The PSC
The Program of Coordinated Medical Care or PSC, 'Programme de Soins Coordonnés', is essentially the program which details that each patient must choose a regular doctor, and this doctor must keep a Personalised Medical File or DMP, 'Dossier Médical Personnalisé', for each patient. Most of the time the patient's regular doctor will be a general practitioner, but this is not always the case.
Whenever necessary, a patient's regular doctor can ask for the opinion of his colleagues, whether general practitioners or specialists. The Program of Coordinated Medical Care gives this procedure a framework and establishes three categories of applicable cases:
Gaining a second opinion – A doctor may approach another doctor to gain a second opinion. If the other doctor is a specialist, the patient will be charged €44 for the consultation, but 70% of this charge can be claimed back from the health service. This will usually be a one-off consultation: the patient should not have consulted the specialist in the six months prior to this appointment, nor be likely to require another consultation in the following six months. Otherwise, further consultations will be subject to higher fees.
When repeated treatment is required – A doctor may advise their patient that a long course of specialised medical care is required. The patient will be treated by the specialist or specialists assigned to them by their GP. The main advantage of this system is that patients affected by long-term disorders, or those who require several appointments with a specialist for the same condition, do not need to visit their GP to gain permission for each consultation. In this case, consultations are charged at €28 by the specialist, but 70% of this can be claimed back from the health service.
If a regular doctor wishes to address a general practitioner – if your regular doctor is a specialist and not a GP, they may on occasion seek a GP's opinion before advising a suitable course of treatment.
The following cases are excluded from paying PSC fees:
Children under 16
Foreigners residing temporarily in France
Nationals of overseas French territories who are registered with other medical and social security systems
Illegal immigrants requiring medical treatment upon arrival in France
The patient contribution
The patient contribution is the amount of any charge or fee not refunded by the health service: this is typically 30% of a charge. However, patients can purchase cover from a private insurance company, to obtain partial or complete coverage of the patient contribution.
The exact value of the patient contribution depends on numerous factors, including the type of consultation or treatment involved, the length of the treatment and potential disability benefits. For a €22 consultation with your regular 'sector 1' doctor, the health service will refund 70%: the patient contribution will be 30% of the charge, in this case €6.60.
