France faces a major health challenge: a shortage of doctors. This issue directly impacts the quality of care and the public health system.

As of January 1, 2025, France had 241,255 practicing doctors, a moderate increase of 1.7% compared to 2024. However, this growth masks a worrying reality: a shortage of general practitioners, essential for primary care.

This shortage, exacerbated by an uneven distribution of professionals across the country, creates "medical deserts." Today, 87% of metropolitan and overseas territories suffer from limited access to healthcare, particularly in rural areas. In this article, we will analyze the causes, consequences, and possible solutions to guarantee equitable medical coverage and address future challenges. Overview of the shortage of doctors in France: The gradual decline in the number of general practitioners. France is facing a worrying decline in the number of general practitioners. Between 2007 and 2025, the country lost one in four general practitioners, representing a decrease of more than 8% over this period. This trend is largely explained by the failure to replace retiring doctors, which exacerbates the shortage in this essential sector of primary care. With the exception of a few departments such as Savoie and Loire-Atlantique, all French territories have recorded a decline in their medical density. Some regions, such as Paris and Nièvre, lost up to a quarter of their general practitioners between 2007 and 2016. This demographic decline affects both rural and urban areas, making access to healthcare increasingly difficult for residents. For example, the Bourgogne-Franche-Comté region has only 9.1 general practitioners per 10,000 inhabitants, a figure well below the national average of 11.3. Furthermore, nearly 43% of general practitioners are over 60 years old, suggesting even greater challenges in the years to come. The alarming situation among specialists: The shortage of general practitioners is already worrying, but the situation among specialists is hardly more reassuring. While some specialties, such as dermatology and ophthalmology, are overrepresented in large urban areas like the Provence-Alpes-Côte d'Azur region, peri-urban and rural areas suffer from a severe shortage of specialists. In regions like Alpes-de-Haute-Provence and Haut-Var, less than 20% of specialists are under 40, exacerbating inequalities in access to specialized care. This concentration of specialists in large cities, to the detriment of rural and peri-urban areas, highlights the need for territorial regulation of medical services. Such an adjustment is essential to guarantee equitable access to healthcare for the entire population.

Multifactorial Causes of the Doctor Shortage

The Aging of the Medical Population

The aging of the medical population is one of the major causes of the doctor shortage in France. Nearly 43% of general practitioners are now over 60 years old, and this trend is only increasing.

This phenomenon leads to a high retirement rate, which is not always offset by the arrival of new doctors. This situation is particularly critical in rural areas, where doctors are often older than in urban areas, thus exacerbating the shortage of doctors. The perverse effects of the numerus clausus: The numerus clausus, which limits the number of students admitted to the first year of medical studies, has perverse effects on medical demographics. Although this system aims to regulate the number of future doctors, it does not take into account the actual needs of the region and geographical disparities. This limitation can lead to a shortage of doctors in some regions, while other areas may have a surplus of healthcare professionals. Furthermore, the numerus clausus does not necessarily encourage young doctors to settle in the most underserved areas. Unattractive working conditions and pay: Working conditions and pay for doctors in France are often unattractive, particularly for general practitioners. Long working hours, a heavy administrative burden, and salaries that don't always meet expectations contribute to discouraging young doctors from choosing this path. Furthermore, the pressure exerted by patients and the healthcare system, as well as the lack of administrative and logistical support, exacerbate burnout and demotivation among healthcare professionals. Difficulties related to the organization of the healthcare system: The organization of the French healthcare system also presents significant challenges that contribute to the shortage of doctors. Administrative complexity, regulatory constraints, and the financial difficulties faced by both private practice and hospital-based physicians are all factors that make practicing medicine less attractive. Furthermore, debates surrounding the regulation of physician establishment within a given territory, while aiming to improve access to care, can be perceived as coercive and discourage some doctors from settling in areas where they are most needed. Impact on public health and access to care src="https://cdn.prod.website-files.com/61f1c5bbc327ec3679e7457c/682c3857d9e36975b7d24d66_89089954571.webp" width="auto" height="auto" loading="auto">

The increase in medical deserts

The increase in medical deserts has serious implications for access to care for a large part of the French population. In 2024, 87% of metropolitan and overseas France was classified as a medical desert, affecting six million French people who did not have a primary care physician. These areas, often rural or suburban, suffer from a chronic shortage of doctors, which leads to significant difficulties for patients. They often have to travel long distances to obtain basic care, which worsens their situation. The shortage of general practitioners and specialists also results in longer waiting times for appointments. Patients often have to wait several weeks, or even months, to see a doctor, which can delay the diagnosis and treatment of potentially serious illnesses. This situation is particularly concerning for patients with chronic conditions that require regular monitoring and prompt care. The impact on hospital emergency departments: Medical deserts and the shortage of doctors also have direct consequences on hospital emergency departments. With fewer primary care physicians, patients are more likely to turn to the emergency room for care that could have been provided in a doctor's office. This overloads emergency services, which are already often overcrowded, and can lead to delays in treating genuine emergencies. This overload can compromise the quality of care and endanger the lives of patients requiring immediate intervention.

The solutions considered and their limitations

The elimination of the numerus clausus and the reform of health studies

One ​​of the

The use of telemedicine and new technologies

Telemedicine and new technologies represent another solution being considered to improve access to care, particularly in underserved areas. Telemedicine allows patients to consult doctors remotely, thus reducing geographical barriers and appointment wait times.

Telemedicine platforms and remote diagnostic tools are increasingly being used to address the shortage of doctors.

However, this solution is heavily dependent on the available digital infrastructure and connectivity in rural areas, which can be inadequate. Furthermore, telemedicine cannot entirely replace local care and in-person consultations, which remain essential for many patients.

Developing Interprofessional Cooperation

Interprofessional cooperation between doctors, nurses, physiotherapists, and other healthcare professionals is a key solution for improving the efficiency and quality of care. multidisciplinary care teams allow for the sharing of responsibilities and the optimization of available resources, thus better meeting patients' needs.

However, this approach requires effective coordination and communication between the different healthcare professionals, which can be complex to implement and maintain. Furthermore, regulatory barriers and differences in professional practices can hinder the adoption of these collaborative care models.

Conclusion

The shortage of doctors in France, particularly among general practitioners and specialists, represents a major crisis for the healthcare system. Medical deserts, exacerbated by the aging medical population and unattractive working conditions, have a serious impact on access to healthcare for millions of French people. The proposed solutions, such as abolishing the numerus clausus (the quota system for medical school admissions), incentives for setting up practices in underserved areas, and the use of telemedicine, must be implemented urgently and in a coordinated manner. It is essential that public policies be adapted to encourage young doctors to establish themselves in rural areas, while simultaneously improving their working conditions and compensation. Immediate, collective action from policymakers, healthcare professionals, and civil society is essential to resolve this issue and guarantee equitable and high-quality access to healthcare for all.

FAQ

What are the main factors contributing to the shortage of doctors in France, particularly in terms of demographics and geographical distribution?

The shortage of doctors in France results from several key factors. First, the aging population leads to an increase in healthcare needs, while a low generational replacement rate, linked to a higher number of deaths than births, exacerbates the situation. Furthermore, the uneven geographical distribution of doctors intensifies the problem: rural areas are often less attractive due to difficult working conditions, less competitive salaries, and limited career prospects. Furthermore, young doctors tend to work fewer hours than their predecessors and favor urban centers.

How have public authorities responded so far to address the problem of medical deserts, and what plans and initiatives have been implemented?

Faced with medical deserts, public authorities have implemented various initiatives. Regional Health Agencies (ARS) play a key role in identifying and targeting underserved areas to improve the provision of care. Financial incentives and specific benefits are offered to doctors who agree to set up practice in these areas.

In addition, telemedicine is encouraged to expand access to remote care, particularly in isolated regions. Training and recruitment programs for healthcare professionals are also being strengthened to address labor shortages.

What are the anticipated consequences of the declining number of doctors on public health and the healthcare needs of the French population, especially considering the aging population?

The decline in the number of doctors in France poses considerable challenges for public health. Although a temporary increase is expected, the aging population continues to drive up the demand for care. This situation exacerbates the medical deserts, where six million French people lack a primary care physician and eight million live in underserved areas.

Furthermore, general practitioners are already heavily impacted by burnout, with nearly 45% of GPs affected. Increased demands could exacerbate this burnout, thus affecting the quality of care provided.

What long-term measures, such as raising the numerus clausus, are expected to improve the density of medical professionals in France, and when can they produce significant effects?

To address the shortage of doctors, the numerus clausus is being progressively replaced by a numerus apertus, allowing for a substantial increase in the number of medical students. Between 2025 and 2027, the number of places will increase from 11,500 to 16,000, with 12,000 places already planned for the start of the 2025 academic year. This reform is designed to increase the density of medical professionals in France and should have a significant impact from 2026-2027 onwards, when new graduates begin practicing.