The Auscitain hospital is working on a protocol capable of providing a solution to the lack of urology services in the Gers, following the closure of the Gascony polyclinic. This project could integrate private practitioners.
The people of Gers looking for urology care are the big losers from the disappearance of the Champagne clinic, which provided most of the surgery and care in this specialty. If many liberal doctors have crossed the doors of the hospital to practice there, since March 16 and the cessation of the clinic, the urologists were missing.
For the teams of doctors and hospital management, the situation cannot last. “There is a real need of the population, explains the director of the hospital, Sylvie Lacarrière. The public service had to take over. The managers’ first reflex led them to suggest that the private urologists from the clinic come and work at the hospital. The options in the running at the start of the crisis – from surgical blocks to the Reviscolada – and the difficulties that arose afterwards, led private practitioners to refuse, before returning to the discussion table.
Sector to be set up
This Wednesday, “frank” exchanges began at the ARS between hospital doctors and urologists from the clinic, Drs Secco and Descamps. “We have been able to make progress on the question of the management of patients in urology,” says Dr. Lejeune. Currently, there is no more permanent care, but we have worked out a patient care agreement with the Toulouse University Hospital. “The rare absolute emergencies, which require immediate surgical interventions, are directed directly to the Toulouse plateaus.
For other urological emergencies, first aid rescue is carried out by the emergency physicians of Auch, before an opinion from a urologist attached to the CHU, or Agen, Mont-de-Marsan. “According to this opinion, the patient is hospitalized in Auch or transferred to another establishment”, specifies Dr Lejeune. This protocol has been sent to health centers in the Gers.
At the same time, the Auch hospital has approached the Toulouse University Hospital to set up a public urology sector in the Gers. After the summer, two practitioners will come to Auch for consultations and give advice on hospitalized patients. Second stage, the implementation of outpatient surgery, at the beginning of 2024. Finally, the implementation of a urology service, with professionals perhaps shared between Auch and Toulouse.
Integrate the Liberals
“The private sector has its place in this service, which must be able to accommodate liberals, insists Dr. Lejeune. But for the moment, this service does not exist. Until then, it is impossible for the Liberals to perform surgery requiring hospitalization. “On the other hand, day surgery is possible, says Dr. Lejeune, and we hope to see them begin their activity in the coming weeks. “But not all of their activity: “mainly priority outpatient care for the moment, on a case-by-case basis, to guarantee patient safety and quality of care”, specifies the director. To integrate a complete activity, the hospital must acquire specific equipment, find caregivers – there is a shortage of 60 professionals – and expand the reception in surgery, the easiest part to settle.
And the influx of specialists from the clinic to hospital facilities no longer leaves many free slots in surgery for urologists, the last to decide. “The hospital has emergencies 24 hours a day, which takes precedence over everything else, explains Sylvie Lacarrière. We cannot guarantee them 100% free beaches. “However, the hospital is working to make external procedures possible for them as quickly as possible, which do not require any hospitalization: calculations, cancer diagnoses… “We hope that in the fall, we will be able to offer them an “upgrade”, once the work is done, on the condition that the staff is recruited,” says Sylvie Lacarrière.
The hospital therefore opens the door to liberal urologists, to allow them to work, in the absence of other available trays, but covers its back by setting up its own permanent sector. “This foreshadows the future of Auch hospital, where private and public can coexist,” says Sylvie Lacarrière. And this sector will eventually be able to accommodate a future urologist, whether he wishes to come and practice as a liberal or in public. »
Urology: also in Eauze and Condom, soon in Vic
Consultations are already in place in Eauze (via CH Mont-de-Marsan) and Condom (by Dr Secco). From July, consultations will be provided at the CH of Vic-Fezensac by the teams of the urological center of Mont-de-Marsan.