Five retired general practitioners, including Dr Philippe Julien, have returned to work at the health clinic in Puycasquier, a village in the Gers department of southwestern France, to keep the surgery running until a younger doctor can be persuaded to take it over. Mayor Louis Turchi formally inaugurated the scheme on Thursday, cutting the ribbon on the village's new health outpost.
Dr Julien said he had stopped practising in December 2025 but had now returned, adding that the goal was not to stay too long and to attract a younger colleague to the village. He will consult one day a week, alongside four other retired general practitioners at the health centre.
Puycasquier is a small commune in the Gers, a largely rural department in southwestern France that, like many parts of the French countryside, has struggled in recent years to keep doctors in its villages.
Finding a fix after the last doctor retired
Mayor Turchi said that when Dr Julien, the last doctor in the commune, retired in 2025, he wondered how the village would manage. He searched for a replacement for the medical practice set up in 2017, without success. He said a contact with the employers' group Gers en Gascogne, known as GEGG, allowed the village to begin drawing up a solution.
The idea was to find enough retired doctors to provide cover five days out of seven, keeping patients in the village and making it easier for a young doctor to eventually settle there. Dr Julien acknowledged that setting up alone can discourage young practitioners today, but said that with this arrangement, a newcomer would feel supported.
Pharmacist Éric Milleret, who lives in Puycasquier, helped the municipality find retired doctors by offering his own contacts. He described it as a story of mutual trust. The four other doctors are expected to arrive by the end of the year.
Untangling the administration
Setting up the scheme administratively has been complicated, since there was no precedent to follow. The mayor said Puycasquier knew the drill: authorisation to reopen the village pharmacy in January had not come through until mid-August.
Two partners have helped speed things up. The Gers departmental council is linking the new outpost to the health centre in Fleurance as part of a planned "territorial health outpost." Its departmental health centre has made its legal, human, financial and IT resources available to draw up a partnership agreement, employment contracts and a pay scale.
Council president Philippe Dupouy told Dr Julien that it was an original arrangement that brought great flexibility, and said Julien was something of an ambassador, since the medical profession needed reassurance.
A specialist employer for health workers
The other partner is GESGG, the Groupement d'Employeurs Santé Gers en Gascogne, an offshoot of GEGG that specialises in health professions. Under the arrangement, the doctors are salaried employees made available to the departmental council by GESGG. Denis Cassaing, the group's president, said GESGG pays the doctors and then bills the department, which in turn recovers the money through consultation fees.
In practice, patients call the Fleurance health centre to book an appointment and pay by card at the consultation. Dr Julien is currently the only doctor working in Puycasquier, but two other doctors already signed up to the scheme attended Thursday's opening. One of them, Dr Camo, said the format seemed effective and was likely to appeal to other retired practitioners.
Plans to expand elsewhere in the Gers
Mayor Turchi said he was glad to have had the expertise of the two partners. Without them, he said, the village would have had to build the whole structure itself, which would have taken far longer, if it had been possible at all, since he was not aware of a similar structure existing anywhere else.
GESGG already has plans to open other, similar health outposts elsewhere in the Gers.
