Question 5621 — health professions

Summary

Mr. Christophe Marion draws the attention of the Minister to the Minister of Labor, Health, Solidarity and Families, responsible for health and access to care, to the situation of occupational therapists, who contribute to the maintenance or restoration of autonomy by allowing the person, whatever their age and health situation, to continue to carry out their daily life activities in their environment. Like the others rehabilitators, they are subject to medical prescription (article L. 4331-1 of the public health code). This prescription does not allow the user to be reimbursed since occupational therapy is not approved. Since the occupational therapist most of the time practices within the framework of coordinated or multidisciplinary courses, this prescription is, in the vast majority of cases, a formality: an address, more than a real prescription. Also, for several years now, the majority of occupational therapists have been forced to intervene outside the legal framework due to the absence of this medical prescription for occupational therapy. Many occupational therapists employed in medical-social establishments and services do not have doctors within their practice structure (EHPAD, FAM, SSIAD, etc.). In mobile teams where occupational therapists work, patients are referred to the service without specific mention of occupational therapy. Finally, certain systems, in which occupational therapists are involved, do not provide for a link with the doctor. In fact, according to a study carried out in 2023 by ANFE, only 35% of occupational therapists systematically have a medical prescription to provide their care. However, since June 2023, occupational therapists have been prescribing technical aids, which has constituted an important step forward in preventing loss of autonomy, reducing the time taken to allocate equipment and the costs linked to avoidable medical consultations. This expertise finds its full meaning in the current context of full reimbursement for wheelchairs. However, this new right has increased the concerns and tensions of occupational therapists regarding their conditions of practice outside of medical prescription. HAS At a time when medical time has become a rare commodity and the lack of general practitioners and specialists reaches a critical threshold, he questions the advisability of allowing occupational therapists to exercise their expertise in direct access in order to put an end to avoidable prescriptions, to streamline access to care and equipment, to facilitate the territorial organization of care and to promote universal accessibility and prevention of loss of autonomy.

Machine translation from French. The official text remains authoritative.

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