients therefore find the door closed on Wednesday, the doctor devotes himself to his three children. “If we add Saturday morning and home visits on the same days between 2 and 4 pm, it still makes busy weeks,” she concedes. And as with most of his colleagues, the days always end with administrative paperwork. She indicates to close shop at the latest around 7:00 p.m.

Unlike the main character in the film, our practitioner therefore chose not to see her profession as a priesthood. The phone calls from the patients on short notice, very little for her. Besides, no patient has their cell phone. Even in Saône-et-Loire, the country doctor who works at the mercy of his patients seems to be becoming an endangered species… “Replaced by on-call medicine organized by the center 15”, she explains.

Listen…

Dr Cécile Gogué-Meunier, general practitioner in Lucenay-l’Évêque: ” To stay in the country, it suffices to be firm and to have a good secretary. Many former doctors who had made their profession a priesthood regrett today… “

A version confirmed by Nicolas Guyotat, an intern in 8^th year of general medicine. At 26, he chose Dr Gogué-Meunier’s practice for his internship, the second in the region. And he is once again under the spell of the working conditions that the countryside offers. Suddenly, the one who will be a doctor in a year would see himself practicing there. But with another fracture with the doctors of yesteryear, that of the rejection of isolated exercise. He rather plans to practice in a group, “why not in a practice in association”, he suggests.

Martrette / Pourquoidocteur / TDR

The young man, who quickly became attached to the locals, said, however, that he understood the reluctance of his colleagues. “I like the setting, but many at my age prefer the city”. So, to attract other doctors to the canton, the trainee insists that in Autun, the sub-prefecture of Saône-et-Loire, “there are a lot of activities on offer”, that is to say ” everything you need to lead a life as a young person or as a family, ”he adds.

Listen…

Nicolas Guyotat, intern in general medicine: ” Home visits are very interesting. We have the patient, we see him as a whole, with his environment… “

Except that life in the capital is not all rosy either. This town of nearly 14,000 inhabitants faces the same problems as Lucenay-l’Évêque. There, too, doctors are leaving without being replaced. Dr. Gogué no longer takes any patient from Autun in his waiting room. In her defense, the practitioner already covers the medical needs of several villages in the canton, in particular during home visits. The most distant municipalities where she goes are still 21 km from her medical center. Kilometers that she swallows every day despite the fatigue, and without respite in winter when the climate is very harsh in this corner of the Morvan.

The feeling of abandonment of patients

But life in the country isn’t just hard for doctors. Its inhabitants are indeed the first victims of medical deserts. All repeat that they would like to have more practitioners available. Because because of the shortage of doctors, many of them admit regularly giving up care. This is the case of this 32-year-old man crossed in the waiting room. “When I call on Thursday and I am told that I would only have an appointment on Saturday, I personally give up. I opt for self-medication ”.

Listen…

Benedict, 32 years old and father of 2 children: ” When we arrived at Autun, all the doctors no longer had any place. They are all crowded… “

And for others, places are expensive. A mother who came with her daughter confides that when she called the secretary of Dr Gogué at 7 am there was only one place left, and at noon! “Not easy when you work, you imagine it”, she laments. Others like Michel, 67, turn to the hospital when Dr Gogué is not available. To his great despair, obviously. “We wait there for hours in the corridors, with overwhelmed doctors who don’t pay too much attention to us. Fortunately the Dr is there, ”he blurted out. For him, she is, it must be said, the only general practitioner around 40km away. During the discussion, we realize that all the others have, over the years, thrown in the towel …

The solutions considered

In an attempt to resolve the problems of access to his practice, Dr Gogué-Meunier believed he had found the miracle solution in the past. His name was “Serghei”, a Romanian doctor, recruited by a head hunter to settle in the town.

Hope quickly disappointed since this practitioner left overnight. He obviously warned Dr Gogué-Meunier, but the day before his departure! As much to say to you that even today the pill is difficult to pass. At present, the practitioner seems a little resigned to the crisis of vocations in the profession of country doctor. In a last standstill, she delivers her last weapon.

By opening the large windows of his office, we see that a river flows one meter from his floor. “It’s not deep enough for me to dive in but I could almost take my fishing rod and go get the fish between noon and two.” The setting, always the setting, “far from pollution and noise from city cars,” she concludes. Hopefully the view of the river will give birth to vocations …

Martrette / Pourquoidocteur / TDR

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Medical deserts: the hunt for general practitioners has no limits