That's how sociologist Eli Chinoy once characterised American doctors with their fixation on money-making. Fresh, maybe, from watching Michael Moore's Sicko, we might like to feel that French medics are quite different and deserve to wear white hats to match their white coats. Not quite true. Recent reports have uncovered a murky state of affairs among a minority of the country's specialist MDs.

Under a law of 1958 hospital doctors working in the public sector can use the same facilities for up to two half-days a week to receive private patients. Around one in eight physicians and surgeons work in this way officially. And they often abuse the system. In some cases they give immediate priority to their private patients and push as many people as possible to come to them en privé. Although the law says those working in public hospitals should charge private patients "reasonable" fees, doctors frequently quote sums many times above the rates fixed by la Sécu (€4000 for a prostate operation, for example, or €2000 for a mammogram). The most dedicated "dealers" put pressure even on patients who are not private to make additional payments "under the table".

Although these abuses are well known in medical circles - theordre des médecins in Paris admits to ten per cent "black sheep" in its ranks - for the most part the issue has been veiled in silence. Exploited patients rarely complain. Meanwhile the money-mad medics are trousering annual incomes well above the official average pay for hospital specialists of €110,000 a year.

Getting a raw deal from a doctor? To find out what you can do about it have a look at www.leciss.org

From Riviera Reporter 124, Dec 2007/Jan 2008

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