Introduction Cardiovascular risk management by primary care in France
The French Society of General Medicine is a learned society. We have a College of General Medicine on top of old unions, scientific societies, and so on. The French Society of General Medicine has about 800 members and 3 working groups on cardiovascular disease; 1 is multi morbidity with a lot of disease of the cardiovascular field, 1 is hypertension, and 1 on Type II diabetes. Society members are active in research on typologies of patients, using data from observations and in the management of multi-morbidity because it is the future of the work of GPs. The society has a partnership with CONSTANCES, a representative cohort of 200,000 people in France and these data in used in member research. This partnership has been ongoing for 2 years and has been very successful.
The aim of the French Society is to promote general medicine. This is done by developing concepts of GP research and continued medical education. Members participate in the development of national guidelines, which is a state agency in France. The state agency High Authority of Health drafts those guidelines with input from cardiologists, GPs, economists, and so on.
The French Society has developed a consultation result dictionary to describe problems when patients are seen by GPs, and it is linked to ICD-10, ICPC. For 20 years a general medicine observatory, was developed with data collected from the EMR of GPs, like what is done in England in the GPLD. However, it was recently closed as it became too costly for the society
There are approximately 53,000 GPs in France with 98% in private practice. This is now beginning to change as young GPs now want to practice in a pluri-professional group with nurse or another GP. Currently, the remuneration for GPs are fee for practice, fee for service. French GPs manage a wide range of cardiovascular disease with few limitations in medication and therapy.
The State Association of GPs promotes national guidelines and does do not use any foreign guidelines. The ESC is not used and national guidelines, diabetes for example, are very far from the European guidelines. Overall, GPs in France have a real limitation of using English as the first and second languages are both French.
