To make replacements, you must be registered with the College of Physicians or be registered on the list of service providers.

You must ask the departmental council of the Order for a certificate of registration specifying its qualification. It will be presented by the replacement doctor to the replaced doctor at each replacement.

Once the replacement has been found, a replacement contract must be written in 3 copies:

• one for the replacement doctor
• one for the settled doctor
• and one for the Order's departmental council.

The National Council of the Medical Association makes available a model contract of replacement in liberal practice:

Contract templates for physicians

Once in the office, the surrogate doctor exercises instead of the settled doctor. He shall use the prescriptions of the latter, indicating his capacity as a substitute and his name.

During the interview, the CPAM proceeds with the membership of the health insurance scheme of licensed medical practitioners and assistants (CMAP).

The doctors in Sector 1 contribute to the Urssaf under this scheme.

On the other hand, doctors in sector 2 have the right of option between the ‘PAMC’ scheme and the ‘TI PL’ scheme (self-employed person - liberal profession). Thus, some doctors are covered by the CMAP and others by the TI PL scheme.

All doctors practicing as a liberal have the obligation to take out professional indemnity insurance (CPR) before starting to practice.

The SPC guarantees the damage caused to third parties in the course of the activity: choice of the wrong treatment, poor follow-up of the patient, etc. It offers support in the search for an amicable solution, a covering of legal and procedural costs, as well as compensation for the damage.

The doctor substitute is solely responsible for his mistakes. He is also required to take out insurance to cover his civil liability.

Businesses must also comply with this obligation.

Failure to comply with that insurance obligation shall be punishable by a fine of €45,000.

Liberal practitioners also face a additional penalty prohibition of practice.

The businesses shall be fined €225,000.

From the date of commencement of activity, the general practitioner pays social security contributions to the Urssaf. They are calculated on the basis of realized income.

These contributions are must be paid online in one of the following ways:

• Either every month. The monthly payment is made on the 5th of each month (or the 20th on option) by direct debit.
• Either every quarter. The quarterly payment is made by direct debit, by electronic payment or by credit card. Contributions are payable for February 5, May 5, August 5, and November 5.

For more information on the social contributions of the general practitioner: see the sheet Social protection for the liberal professional.

Social contributions are calculated on the basis of self-employment income.

The general practitioner acting as a substitute may benefit from the simplified offer proposed by the Urssaf. The following conditions must be met:

• Perform only overrides
• To have retroceded fees not exceeding €19,000by calendar year (1^er January to December 31)
• Not to engage in any other activity as self-employed

This offer allows you to declare the activity, the retrocession of fees or remuneration and to pay the related social contributions directly from a personal online space.

The reporting and payment of contributions are simplified. They will be carried out quarterly (or monthly according to the initial choice) and only in the case of replacement and therefore of actual receipt of fee retrocessions, and without cash-flow lag.

Simplified offer for replacement doctors

The primary care physician should adhere to the Caisse Autonome de Retirement des Médecins de France (CARMF) within one month of commencement of business. Membership is compulsory for all doctors practicing in the liberal profession: installation, replacements, in the business of liberal practice.

Membership shall be pronounced on the first day of the calendar quarter following the beginning of the self-employed financial year.

The Liberal physician contributes to the following plans:

• Three pension schemes :
  
  • Basic scheme: operates in insurance points and quarters, part of the contributions of doctors in sector 1 is paid by the sickness funds;
  • Supplementary old-age scheme: managed on a provisioned basis and operated in points;
  • Supplementary Old Age Allowance (SSA) plan, if you have a contract. It works in points. Two thirds of the contribution of doctors in sector 1 is financed by the health insurance funds.
• A provident scheme : disability-death plan.
• A voluntary scheme : Capitalized Capimed, Pension Savings Plan (PER)

The Code of Medical Ethics is binding on all doctors practicing in France, whether they are registered with the Ordre or whether they are nationals of the European Union or parties to the Agreement on the European Economic Area, providing a service in France on a temporary or occasional basis.

It is also mandatory for replacement medical students.

In particular, the doctor should adhere to the following principles:

• Principles of morality, probity, and dedication essential to the practice of medicine
• Medical confidentiality
• Assistance to anyone in danger.

Code of Medical Ethics

National College of Physicians

Pour en savoir plus

The Council of the Medical Association itself exercises disciplinary authority in cases of non-compliance with the code of medical ethics.

Regional Disciplinary Chambers may impose professional sentences: warning, reprimand, temporary prohibition of practice, removal from the Order’s register, etc.

Appeals to the National Disciplinary Chamber are possible.

The combination of the practice of medicine with another activity must respect the principles of professional independence and dignity.

For example, professions that are subject to self-benchmarking are prohibited. Self-compounding is the act of profit from prescriptions or medical advice. As a result, a doctor cannot do the following:

• Manufacturer or vendor of medical devices
• Optician
• An ambulance attendant or an ambulance business manager
• Owner or manager of a hotel for patients, a fitness room, a treatment facility, a center for advice on aesthetics, hygiene or dietetics, a fitness center, a spa, a massage room, a beauty institute, etc.

Similarly, a doctor is prohibited from using an elected, political or union mandate or administrative function to increase his client base.

In addition, an associate doctor of a liberal practice business (SEL) may exercise his activity only within that business. He cannot combine with a liberal activity outside this business. On the other hand, he may develop paid employment.