Vincent Jacquelinet
CEO
5 to 6 minutes
Finding a primary care doctor, getting an appointment quickly, seeing a specialist without waiting several months... For a growing part of the French population, accessing healthcare is becoming increasingly difficult.
In some areas, residents must travel several dozen kilometres to see a healthcare professional. In others, waiting times are getting longer, to the point of delaying certain diagnoses or medical follow-up.
This phenomenon is now widely referred to as a “medical desert”.
But behind this highly publicised expression, the reality is often more complex than a simple shortage of doctors.
Because a medical desert does not necessarily mean the complete absence of healthcare professionals. It mainly refers to difficulty accessing care, which can take several forms: lack of primary care doctors, long appointment waiting times, insufficient medical follow-up, or overstretched practices.
So what exactly is a medical desert? Why are these situations developing? And what are the concrete consequences for patients and healthcare professionals?
What is a medical desert?
The term “medical desert” is often used in the media or public debate, but it does not have a strict legal definition.
In practice, health authorities more often speak of “under-served areas” in terms of healthcare professionals. These areas are identified using several criteria, including:
the number of doctors available;
the density of professionals per inhabitant;
the time needed to access care;
the actual activity of the doctors present;
or the health needs of the local population.
The Directorate for Research, Studies, Evaluation and Statistics (DREES) uses in particular an indicator called locally available potential accessibility (APL), which measures access to general practitioners by taking into account both their geographical proximity, their activity and the needs of local residents. (1)
In other words, a medical desert does not necessarily correspond to an area with no doctors.
👉 An area can be considered under-served even when healthcare professionals are present, if:
appointment delays become too long;
doctors can no longer accept new patients;
access to regular follow-up becomes difficult;
or the local population has significant health needs.
This distinction is essential: the problem concerns both the actual availability of medical time and the number of doctors present in an area.
A reality that concerns a growing share of the population
Access to care is now becoming a concrete difficulty for a significant share of the French population.
According to DREES data published in 2021:
around 5.7% of the French population lives in an area undersupplied with general practitioners; (2)
nearly 87% of French territory is classified as a “medical desert” for at least one medical specialty according to a Senate study published in 2022; (3)
and nearly 6 million French people had no declared primary care doctor in 2024 according to data from Health Insurance and the Senate. (4)
Access difficulties particularly concern:
certain rural areas;
peri-urban areas;
but also certain mid-sized cities such as Nevers, Guéret, Vierzon, Châteauroux or Alençon, which are regularly confronted with difficulties accessing general practice or certain specialties.
The situation varies greatly depending on the medical specialty.
In general practice, the difficulties mainly concern regular follow-up and access to a primary care doctor.
For certain medical specialties, waiting times can become particularly long. According to several surveys by UFC-Que Choisir and patient associations, average waiting times can exceed:
3 to 6 months in ophthalmology;
several months in dermatology;
and sometimes longer in psychiatry or gynecology depending on the areas concerned. (5)
👉 The medical desert is therefore not limited to a geographical issue: it directly affects the continuity and speed of care.
Why are medical deserts increasing?
The development of medical deserts is explained by several phenomena that gradually combine.
The aging of the medical population
A significant share of currently practicing doctors is approaching retirement age.
According to the National Council of the Order of Physicians, nearly one out of two regularly practicing doctors is over 55 in certain specialties. (6)
In several areas, retirements are now happening faster than the arrival of new professionals.
The increase in health needs
At the same time, care needs are rising sharply.
Population aging is accompanied by an increase in chronic diseases:
diabetes;
cardiovascular diseases;
cancers;
mental disorders;
chronic respiratory diseases.
These conditions require regular follow-up, sometimes over several years, which mobilizes more medical time.
According to Health Insurance, nearly 12 million French people were affected by a long-term illness (ALD) in 2021. (7)
An uneven distribution of professionals
Not all areas attract doctors in the same way.
Several factors currently influence where they choose to set up practice:
working conditions;
ability to practice in a group;
access to infrastructure;
work/life balance;
administrative burden;
employment opportunities for family members.
Young doctors more often favor group or salaried practice, which can worsen difficulties in some more isolated areas.
A reduction in available medical time
The issue is not only about the number of doctors.
The actual time available for consultations is also under pressure.
Consultations are now more complex than before:
more chronic diseases;
more coordination;
greater administrative follow-up;
prevention;
renewals;
management of medical documents.
👉 Even when the number of doctors remains relatively stable, the medical time available per patient can decrease.
What are the consequences for patients?
Medical deserts have very concrete consequences for the care pathway.
Delays in treatment
When waiting times grow longer, some diagnoses may be delayed.
This concerns in particular:
chronic diseases;
certain cancers;
mental health disorders;
or conditions requiring regular follow-up.
In several situations, patients consult later, sometimes when symptoms have worsened.
Giving up on care
Faced with difficulties accessing care, some patients end up abandoning certain medical appointments.
According to IRDES and DREES, around one quarter of French people say they have already given up or postponed care, notably for financial reasons, delays, or geographic accessibility. (8)
That represents several million people affected each year.
This can concern:
follow-up appointments;
screenings;
specialist consultations;
or preventive care.
Increased pressure on emergency services
When it becomes difficult to get a quick appointment in the community, some patients turn to hospital emergency departments.
This situation contributes to the overcrowding of emergency services, which have already faced a sharp increase in activity for several years.
A break in medical follow-up
Regular follow-up plays an essential role in several medical situations, notably:
among older patients;
in the follow-up of chronic diseases;
for prevention and screening actions;
or in the management of mental health.
Many studies show that regular medical follow-up makes it possible to detect certain complications earlier, improve treatment adherence, and reduce some avoidable hospitalizations, particularly among patients with chronic diseases. (9)
👉 Yet, when access to care becomes difficult, this continuity can become fragile.
The problem is not limited to the number of doctors alone
When it comes to medical deserts, the most commonly mentioned response is to increase the number of doctors.
This is a real issue, but it alone is not enough to solve the problem in the short term.
Training a doctor takes several years, and health needs continue to increase in the meantime.
Moreover, a significant part of medical time is currently devoted to:
collecting information;
coordination;
administrative tasks;
documentation tracking;
or organizing the care pathway.
In other words, the issue is also about how medical time is used and organized.
That is why current responses combine several approaches:
development of health centers;
medical assistants;
CPTS;
cooperation among professionals;
telemedicine;
and digital coordination tools.
How can digital technology help address medical deserts?
Digital technology does not replace a doctor.
However, it can help improve the organization of care pathways and make better use of the available clinical time.
Concretely, digital tools can notably help to:
prepare certain information before a consultation;
structure symptoms and medical history;
facilitate patient follow-up;
improve coordination among professionals;
strengthen certain prevention and screening actions.
This approach is particularly useful in areas where medical resources are limited.
When part of the information gathering or follow-up can be prepared in advance, the doctor can devote more time to:
clinical assessment;
talking with the patient;
medical decision-making;
and organizing care.
What role for human or digital medical assistants
Faced with difficulties accessing care, part of the solution is to better distribute certain tasks around the doctor in order to free up clinical time.
Human medical assistants can notably help to:
welcome patients;
prepare certain documents;
collect medical information;
organize the care pathway.
Some specialties have already used this model for several years, notably ophthalmology. In many practices, orthoptists or assistants carry out part of the preparatory examinations before the doctor's intervention. The ophthalmologist can thus devote more time to analysis and diagnosis.
This organization has made it possible to greatly increase the activity of ophthalmology practices despite the decline in the number of ophthalmologists. According to data relayed by CNAM and the specialist press, the number of procedures performed in ophthalmology practices rose from about 22 million in 2012 to more than 45 million in 2022, notably thanks to the development of “assisted work” with orthoptists, medical assistants and other paramedical professionals. (10)
In a context of growing strain on access to care, Martial Jardel, president of the Médecins Solidaires association, recently recalled the importance of “improving the structural organization of care access pathways,” as more and more patients are having difficulty getting an appointment. (11)
Digital medical assistants fit into this same organizational logic. They notably make it possible to prepare and structure certain information before the consultation:
medical questionnaires collecting symptoms and updating medical history;
support for prevention, screening and identifying certain risk factors;
automated calculation of scores or clinical indicators useful for follow-up;
centralization and tracking of useful medical documents (prescriptions, tests, reports, follow-up measurements).
The goal remains the same: to enable the doctor to access structured information more quickly and devote more time to clinical discussion and medical decision-making.
Solutions like Aldebaran thus help structure medical information and streamline patient follow-up, especially in areas where medical resources are more limited.
Conclusion
A medical desert does not simply mean a lack of doctors.
It more broadly reflects a growing imbalance between the health needs of the population and the medical time actually available.
This situation has concrete consequences:
difficulties finding a regular doctor;
longer appointment wait times;
delays in care;
forgoing treatment;
weakened continuity of care.
Faced with these challenges, the responses do not rely on a single solution.
Care organization, prevention, cooperation among professionals, and digital tools are now playing an increasingly important role in improving access to care and making better use of the medical time available.
In this logic, digital medical assistants can help better prepare consultations, streamline care pathways, and strengthen patient follow-up, particularly in areas where medical resources are most constrained.
(1) DREES. “Localized potential accessibility (APL): a measure of access to general practitioners.”
(2) DREES. “In 2018, areas undersupplied in general practitioners.” Studies and Results" 2021.
(3) Senate. “Medical deserts: taking real action.” Information report, 2022.
(4) National Health Insurance. “Your GP: a central role in your medical follow-up.” 2024.
(5) UFC-Que Choisir. “Access to specialists: ever longer waiting times.” 2024.
(6) National Council of the Order of Physicians (CNOM). “Atlas of the medical workforce in France.” 2024.
(7) National Health Insurance. “Long-term illnesses (ALD).” 2024.
(8) IRDES. “Forgoing care: measurement and analysis.” Health Economics Questions, 2023.
(9) OECD. “Health at a Glance 2023.” Organisation for Economic Co-operation and Development, 2023.
(10) Acuité. “Doubling of procedures performed in ophthalmology practices in 10 years.” 2024.
(11) Franceinfo. “Access to care: ‘We have never been exposed to such a difficulty in getting treatment,’ warns the Médecins Solidaires association.” 2025.
