The difficulty of accessing primary care is a key issue at the national level, as evidenced by the recent debate on restrictions on the freedom to settle. The lack of general practitioners in France exacerbates inequalities in access to healthcare, a phenomenon aggravated by the dysfunctional nature of the French healthcare system. The establishment of new doctors therefore appears to be essential to guarantee access to healthcare for all. In this regard, healthcare authorities can play a key role in encouraging general practitioners to set up practices by using levers that have yet to be identified.Main objective: Identify the motivations, sustainability, and obstacles to the establishment of young French general practitioners exercising in private practice. Secondary objectives: identify political drivers for establishment, identify trends according to profiles (interns, established practitioners, substitute practitioners), identify whether the study methodology has an impact on the results.A systematic review of the literature was conducted to answer the question. Bibliographic databases (Medline, Web of Science, Cairn) were searched using an original search equation. Studies were selected in duplicate and each article was analyzed individually. Determinants were extracted from the included studies and classified into categories and then subcategories. A subgroup analysis was performed according to the profile of the physicians interviewed and the methodology of the studies.The systematic review included 81 original articles and theses. The analysis identified eight categories of determinants. The most frequently cited determinants are those related to the organization of care, both professional and private. The subgroup analysis identified the main determinants for setting up practice: the partner's place of work, setting up in a group practice, and simplification of administrative procedures.This study is systematic and original. Its main limitations are the analysis of individual articles, the biases inherent in each methodology (quantitative and qualitative), and the lack of data on the sustainability of physicians' practices after setting up.This review could offer useful insights to decision-makers on how to promote the long-term retention of general practitioners.

French general practice is undergoing profound transformations, marked by increasing waiting time for a general practitioner, feminization of the profession, and a shift toward salaried practice, creating a dual system amidst access-to-care tensionsTo describe and compare the real-world activity (care, coordination, and administration)—and working conditions of General Practitioners (GPs) based on their practice model (private/mixed versus exclusive salaried) in two contrasting regions: Nouvelle‑Aquitaine and Île‑de‑France.Across‑sectional observational study was conducted in 2025. From 1,787 eligible respondents, 499 GPs provided detailed prospective data regarding a randomized typical workday.The study reveals two distinct, complementary ecosystems. Among exclusive private GPs (N=356), most worked in group offices (56.4%), private health centers (“Maison de santé” 27.0%), or solo practice (22.5%). Exclusive salaried GPs (N=92) were predominantly based in public health centers (“Centre de santé”, 70.7%), with additional activity in hospital facilities (37.0%). The private/mixed model (81.6% of the sample)is characterized by high intensity: 22.1 procedures/day, 9.3-hour workday. It remains the pillar of longitudinal follow-up (78.6% of patients seen are their own), out-of-hours duties (40.0% participation), and training (48.4% are internship supervisors(‘’MSU’’).However, 60.4% report excessive administrative burden By contrast the salaried model (18.4% of the sample) offers a protected framework: shorter days (8.4 hours)and fewer procedures(16.4/day).It acts as a social "safety net," managing significantly more patients with economic difficulties(45.7% vs. 17.0%) and those without designated primary GP (13.1% vs. 3.7%). However, continuity of care is lower (35.6% own patients), and appointment non-attendance is higher (9.9% vs. 3.0%).Various others results come from analyses according to regions, GPs ’age and MSUs ’activityTAMGE highlight new needs to optimize patients’ pathways according to populations, health services and traditional or new health providers involved.TAMGE report the functional duality of French primary care: a private sector ensuring volume and continuity but facing administrative saturation, and a salaried sector focused on access for vulnerable populations. Future policies must apply differentiated support to alleviate administrative weight on private GPs and secure medical training capacity, which currently relies heavily on the private sector.

A doctor's family may ask them for a diagnosis, a prescription, a certificate... In this age of telemedicine and tele-expertise, in a hyperconnected society, it has become easy to ask a relative who is a doctor for medical advice via their personal messaging service. However, few studies have looked at how these family doctors feel about this.To understand and explore the views of private general practitioners in (XXX) on remote consultations conducted via unsecured tools (personal email, text messages, social media) at the request of their family members, and the consequences on their personal and professional lives.Qualitative study using semi-structured individual interviews, audio-recorded with general practitioners practising privately in (XXX). Full verbatim transcription followed by analysis of the transcripts and non-verbal communication data on an ongoing basis according to phenomenology, with triangulation of coding. Interviews stopped once sufficient data had been collected.Thirteen general practitioners participated. They consider the requests easy and quick to deal with, but exhausting because they are recurring. The satisfaction and pride of having helped their loved ones was overshadowed by the anxiety caused by more complex requests. The lack of objectivity and the absence of elements found in a face-to-face consultation, such as an in-depth interview or clinical examination, could result in a loss of opportunity for the requesting parent.Receiving requests from loved ones is inevitable, especially in areas with a shortage of medical professionals. One must learn to be a doctor for one's family from university onwards, and sometimes know how to impose a formal framework and rules to protect oneself... or choose to refuse, know how to say no and refer the patient to a colleague for objective care.Any doctor may be called upon by a member of their family and must be prepared for this. But educating families also seems essential: their doctor, with their strengths and weaknesses, must be able to enjoy moments of relaxation with or without them, and they must be allowed ‘to simply not work outside of working hours’.

The number of practising general practitioners in France is decreasing, while the population is growing and ageing. Preserving medical time has become a priority, particularly by reducing administrative workload. General practitioners estimate spending on average 1.5 to 2 hours per week dealing with unjustified medical certificates. To address this issue, a collaborative initiative was launched between the website XXX and eleven Departmental Medical Councils (Conseils Départementaux de l’Ordre des Médecins, CDOM) to provide evidence-based responses on whether medical certificate requests were justified or not.To describe the types of medical certificate requests considered abusive by general practitioners and reported to CDOMs through this initiative.We conducted a prospective, multicentre, descriptive study from July 2023 to December 2025 (2,5 years) involving the following CDOMs: XXXXXXXXXXXXXX. General practitioners affiliated with these CDOMs could submit requests they considered abusive by email. A personalised response was written by author, then provided to both the physician and the requester, including references to applicable legislation when relevant. All complaints received were included. Each request was classified by domain (insurance contracts, school-related, sport, work, healthcare, etc.), and its legal status was assessed through a review of LegiFrance and CDOM regulatory guidance.A total of 423 complaints were received: 285 from the XXXX department (67%). Requests mainly concerned insurance or disability contracts (N=180; 43%), school or extracurricular settings (N=78; 18%), work and healthcare-related issues (N=47; 11%), and other requests such as training or sport (N=118; 28%). Overall, 78% of requests were judged abusive, or illegal (including breaches of medical confidentiality).The main strength of this study is its longitudinal and multicentre design, confirming the high frequency of medical certificate requests without legal basis, particularly from insurance providers and the school sector. Limitations include restricted geographical coverage (11 of 99 CDOMs) and variable physician engagement between departments. A qualitative study could help further improve the initiative.This work supports targeted communication with institutions to prioritise action on the most problematic certificate requests: insurance, schools, and sports. Scaling up this initiative at the national level, in collaboration with the National Medical Council or French Nationa Health Insurance would be helpful.

The online reputation of general practitioners is an expanding phenomenon and raises ethical, legal, and practical issues in the context of the growing digitization of healthcare services. Google®, through its business listings, has become the main platform for such evaluations.The aim of our study was to examine the nature and determinants of online reviews concerning general practitioners in the Landes department in France, published on Google in 2024.A mixed-methods observational study combined a cross-sectional quantitative analysis of the Google® list of general practitioners (GPs) and healthcare facilities identified via the Health Insurance in October 2024, and a qualitative analysis of published reviews. Data collected included ratings, reviewer status presence of written comments, and GP characteristics (gender, practice type, location, additional activities). A thematic categorization of comments was conducted into three main domains: doctor–patient relationship, medical competence, and office organization.Among the 473 GP and healthcare structures studied, 63% had a Google® listing, and 58% had received at least one review. The average rating was 4.2/5, with 92.3% of extreme evaluations. Qualitative analysis of 3,036 published reviews revealed a predominance of relational criteria: listening (669 mentions), kindness (638), and competence (645). In contrast, organizational aspects (reception, appointment scheduling, punctuality) were less often mentioned and more frequently associated with negative comments. GP practicing in rural areas, those with a specific medical focus, or those working alone generally received more positive evaluations. Conversely, healthcare structures, though receiving more reviews, were rated less favorably overall. Practice setting emerged as a major discriminating factor in the nature of comments. Lastly, reviewers identified as “Local Guides” (27.5% of evaluators) gave more moderate ratings.The online reputation of GP is generally positive but highly polarized. It is primarily shaped by relational aspects of care, rather than technical or organizational criteria. Google® has established itself as the central platform for digital reputation, accounting for 93% of reviews. Our comprehensive data did not include the age of GP and may change with the territory.These findings offer valuable insights into patient expectations and could serve as a lever for improving practices in general medicine.

Retirement is a lived process that can be complex, questioning the identity of the newly retired individual. A genuine topic of political relevance, retirement also concerns physicians, whose demographics have been closely monitored for several decades in the face of growing medical desertification. Moreover, the profession of general practitioner appears to carry strong intrinsic value, imbued with meaning and significant social recognition.To explore the lived experience of the transition in social status from active general practitioner to retired physician.A qualitative phenomenological study conducted with general practitioners retired for less than five years. Data were collected through participants’ narratives (semi-structured interviews) and a verbal association method. The study was carried out by a single investigator with interview guide and data triangulation.The study was based on twelve interviews and twenty verbal association between 2022 and 2023. The analysis identified the main components of the retired general practitioner’s lived experience. First, in relation to the Other, the patient, particularly regarding recognition and the absence thereof. Second, in relation to the self, especially around the themes of meaning and the identity of the retired physician. Finally, as a major component, the changed relationship to time.The strengths of the study lie mainly in the originality of its subject, the lack of substantial literature on this topic, and its dual methodology. However, its limitations stem from its qualitative nature: recruitment, saturation and data collection, and finally the potential social desirability bias. The discussion revisits the central dichotomy of the topic through the works of various philosophers, sociologists, and physicians: The experience in relation to the Other (Does the patient make us doctors? Desire and absence of the patient, feeling of abandonment, the infinite time of the patient). The experience in relation to oneself (Loss, reconstruction of meaning, identity: sameness/selfhood, time and duration, finitude).The experience of retired general practitioners appears as a major paradigm shift that is often unanticipated, triggering numerous and sometimes profound cross-cutting questions. The analysis of this lived experience reflects their capacity to adapt to this new stage of life confronting them with the limits of body and time.

According to the Canadian Medical Association, over 50% of family physicians are experiencing professional burnout. The lack of well-being among family physicians has significant impacts at both the individual and healthcare system levels. Few studies have examined the well-being of family physicians from a multidimensional perspective, while evaluating the relative importance of associated factors.The purpose of this study was to examine the relative importance of individual factors and external factors associated with their level of well-being.Cross-sectional study design based on a survey of family physicians conducted between December 2023 and July 2024, to all practicing family physicians in Quebec. An ordinal logistic regression was performed.The main measure was the 9-item Physician Well-Being Index (PWBI). According to the index, a score of 3 or higher indicates a risk of low well-being. The independent variables (demographic and organizational charcteristics), chosen according to Brigham et al.'s  (2018) framework.Participants in this study were family physicians practising in Quebec, Canada (N=1252). Nearly two thirds (62.5%) of participants were at risk of low well-being. In order of importance, the major factors associated with well-being were satisfaction with work-life balance, feeling fulfilled in one's role as a family physicians, often facing excessive expectations or verbal abuse from their patients, satisfaction with human resources, and finally, awareness of governmental actions aimed at improving family physicians’ well-being and job satisfaction.Nearly two thirds of family physicians in Quebec showed poor well-being, similar to the 57% found in Belgium Cholewa et al (2024). Satisfaction with work-life balance was the most influential factor for their well-being. Other important aspects included feeling fulfilled in one's role as a family physicians, frequently facing excessive expectations or verbal abuse from patients, satisfaction with human resources, and awareness of governmental actions aimed at improving family physicians’ well-being and job satisfaction. This study contributes to the scientific literature, notably by prioritizing factors influencing family physicians’ well-being and proposing a framework for prioritizing interventions.The results of this study show a low level of well-being among family physicians and highlight priorities for policy and interventions aimed at improving the well-being of family physicians.