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

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

This shortage, exacerbated by an uneven distribution of healthcare 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 ensure equitable healthcare coverage and address future challenges. Overview of the doctor shortage in France: The gradual decline in the number of general practitioners. France is facing a concerning 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 due to 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 regions have seen a decline in their doctor-to-population ratio. Some regions, such as Paris and Nièvre, lost up to a quarter of their general practitioners between 2007 and 2016. This 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 concerning, 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 such as 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 regional 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 workforce is one of the main 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, thereby exacerbating the shortage of doctors. The adverse effects of the numerus clausus: The numerus clausus, which limits the number of students admitted to the first year of medical school, has adverse 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 or 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 do not 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 rise in medical deserts

The increase in medical deserts has serious implications for access to care for a large portion 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 wait 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 for 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 medical education

One of the

The use of telemedicine and new technologies

Telemedicine and new technologies are another option being considered to improve access to care, particularly in underserved areas. Telemedicine allows patients to consult with doctors remotely, thereby reducing geographical barriers and wait times for appointments.

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

However, this solution is heavily dependent on the digital infrastructure and connectivity available 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 Collaboration

Interprofessional collaboration among doctors, nurses, physical therapists, and other healthcare professionals is a key strategy for improving the efficiency and quality of care. Multidisciplinary care teams enable the sharing of responsibilities and the optimization of available resources, thereby better meeting patients' needs.

However, this approach requires effective coordination and communication among different healthcare professionals, which can be difficult 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 an aging medical workforce 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 establishing 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 by 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 stems from several key factors. First, the aging population is leading to an increase in healthcare needs, while a low replacement rate—due to more deaths than births—is exacerbating the situation. Furthermore, the uneven geographical distribution of doctors is intensifying the problem: rural areas are often less attractive because of difficult working conditions, lower salaries, and limited career prospects. In addition, young doctors tend to work fewer hours than their predecessors and prefer to practice in 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 access to care. Financial incentives and specific benefits are offered to doctors who agree to set up practice in these areas.

In addition, telemedicine is being promoted to expand access to remote care, particularly in remote areas. Training and recruitment programs for healthcare professionals are also being expanded 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 given the aging population?

The decline in the number of doctors in France poses significant 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 shortage of medical care, with six million French people lacking a primary care physician and eight million living in underserved areas.

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

What long-term measures, such as raising the enrollment cap, are expected to increase the density of medical professionals in France, and when can they have a significant impact?

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