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RésuméCette étude a pour objectif de recenser et comprendre les cessations d’activité libérale de médecine générale en soins primaires, et d’appréhender leur rôle dans l’évolution de la démographie médicale actuelle. Elle concerne les cessations effectives dans trois départements de l’Ouest de la France de 2000 à 2005. Les données ont été recueillies auprès des conseils départementaux de l’ordre des médecins, puis par questionnaire auprès de 75 médecins (taux de participation 60 %). Elle révèle que seules 29 % des cessations sont des départs en retraite. Plus d’un médecin sur deux a poursuivi un exercice salarié, 18 % ont choisi une nouvelle installation libérale hors département. Les deux tiers exerçaient en zone rurale ou semi rurale. Moins de la moitié, 47 %, a eu un successeur. Les médecins ne cessent pas toute activité médicale : leur carrière est polymorphe et ils sont mobiles. Les raisons retrouvées sont majoritairement les contraintes de travail et la difficulté à concilier vie familiale et personnelle. Ils recherchent alors une activité libérale ou non, en soins primaires ou non, qui répondent à leur exigence de temps pour soi, de mobilité.

Early suspension of private practice: the current trends for general practitioners in three counties in western FranceThe purpose of this study is to conduct a census of general practitioners in order to better understand their early withdrawal from primary care practice and to assess the impact of such withdrawal on current medical demography. The study covers the withdrawals from January 2000 to December 2005 in three western French counties. Data were collected through the district councils of the practitioners’ guild, followed by a questionnaire filled in by 75 doctors. The participation rate was 60%. The study reveals that only 29% of these withdrawals are due to retirement. More than one in two doctors left to pursue another paid employment, and more than 25% chose to relocate their practice in a different area of the county. Two thirds of them were practicing in rural or semi-rural locations. Less than half, 47%, were replaced by a successor. General practitioners surveyed did not stop all profes-sional medical care provision and service activities. Their careers are complex, and they are mobile professionals. The main reasons for suspending their activities in a given location were essentially related to the difficulties they had in dealing with their work loads and in maintaining a healthy work-life balance. They have noted that they will leave a range of possibilities open, either looking for private practice or not, exploring the possibility of primary care or not; the basis of their decision is whether a new position will correspond to their desire of mobility and meet their needs for more free.