Analyse du cadre réglementaire des certificats médicaux demandés par une municipalité en 2019

Medical certificates have a regular place in general medicine consultation. Since 2011, the french law has highlighted the absence of regulatory support of certain certificates, in particular of public services. The objective of this study was to find out which regulatory texts were based on the medical certificates required by a municipal administration, 8 years after the 2011 rationalization circular?

Material and method

Qualitative study by observation and critical analysis of certificates by literature reviews according to the main PRISMA quality criteria (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes). The first step consisted of the exhaustive collection of the medical certificates provided by the municipality, for the citizens or the employees of the city. The origin of one of the municipal services was the only criterion for inclusion. The second stage consisted in analyzing the certificates according to the law by using databases classified depending on their level, taking their regulatory value into account as a priority. The research equations were constructed with an inductive process as the certificates were collected.

Results

Forty-two certificates were collected and analyzed. Twenty-seven had regulatory support, two of which (not concerned in general medicine) complied with its content. No regulatory support was found for the 15 other certificates. The regulatory vagueness around sports accidents, or even the abuse of authority, are explanations for these certificates without existing or respected regulatory support.

Conclusion

The general practitioner is put in a difficult and ambivalent position. A major institutional commitment should be considered for the rationalization of medical certificates, in particular through medical education, health education for users and law enforcement.