Working as a doctor in France: self-employed (“médicin libéral”) or salaried?

4 March 2020 | Medical career

As a current or future expat doctor in France, this is a critical question in your search for employment. What you want is a good balance between your professional and private lives, good working conditions, and satisfaction in practicing your career of choice. It’s good to bear in mind that whatever you choose, it likely won’t be permanent. In the course of their career, many doctors change their employment status, the way they practice, or where they practice. Following are some details that may help inform your decision.

Salaried or self-employed doctor: What are the main differences?

Salaried doctors (“salarié”) in France receive a monthly salary that is independent of the care they provide, and are under contract with an employer (hospital, health care provider, company, etc.) This implies a chain of subordination, though they do have autonomy in terms of their medical decisions and prescriptions. Depending on the terms of their contract, salaried doctors may also have a private practice on the side, typically at a private clinic.

As for self-employed, or so-called “private” doctors, they are remunerated on the basis of care provided, and are responsible for their own practice. Such doctors may have their own clinic, a joint practice with other doctors, or work at a clinic who they pay for the use of the premises. Such doctors can choose between three types of remuneration for their medical care (called “secteurs” in France). Secteur 1: Social security sets and reimburses doctor fees paid by patients, and also funds a portion of the doctor’s expenses. Secteur 2: Social security sets the reimbursable doctor fees, but doctors may charge fees above that which are not reimbursed. Secteur 3: Doctors set their own rates and patients receive very little reimbursement from the state. 

Advantages and disadvantages

Salaried doctors receive a fixed income, work regular hours, receive social benefits, paid time off, access to training, and help with administrative matters. Such doctors may be able to work together as a team, which can make things easier for foreign doctors. On the other hand, they must be willing to work under a certain hierarchy which sometimes means less autonomy. As a self-employed or private (“libéral”) doctor in France, your income is likely to be higher but irregular, you will work longer hours but have more control over your schedule. You will be independent but may work alone, and must handle your own administrative matters. The social and relationship aspects of the job are greater for private general practitioners in particular. Nursing facilities that are growing may allow private general practitioners to become salaried. 

Self-employed or salaried? Our consultants are on the ready to help you in your decision-making, identify your needs, and find job offers that best meet your criteria.

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