84. Multidisciplinary Primary Care Groups (Maisons de Santé Pluriprofessionnelles, MSPs) and the Long Path to Team Practice

Like other member countries of the Organization for Economic Co-operation and Development (OECD), the French healthcare system faces a shortage of general practitioners (GPs), resulting in medically underserved areas and increasing disparities in access to health care. For a long time, solo practice remained the norm among French GPs—who are mainly self-employed—in a poorly structured outpatient sector. However, since 2007, new private coordinated care facilities—known as “Multidisciplinary Primary Care Groups” (Maisons de Santé Pluriprofessionnelles, MSPs, in French)—have emerged. These structures, led by self-employed GPs and supported by the public authorities, have catalyzed significant changes in the organization and financing of outpatient care. Alongside GPs, MSPs integrate nurses and allied healthcare professionals, with the aim of fostering coordinated and preventive care through formal contracts signed with local public authorities. The number of MSPs gradually increased, reaching 2251 by the end of 2022. Studies indicate MSPs have positive impacts on the distribution of primary healthcare providers, the evolution of professional practice with an expansion of the range of public health services offered to patients, the quality of care, and GPs working conditions. However, the dissemination of this model, which involves only 17% of GPs and remains heterogeneous, faces a number of obstacles and competes with other forms of integration.