Doctor takes a tour de France, one “medical desert” at a time
OLES PIEUX, FRANCE» n a sunny but chilly June morning, Dr. Martial Jardel took his black motorcycle out of his camper van, put his helmet on and started the engine. For his last day on Normandy’s Cotentin Peninsula, he was ready to hit the road along the English Channel to visit a patient.
Michel Piquot, 92, standing on his doorstep in blue slippers, was waiting impatiently.
“When was the last time you had a blood test?” Jardel asked after arriving at the single-story house, speaking louder for Piquot, a former employee of an aviation company, who is hard of hearing. “I have no idea,” Piquot replied, looking at the young doctor with vacant eyes. “I tell you, it’s hell getting old.”
In March, a newly graduated Jardel, 30, decided to go on a five-month “Tour de France” trip. But unlike the prestigious cycling race, his journey took him to what the French call “medical deserts” — areas with an acute shortage of physicians. Jardel offers an irresistible deal to overworked doctors in these areas: He replaces them for two weeks while they go on vacation.
Over the past few months, Jardel has traveled more than 2,800 miles with his camper van, sharing his experience on his website and with more than 1,500 followers on Instagram, hoping to change the minds of young doctors who are often reluctant to settle in rural areas that are full of patients but lack the appeal of big cities.
Despite France’s world-renowned health care system, about 7 million people live in areas where access to a doctor is limited, according to a recent survey published by Mutualité Française, a leading professional union of health insurance companies. Making matters worse, officials are bracing for a big wave of retirements over the next decade in France, where the average age of doctors is now 49, according to the government.
Normandy is one of the regions that is hit hardest by the shortage of physicians, according to a recent report by the French Senate, especially on the Cotentin Peninsula, where 40% of medical practitioners are over 60.
The imbalance between underserved regions and urban areas where physicians cluster has fueled perceptions of a widening gap between a wealthy, well-connected
France and one that is more peripheral and taken for granted. These divisions have fueled Yellow Vest protests and the anger of health care workers, who are exhausted by the pandemic and staff shortages.
“We must act quickly,” said David Margueritte, president of the authority that oversees Cotentin. “A territory cannot be attractive in the long run if there’s no possibility to seek treatment.”
For the sixth stage of his medical road trip, after stopping in central, eastern and northern France, Jardel replaced Mathieu Bansard, 32, a general practitioner in Les Pieux, a town of 3,000 on the peninsula where the main street is a hodgepodge of stone cottages and businesses, including a bakery, a creperie and a hairdresser.
“I wanted him to see that even here, we could have optimal working and life conditions,” Bansard said. “It is not because we are in the countryside that it stinks!”
More than 30 people, including midwives and psychologists, work at the health center where Bansard practices. About 60 miles from Omaha Beach, it is an exception on the Cotentin Peninsula, which is affected by a scarcity of specialists such as dentists — only 33 for 100,000 inhabitants. The doctors in Les Pieux have 1,800 to 2,200 patients each, while the national average is about 900, making it “impossible” for newcomers to find an attending physician.
Local authorities are trying to attract young doctors to underserved rural areas with incentives such as covering tuition for newly graduated physiotherapists.
“It is a charm offensive,” said Margueritte, the Cotentin official. “We hope they’ll have a crush.”
For some, the charm seemed to work. Axel Guérin, 25, a doctor in training at the University of Caen who is working at the health center in Les Pieux, said he was planning to stay in the region after his sixmonth residency.
“I like the mentality, the rural life, the living environment,” he said as he contemplated the panoramic seaside view from his office. Doctors and interns sometimes enjoy lunchtime surf sessions, Bansard said.
But Jardel, the itinerant physician, was not smitten, even after two weeks and a farewell gift from Bansard — beer from a local brewery.
“You can come back anytime, and don’t forget to bring us some friends!” Bansard said as he waved goodbye.
“I’m taking my shot of rural life, but to settle here for the next 30 years, I can’t,” Jardel admitted.
He stowed his motorcycle in his camper van and drove past Mont Saint-michel — the Norman island abbey that dominates the region — for the next stage of his trip, in Brittany.
Following in his father’s footsteps, Jardel studied medicine for nine grueling years. But he wanted to take a “breath of fresh air” after graduation, in the middle of the pandemic, by discovering France’s countryside and its small-town medical practices.
In Brittany, Jardel was replacing Dr. Marion Molié, 33, the only physician in Pleumeur-gautier.
“There used to be eight doctors,” said Molié, who works at a care home that was established by two doctors in 2014. They quit less than a year later to open an office in a bigger town.
“Now, for the 8,000 inhabitants of the peninsula, we are only two,” she said.
Overburdened with the 1,800 patients she treats, Molié has said since March she cannot take on new ones. The situation is becoming “more and more worrisome,” she added, especially now that the doctor in a neighboring town is about to retire.
After touring the care home and collecting the keys, Jardel looked for a place to park his camper van before sundown. Along Brittany’s foggy coastal landscape, he settled next to old men fishing.
Jardel took in the salty sea breeze and watched the waves. He has already thought of a new project: creating an organization to encourage other young doctors to discover underserved areas.
Would he embark on another tour? “It is not impossible. I saw 10 of France’s 101 departments. I still have 91 left.”