The primary care physician system took effect on 1 July 2012. Up until 30 June 2015, various measures will be gradually introduced to complete the implementation of the system. The role of the primary care physician is to provide care and individualised professional monitoring, in particular (but not only) for patients suffering from serious and chronic illnesses. The goal is to offer the most appropriate medical care for the patient's health status.
Who is concerned
During the start-up phase, in other words until 30 June 2015, primary care physicians will primarily serve adults who are enrolled with the Joint Social Security Centre (Centre Commun de la Sécurité Sociale - CCSS), whether voluntarily or by requirement..
To be able to choose a primary care physician, you must:
- be older than 18 years of age; or
- suffer from a serious chronic disease (such as diabetes, Alzheimer's disease or cystic fibrosis).
How to proceed
Duties and tools of the primary care physician
Duties of the primary care physician
Generally, the primary care physician is required to:
- provide first-level and preventative care;
- monitor and supervise the patient's healthcare, and notably make them aware of any issues relating to overlapping use, overuse or side effects of medications, exams or treatments;
- coordinate care in the case of severe or chronic diseases, or for long-term care;
- and generally, inform, provide guidance and advise the patient in matters relating to their healthcare.
Tools at their disposal
To perform their duties, the primary care physician mainly uses a 'patient summary form'. This provides a complete overview of the health status of the patient, so that care can be provided without interruption. It is regularly updated by the primary care physician.
The 'patient summary' form must be completed by the primary care physician at the latest 3 months after signing the declaration of enrolment. To do so, and upon validation of enrolment, the National Health Fund (Caisse nationale de santé - CNS) sends the patient a history of their healthcare-related benefits (summary of benefits).
Choice of primary care physician
To choose a primary care physician, the patient simply needs to sign a written declaration of 'primary care physician'. This declaration must then be jointly signed by the designated physician (who is free to accept or refuse to be the patient's primary care physician) and sent to the National Health Fund (CNS).
The CNS will then assign a "primary care physician" declaration number. This number must be used in subsequent communications with the CNS for all procedures involving the primary care physician.
The patient may also designate a substitute primary care physician in the 'primary care physician' declaration form, who may then intervene in the event of a prolonged absence of the primary care physician, or if the latter dies.
Revocation of the primary care physician
In theory, the relationship between the primary care physician and the patient is established for an open-ended period of time. Nevertheless, if the patient wishes to revoke their primary care physician, they are free to do so, on the condition that they comply with the following formalities:
- fill out the 'revocation of primary care physician by mutual consent' form, if the revocation occurs within the first 12 months. This form must then be sent to the CNS. In that case, the patient must still obtain the physician's consent and give 2 months' advance notice. The change in primary care physician will therefore only become effective 2 months after the form is sent to the CNS.
- fill out the 'unilateral revocation of primary care physician' form if the revocation occurs after the first 12 months. This form must also be sent to the CNS. The patient is not required to obtain the physician's consent in this case, but must merely comply with the requirement to provide 2 months' advance notice.
Once the revocation has been completed, the patient may choose a new primary care physician and sign a new 'primary care physician' declaration with the physician of their choosing. The new primary care physician is entitled to have the previous physician transfer all of the data they need to perform their job.
Termination of the primary care physician's practice
If the primary care physician stops working, the CNS will inform the patient accordingly. The patient is then free to choose another primary care physician.
Death of the primary care physician
Should the primary care physician die, the National Health Fund (CNS) will inform the patient as soon as possible. The relationship between the primary care physician and the patient thus automatically ceases to exist.
A patient who wishes to obtain their medical file may contact the deceased physician's office:
- by phone; or
- by post.
The file will then be transferred by the heirs of the deceased physician, or by the professional who has taken over their practice.