The French Federation of Multidisciplinary Health Houses as interest group: Representativeness, narrative thread building and lobbying

Abstract

Understanding how health care in France is reconfigured requires an appreciation of the relationship between the public organization and distribution of health care and a largely private outpatient medicine (i.e., offered mostly by liberal health professionals). The French Federation of Multidisciplinary Group Practices (Fédération Française des Maisons et Pôles de Santé, known by the acronym FFMPS) plays a role on the premise that members of different professions can form a coalition and act as an interest group in the implementation of public policies. From the perspective of linked ecologies, the FFMPS has instrumentalized multidisciplinary group practices as a way to pre-empt a space that the state has yet to overtake. By positioning themselves on this “mandate” (Hughes, 1996), health professionals ensure that the state’s presence (and governance) in the medical field remains weak, or at least not as strong as what is conveyed by the “repellent” representations that circulate around the “nationalization” of health and the “integration” of health professionals into the civil service. In order to draw support from the public authorities and to obtain the corresponding mandate, atypical liberal health professionals of the FFMPS have put forward the argument that they can self-organize while serving the general interest in such a way as to offset the poor organization of primary care in France.