Tensions relating to the reduction in the working hours of emergency physicians are beginning to be felt. A Parisian hospital manager even speaks of segregation between doctors.
A circular from the Ministry of Health recently set 48 hours (39 for clinical work and 9 for non-clinical tasks) as the maximum weekly working time for hospital emergency physicians. As they could work up to 60 hours previously, the trade unions in the profession welcomed this while remaining wary of the application of this new standard. But on the side of other doctors, we take a dim view of this exception made only to emergency physicians.
Segregation between hospital practitioners
The first to draw was Pr Stanislas Chaussade, president of the medical commission (CME) of the Cochin, Broca and Hôtel-Dieu group, within the Public Assistance – Hospitals of Paris (AP-HP). In an email addressed to the management of the AP-HP, consulted by Agence France Presse (AFP), he simply denounces “a segregation between hospital practitioners for trade union and political reasons”.
Indeed, other hospital practitioners continue to work “48 hours a week”, he is indignant in his email. For emergency physicians, all hours exceeded beyond 39 hours will be subject to additional remuneration.
Worse yet, this eminent professor of gastroenterology and digestive oncology talks about the economic consequences of this circular. “To respond to this new situation, the AP-HP provides for the creation of 26 emergency posts, for a total cost of 3 million euros,” he wrote in his indictment.
A refusal to apply the new working time
However, “more than 4 million euros in savings are requested on staff for the year 2015”, including 600,000 within his hospital group (GH), he laments. “If there is a lack of staff in the emergency room, they must be put in, but not by stripping the other services (…) without consultation. Under these conditions, I refuse to apply the efficiency plan on the medical workforce within my GH in 2015, ”he warns in his e-mail.
And in his fight, this president of CME does not seem alone. The French Hospital Federation (FHF) and the presidents of CME hospitals had already contested the circular for the application of the new working hours of emergency physicians when it was published. The FHF had even assessed the additional cost of the measure at a minimum of 90 million euros.
“An additional cost that no one can deny and which once again raises the question of the coherence of government policy which, on the one hand, requires very tough efforts from hospitals and, on the other, increases the number of announcements that weigh down expenses and make the management of hospital teams even more difficult, ”she wrote in her last Press release.
Finally, the SNPHAR union (1) last week called on the government “to apply similar measures to other specialties (anesthesia-resuscitation, medical or specialized resuscitation, radiology, etc.) whose work is also strongly constrained by rigid work organizations such as operating theaters, but also all the other technical platforms (radiology, resuscitation, etc.), so as not to create dissension within the medical community, ”he concluded.
(1) National Union of Hospital Anesthetists-Resuscitators.
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