does a doctor make money by declaring that a patient has tested positive, as Christian Perronne says?


Would general practitioners have a financial interest in declaring patients sick with Covid-19? In the midst of the recovery of the coronavirus epidemic, Christian Perronne, specialist in infectious diseases at the Raymond-Poincaré hospital in Garches (Hauts-de-Seine), hinted at it, Thursday, October 15, at the microphone of André Bercoff on Sud Radio.

“A general practitioner who declares a positive Covid test from one of his patients receives money”, asserted Christian Perronne. “ENo more consultation? “, questioned him André Bercoff. “THEui, of course. So ithe interest in doing a lot of tests (…) He will earn money “, answers the infectious disease specialist. But is Christian Perronne telling the truth or “fake”?

How much money do doctors get for a positive test he’s talking about? As indicated by Medicare, doctors can charge an increase of 30 euros to a patient who tests positive for Covid-19. The sum is added to the usual price of the consultation or teleconsultation (25 euros minimum with a general practitioner).

The patient comes for the first time to consult his doctor, because he fears being ill with Covid-19. His GP prescribed a test for him. The consultation is then billed at the usual rate, indicates Medicare. When the patient returns to his doctor with his positive diagnosis, the practitioner can then invoice the increase. He is also authorized to do so in the event of consultation of a patient to whom he has not prescribed screening, but who has nevertheless already tested positive. In any case, the consultation is covered 100% by Medicare.

According to the latter, the increase “enhances the announcement of the positive test, the prescription of tests for close contact cases (people residing at the patient’s home), the information given to the patient on barrier measures, recording in the patient’s Contact Covid tool and close contact cases “. The practitioner is in fact invited to “validate the patient’s file” if it tests positive and “initiate the contact tracing process” or to “pursue her”, if Medicare has already started it, for example in the case where “the laboratory belatedly informed the doctor that one of his patients tested positive” or “if the patient himself was late in contacting him”.

This increase, called “MIS” because it concerns a “initial consultation to inform the patient and set up a therapeutic strategy”, has been extended to cases of Covid-19. It already applied to patients with cancer or serious or neurodegenerative neurological pathology. Its fixed amount of 30 euros is not specific to the coronavirus epidemic either. In addition, this is not the only increase that doctors can benefit from: home consultations or night-time procedures also entitle them to it.

“When we have a positive case, and only when we have a positive case, and that we have done the work of support and explanation, we can quote an MIS surcharge of 30 euros”, abstract Richard Talbot, general practitioner in Manche, who deals with nomenclature issues at the Federation of Doctors of France.

“Shocked”by the words of Christian Perronne, Richard Talbot argues that this increase remunerates a consultation which “takes a lot of time”. “For two positive patients this morning, it took me 1h20”, he says. According to him, this additional cost of 30 euros is therefore “not excessive”.

Because, when he receives a positive patient for Covid-19 in consultation, the doctor must, list the Norman practitioner, to take care of “the organization of home care, the extension of any sick leave, the explanation or re-explanation of all barrier hygiene measures, the sending of additional prescriptions, the management of other family members, sending PCR orders so that everyone gets tested at the right time, explaining how to monitor them (disappearance of taste, smell, shortness of breath , fever …) and finally the information of the Covid Contact form on the Health Insurance website “.

“To be paid 55 euros for 30 to 45 minutes spent reassuring, explaining, filling out the file and reminding the patient of barrier gestures, that’s not the dream”, already noted the president of the Confederation of French medical unions, Jean-Paul Ortiz, in May in Doctor’s Daily. “The doctors who manage to collect this increase did not steal it”, slice Jean-Paul Hamon, honorary president of the Federation of Doctors of France, joined by franceinfo.

Are GPs better off testing their patients? Here again, the main interested parties refute Christian Perronne’s argument. First, “people can go and get tested on their own”, without going through their doctor, opposes Richard Talbot. “This is not why, contrary to what Professor Perronne says, we are multiplying the tests. It is a public health issue. ” In addition, the doctor is not always the one who declares the patient positive for Covid-19. “When you arrive on the Social Security site, the patient has often already been declared by the laboratory, underlines Jean-Paul Hamon. When you order a PCR test, it’s not for the sake of cash. “

Jean-Paul Hamon formulates another objection to Christian Perronne’s comments, of a technical nature this time. “Myself, I have not yet managed to properly adjust my software to apply third-party payment on this increase. Of the fifteen cases that I have had in recent days, I have only applied it out of three. This is not my primary concern. “

Jérôme Marty, president of the union of the French Union for Free Medicine, also denounces in a video on Twitter “profoundly abject, contemptuous, dishonorable and disgusting remarks towards his sisters and brothers”. He judges “insulting[e]s” these words that have “hinted that the doctors would be enjoying some kind of windfall”.

Benoit Soulié, general practitioner in Normandy, tweet also his anger at this “pure populist fantasy”. He insists on another reality of his medical practice, especially during this Covid-19 epidemic: “Free acts of telephone advice”.

Speaking him also on Twitter, a replacement doctor sees in the declaration of Christian Perronne “outright libel”, and appeals to the National Council of the Order of Physicians. The professional body, as well as the college of ethics of the AP-HP, has already taken up the case of Christian Perronne for previous controversial statements where he defended the use of hydroxychloroquine against Covid-19, and questioned his colleagues.

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