After a historic health crisis, Dr. Jean-François Lemoine receives in this series “The Day After” the main players in the world of health. Today, Professor Yonathan Freund, emergency doctor at Pitié-Salpêtrière. To hear it, we are far from being out of the emergency crisis!
Clairvoyant, lucid, or disillusioned and resigned? It’s hard to describe Professor Yonathan Freund’s state of mind. Proud of his job as an emergency doctor at the Pitié-Salpêtrière – “It’s the place where you immediately serve a purpose, here we treat everyone” -, he does not hesitate to start about his service: “We have always been the doormat of the hospital…”. Not very glorious!
It is true that he is at the heart of what has almost become the symbol of the malaise of the hospital, the emergency crisis. A crisis that lasts and that has enough to make him lose some illusions. Starting with those that could give rise to the Ségur de la santé. “Why do yet another consultation when we know very well what the problems and the demands are?” Asks Yonathan Freund.
“We were afraid of not being able to take care of all the patients”
Doubts that do not even come to calm the satisfaction born of the prowess of the hospital to hold at the height of the health crisis. “We were afraid of not being able to take care of all the patients correctly, but fortunately we completely reorganized ourselves and above all we had unlimited means; this added to the deprogramming of other care, we could all concentrate on a single thing … But with the return of the other patients, we will see the sick again on stretchers”.
So there would be no solution to this emergency crisis? For Yonathan Freund, it is the way in which the subject is approached that would pose a problem. Overwhelmed emergencies because they have to manage cases that could fall under city medicine? “It’s a speech that makes the sick or liberal medicine feel guilty, I’m not in it”, replies Professor Freund who specifies that the presence in the emergency room of these patients who present light pathologies “does not take a lot of resources , they’re not the problem!”
So what to do? Even if his choice is to refer the leaders of the health system to their responsibility, that of making the necessary decisions – “I have no solutions, I give my analysis…” – Yonathan Freund advances everything also some ideas. “A doctor who wants to hospitalize a patient must be able to do his job and choose the hospitalization service for his patient without having to send him to the emergency room,” he says. But what means can be found to make this possible? “There is task delegation, we are going slowly with advanced practice nurses”.
Find beds downstream of the emergency room
Tracks that can only very partially solve the number one obstacle to the proper functioning of emergencies, the difficulty of finding the necessary beds downstream of these services. “In my team, I have two full-time doctors who are only looking for beds!”, the young professor is indignant.
But in the aftermath of the health crisis and the great promises of a better future made to the world of health, does he see anything moving to deal with the problem? “There is no day after, believes Yonathan Freund, we say every day what is wrong, I have no hope…”. And he drives the point home with a conclusion that sounds like a grim prediction: “You will see, in 2022 nothing will have changed, in the emergency room, the sick will still be on stretchers”. Finally, the right word to say the state of mind of Professor Yonathan Freund, it is perhaps “resigned”.
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