This story was originally published by Reasons to be Cheerful
10 min read
At the end of 2020, Dr. Jean-Luc Bernard, a family doctor who had been caring for the community in Ajain, France, for over 40 years, finally hung up his stethoscope and retired.
It was not easy to convince a new general practitioner to settle down in the town of 1,000 people — and there were no appropriate local replacements. Ajain, located in France’s Creuse department, is emblematic of the much-neglected rural center of the country. The decidedly quiet town is home to two bakeries, a grocery store, a pharmacy, a large population of cows and sheep, and not too much else.
“It’s a very rural place,” says Guy Rouchon, who was mayor of Ajain at the time.
The municipality, Rouchon says, did “everything possible” to attract a replacement doctor, from securing coverage in national media outlets to creating promotional videos for social media and lobbying regional authorities in formal meetings.
But to no avail: Ajain was added to France’s ever-growing list of “medical deserts” — areas where health care services are not sufficient to meet the needs of the population, whether that be due to a lack of doctors or facilities. In France, it is defined as an area that provides fewer than 2.5 consultations a year per inhabitant.
Some Ajain residents were able to find general practitioners but in areas that were dozens of kilometers away, not walkable as before; others, including those with diabetes, could only access care if it was an emergency, according to Rouchon.
A 2022 report commissioned by the French Senate estimated that 30 percent of the population lives in a medical desert — in other words, millions of citizens — and found that 45 percent of general practitioners in France felt that they were in a situation of burnout. It’s a growing, urgent crisis: Three-quarters of France’s 101 administrative departments saw their ratio of doctors to the population decline between 2017 and 2021.
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“It’s a major issue,” says Benjamin Montmartin, a professor of econometrics and data science at SKEMA who in 2025 authored a report on addressing medical deserts in France. “There are months-long waiting lists for doctors. In medical deserts, if you have a serious problem, you can only go to the hospital. Sometimes people are less likely to go to the hospital, and they pay the price.”
The paradox is that France has a world-renowned health care system, has never had as many physicians as it does today and ranks in the middle of OECD (Organisation for Economic Co-operation and Development) countries in terms of physicians per capita. In 2025, there were on average 347 doctors per 100,000 inhabitants in mainland France. But the regional disparities are gaping: In the department of Eure, in Normandy, the average was 174, compared with 942 in Paris.
France is far from the only country in the world facing this issue amid growing life expectancy, urbanization, retiring rural doctors and the demand for better, more sophisticated health care than ever. It’s a phenomenon across high-income countries in Europe and North America. More than 80 percent of counties across the U.S. — home to over 120 million Americans — do not have good enough health care services, according to a 2025 report by medical company Good Rx Research.
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Yet a few years ago in Ajain, a remedy for medical deserts surfaced out of the blue.
One afternoon in April 2022, the mayor received a surprise phone call from a young doctor with an idea to restore access to health care in underserved areas. “He told me about this concept of ‘shared time,’” recalls Rouchon. “He presented it as an experiment, that maybe it might not work. I wanted to believe him, but it was quite utopian.”
The caller was Martial Jardel. And his idea was to recruit an army of traveling doctors who would make periodic visits to Ajain from better-served areas of France.
In essence, Jardel believed that many doctors across France want to help fight medical deserts, but, increasingly, younger generations accustomed to urban life don’t want to commit to a multi-year stint in an uneventful rural area.
But Jardel — who completed his clinical training in 2021 before embarking on a five-month journey in a camper van visiting clinics across France — argued that if doctors were given the opportunity to come for just one week, without having to uproot and leave their friends and family, the cumulative impact would be huge.
“It’s about shared time,” says Jardel, himself the son of a doctor. “Instead of asking a lot of a few doctors, it’s about asking a little of many doctors. Collective human effort is the key resolution.”
In France, there are about 100,000 general practitioners. Of those, Jardel claims, about 40,000 have the capacity to spare a week. If 50 doctors agreed to contribute for a week, goes his argument, it would be enough to run a health clinic for a year.
And so, Médecins Solidaires, or Doctors in Solidarity, was born.
Six months after that pivotal phone call, the first Médecins Solidaires health center opened in a former elderly care home in Ajain. The space is provided rent-free by the local authority.
In the first year, 48 doctors came to Ajain, 6,000 medical consultations took place and the center served as the primary care provider for 1,200 patients. Since September 2024, Ajain has been welcoming two doctors a week, increasing the patient capacity to 2,500. The total number of medical consultations has now reached 26,500.
Today, more than 1,000 general practitioners (Médecins Solidaires is, for now, not working with specialists) have signed up to the collective, and 15 medical centers have been opened across four regions of France.
“It required a lot of engagement and time to do the recruitment,” says Jardel, who largely relied on word-of-mouth early on.
In order to be accepted, a doctor must have a short vetting phone call with the team. The nonprofit then takes care of everything, from administration to accommodation logistics and transportation. During their week, doctors are paid €1,000 ($1,153 U.S.) net — a low rate given the circumstances. They stay in local lodgings that showcase the region and are given a car for commuting between their accommodations and the health center, as well as for making house calls.
Dr. Clémentine Labouré, a general practitioner based in Paris, signed up in February 2023 after seeing a post on Facebook.
“I thought it was an excellent idea,” she says. “I was completely in agreement.”
Labouré has since joined the team’s “college of pioneers” who help launch new centers. They spend two weeks at new sites when they open to help iron out the process, and they interview potential doctors.
“I think the project is beautiful,” adds Labouré. “Doctors shouldn’t be forced to live somewhere they don’t want to. It’s unjust. This way, everyone does little by little.”
Early evidence suggests the model is proving attractive to participating doctors. According to surveys by Médecins Solidaires, 99 percent of the doctors who have come to practice say they want to return — and half already have at least once. To date, none of the 15 health centers have gone a single week without a doctor, the nonprofit says.
“It’s a great initiative, the needs are very very high,” says Montmartin.
Jardel says that by the time Médecins Solidaires is running 21 health centers, set for the end of 2027, the project, which now partly relies on subsidies as well as income from services, should be financially self-sufficient. It aims to eventually enroll 10 percent of France’s doctors, enough to run 150 health centers.
“I am very happy, we have found a system that works, but we will need support from the public authorities to expand,” he adds.
Médecins Solidaires currently only works because municipalities provide premises free of charge, and because doctors agree to be underpaid — something it hopes to rectify in the future as the funding model improves. Even so, under the current model, health centers manage to become self-financing within a few months after an initial subsidy of around €160,000 ($184,393 U.S.).
The fact that doctors change every week also means that the handover dossiers between the one departing and the one arriving must be very clear. “When they are there for such a short time, handovers can be difficult, especially with patients with chronic problems,” adds Montmartin.
At the same time, it’s possible the initiative may only be needed over the short and medium term. Reforms in France to increase the number of doctors have been passed to make up for a lack of trainings in the 1990s, but these could take over a decade to have an impact. The National Medical Council estimates that by 2040, the number of doctors in France will have risen by 40 percent.
Montmartin also warns that such a system might be tricky to implement in the U.S., where doctors don’t have complete freedom to set up where they want due to licensing restrictions and the influence of large private health care networks. He instead praises the Australian system and its “structured” response, which includes medical student loan repayment in exchange for years of service in rural areas. Australia has created rural universities such as James Cook University, and some institutions require students to complete internships in rural areas during their training.
There is also debate over whether the best approach is to implement voluntary incentives or obligatory policy, forcing doctors to relocate. “It’s complex because in some places incentives work better, in others, regulation,” says Montmartin.
But at least for now, in rural Ajain, with the opt-in approach of the mobile army of solidarity doctors, coming and going week by week, there are no more doubts.
“If ever a doctor, a private one, wanted to come to Ajain and set up a practice, I would hesitate over it,” says Rouchon. “Here we’ve found something that works.”
The post Traveling Doctors Are Filling the Gaps in Rural France appeared first on Reasons to be Cheerful.
