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HEALTH

Maverick French Covid doctor reprimanded over ‘breaches’ in clinical trials

A French doctor who shot to global notoriety during the Covid pandemic with an unproven treatment for the virus has been formally admonished by health authorities over "serious breaches" in several other clinical trials.

Maverick French Covid doctor reprimanded over 'breaches' in clinical trials
Didier Raoult at the IHU medical institute in Marseille. Photo by Christophe SIMON / AFP

Didier Raoult, a respected tropical disease specialist, earned fans but also widespread condemnation from peers by insisting that Covid could be treated with the anti-malaria drug hydroxychloroquine.

Despite an absence of peer-reviewed evidence, Raoult administered the drug to hundreds of people and helped spur its promotion by former US president Donald Trump and his populist Brazilian counterpart Jair Bolsonaro.

His outspoken defence of hydroxychloroquine despite several trials and studies discrediting its Covid effectiveness earned him an official admonishment from the French Medical Association last December.

The reprimand had little impact, however, because Raoult had already resigned as a practising physician at the hospital university of Marseille in southern France.

But the controversy also drew scrutiny of his other research by health regulators, who opened inquiries late last year of trials at the Mediterranean Infection Foundation of Marseille, which he still directs.

On Wednesday, the ANSM drug security agency said it had found “serious breaches” in clinical tests, most of which were begun several years before the Covid pandemic.

It was the first time France’s national health authorities have explicitly faulted Raoult over his practices.

“Ethical rules have not been systematically respected, which did not allow the proper protection of participants,” the ANSM said in a statement.

In some cases patients were not asked to sign waivers proving their consent, and in others the doctors did not obtain the required notice of opinion from an independent evaluation committee.

It ordered a halt to the faulty trials still underway and said it would oversee “corrective and preventive measures” to ensure proper conduct.

It also filed a legal complaint against Raoult’s foundation, saying it had illegally launched some trials and had submitted a fake document to justify one of them.

But it did not take any action over the administration of an experimental treatment for tuberculosis that provoked severe side-effects in a large number of patients, a scandal revealed by the Mediapart investigative website in October 2021.

The ANSM said Raoult’s foundation had not registered the treatments as a clinical trial, meaning it did not have grounds to intervene – but an inquiry is ongoing and legal complaints may still be made, it said.

Raoult denied doing any tuberculosis research and said at a press conference last week that he might sue Mediapart for describing the treatments as “uncontrolled tests.”

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HEALTH

The different ways you can make a doctor’s appointment in France

Booking a medical appointment in France can be time-consuming – especially if you are new to the country and are looking for an English-speaking doctor.

The different ways you can make a doctor's appointment in France

You do not need a carte vitale to book a doctor’s appointment in France – anyone who needs medical help while in the country is entitled to it, but you may not be entitled to any reimbursement if you are not part of the social security system.

Booking a GP’s appointment can be as simple as phoning up your friendly neighbourhood GP, or using an online service such as Doctolib. 

It helps a lot, if you have a médecin traitant – an attending GP, who adds you (and your family, if they can) to their list of patients. 

READ ALSO Explained: How to register with a doctor in France

It is not always easy to find one. Some parts of the country are short of GPs, which means doctors’ lists can fill up very quickly. But it is important that anyone who lives in France is registered with a named GP, especially if they have a carte vitale.

As well as being the main point of contact between patients and the medical profession in all its guises, it is financially responsible to be registered with a GP in France.

Reimbursement on consultations is typically 70 percent through the French healthcare system, but just 30 percent for anyone without a declared doctor. Meanwhile, top-up mutuelle health insurance companies usually require you to declare a médecin traitant and if you don’t, you may not be able to receive reimbursements on certain treatments.

Bear in mind, it is your responsibility to register with a local médecin traitant. But, even after you have done so, you can still make an appointment with any doctor, anywhere in France, and arrange specialist treatment, if you need it. 

READ ALSO 5 things to know about visiting a doctor in France

How do you go about making a GP appointment in France?

There are several options.

Some health centres – more often in larger towns and cities – operate a walk-in policy. But expect waits to be lengthy. Do not, however, assume that your GP operates a system like this.

You can phone for an appointment. This is another very common method. Your GP will have their own system for making appointments – which may even include something that looks, to the uninitiated, very much like a casual walk-in policy. 

Some may have an assistant to deal with booking appointments and other administration. Others may deal with appointments themselves, and may – for example – operate some sort of triage system based on voice messages from patients. 

What about online booking systems?

And many practitioners are now attached to websites, such as Doctolib. As of 2023, about half of all GP appointments in France were made using Doctolib.

READ ALSO How to use: French medical website Doctolib

Be aware that other online booking systems are available. Doctolib is one of the best known, but your GP may be attached to another system, like the health ministry approved site ‘LeMedecin.Fr’.

This website also has a feature where you can take an immediate online consultation with whatever doctor is available at that moment. By clicking ‘Consultez en vidéo maintenant’ you will be connected to the next doctor who is free. This option may involve an additional charge between €5-10 on top of the price of the consultation, and you will be expected to pay when booking.

If you have any trouble with either of these websites, you can go through the list of registered generalists per département on the ‘Ameli’ website. If you use this option, you will need to call the doctor to see if they are open or available for appointments.

In terms of wait times, online systems have helped to significantly reduce the delay between booking and getting an appointment.

According to a 2023 study by Doctolib, about half of all GP appointments were available within three days from the time of booking on their platform.

Similarly, you can use online platforms to check the medical professional’s qualifications and languages spoken, as well as filter based on the doctor’s English abilities. However, this should be taken with a grain of salt because not every medical professional with English listed on their Doctolib page speaks fluent English. 

An increasing number of doctorsoffer video consultations, known as télémédecine in France. This allows professionals – particularly those in more rural areas – to diagnose less serious conditions remotely. This type of consultation is usually only available from those medical practices that are attached to online booking systems. 

Some pharmacies have also begun offering walk-in télémedicine consults, using ‘Medadom’ machines. More information here.

What about specialists?

In France, you book your own consultations with specialists, even if you are referred by a doctor (your GP may offer a recommendation, but won’t always). The good news is that many specialists do use online booking services. Those that do not usually have assistants to take care of the appointments.

READ ALSO: Urgent care: How to get non-emergency medical treatment in France

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