This is one of those topics that might make you uncomfortable, especially if you’re an American and living in France, because maybe you’ve experienced exactly what I’m going to talk about. But we need to talk about it because it’s a MAJOR cultural difference. Here it is: Do NOT advocate for yourself at the doctor in France the same way you would in the United States. There’s a way you need to approach things and a reason behind it, so read on…
OK, saying “don’t advocate for yourself” needs some context because a blanket statement like that can lead to confusion or defensiveness, so let me say this right off the bat: This is not about telling people to accept bad care, ignore their bodies, or stay silent when something is wrong.
It’s about understanding that what advocacy looks like is deeply cultural… and in France, it looks very different than what you may be used to.
I also want to say that what I talk about here is something I’ve made sense of after living in France for over a decade, both with my own care and the care of the people around me. I can now better articulate what I’ve noticed, so my observations aren’t about one doctor’s visit.
It also doesn’t mean every doctor is going to have the same mindset, personality, or ego, so we can’t put everyone in the same box or generalize saying we’ll all have the same experience. Life doesn’t work like that anywhere.
But there are some overarching cultural points you need to be aware when going to the doctor in France. None of them negate the fact that I like France’s healthcare system overall. A big plus is that your health insurance isn’t tied to your job in France and an accident won’t bankrupt you. But anyway, I’m digressing.
So now that that’s out of the way, here’s what I’ve noticed. It’s something to be very aware of when seeking out medical care in France.
In the American medical system, you’re part of the team.
Love it or hate it, medicine is a business in the United States, a huge one, and one that’s part of the service industry.
Healthcare is expensive, insurance can be complicated, and patients are constantly reminded that they are customers. You are encouraged to research, ask questions, and seek out second opinions. In other words, advocating for yourself is part of the process.
Doctors are often seen as collaborators. You and your doctor are on the same team, working together to decide next steps. If you are curious about a specific test or medication, you can ask in most cases. You might not always get it, but asking is normal and even expected. It’s a conversation.
And then there’s the advertising.
Prescription drug ads direct to consumer are everywhere in the U.S. Watching a 30-minute Jeopardy episode will tell you all about drugs and their side effects for things like eczema and psoriasis treatments, diabetes, weight loss, and even prEP (pre-exposure prophylaxis). My dad and I joke about all the ads and their list of 100 side effects when we watch TV together. This type of advertising is illegal everywhere but the U.S. and New Zealand.
Here’s the point I want to make. In the U.S., you’ll hear the narrators say something at the end like, “Ask your doctor today if X is right for you.”
The message is clear: YOU should be driving the conversation. You have the right to ask for a medication and are encouraged to do so. You can make decisions about your health. You can have a conversation with your doctor about it.
In France, there are no glossy magazine spreads for drugs. No TV commercials listing side effects at lightning speed. No cultural norm of patients being “informed” by pharmaceutical companies. Yes, you may see over-the-counter drug ads and other pharmacy products but no prescription drugs.
So when an American patient asks for a specific drug in France, it doesn’t sound empowered, it sounds annoyingly suspicious.
The doc is thinking, “Do you think you know better than me? How dare you! Why do you want that drug? Where did you hear about it? Why are you questioning my judgment?”
Now, I’m not placing a value judgment on whether or not this is right or wrong, but the fact is that Americans are very accustomed to asking their doctors for exactly what they want, such as suggesting a medication they saw on TV. It cuts to the chase and doesn’t waste time, when you’ll only have a few minutes with the doc anyway. This can create a disconnect or even a misunderstanding in France, or at the very least, get your appointment started off on the wrong foot.
And yeah, the drug might help you, sure. But it’s also a business in the U.S.
France does not see medicine this way.
France does not treat healthcare like a marketplace.
Doctors are not service providers competing for your satisfaction. They are authorities. Trained experts. Gatekeepers. And culturally, they are positioned above the patient, not beside them. This is REALLY important to understand. And some doctors take this to a whole new level. Egos for daysssssss.
Make no mistake, this hierarchy is not subtle.
In France, the doctor decides:
* Which tests are necessary
* Which medications are appropriate
* Whether something is ‘worth’ treating right now or warrants being looked into further
*Whether what you’re saying is valid or should be dismissed, case closed, without further investigation.
Your role is to explain your symptoms clearly and honestly… and then listen.
If you walk into a French doctor’s office requesting a specific medication, test, or treatment, especially one you read about or saw advertised, you may immediately lose credibility.
It’s not because you’re wrong. But without knowing it, you’ve violated an unspoken rule. The doctor is in charge. This is a major French cultural difference and isn’t always noticeable right away. But it’s there.
In the French system, knowledge seems to flow downward. And this attitude doesn’t just extend to patients asking for a specific medication. It also extends to asking about alternate diagnoses, better explanations, and pushing back on anything the doctor has said.
I’m a firm believer in the fact that I know my body best. I think it’s normal to ask questions (of course respectfully) but sometimes doctors seem really triggered and like you’re walking on eggshells.
Let me tell you a quick story. I have a family member here in France who has a medical condition and one day we had a video appointment with a specialist they’d been already seeing for a year. The appointment was hard to get and included several months of waiting.
Now, my family member is modest and downplays their symptoms and struggles. In an effort to be upfront with the doctor, I tried to speak up and reiterate that my family member was suffering more than they let on so she could understand the severity of what they were dealing with. I was advocating for a loved one.
Well, I got out half of my sentence before she overreacted in the craziest way I’ve ever seen. She went on a rant for atleast 2 minutes before we could get a word in. Instead of letting me finish, she assumed I was going to say that my family member was suffering and that she wasn’t doing enough to help. A complete meltdown on her part is what followed. That’s NOT what I was going to say at all, but she wouldn’t let me finish.
She instead cut me off and said she was dropping my family member as a patient effective immediately and screamed at us to never contact her again. She then ended the call before we could even get a word in.
What in the actual heck was that?!?!?! We were stunned. We felt so defeated after that that we just cried, completely devoid of any hope. Starting with a new specialist took eight months of waiting.
Even if I had said I didn’t feel she was doing enough, which I definitely DID NOT DO, there’s a way to respond to a patient and a way to go completely overboard. I barely got out 10 words and wasn’t even saying that and her reaction was the craziest one I’ve ever seen.
Could this have happened in the U.S.? Sure. But it happened in France. Bad experiences at the doctor exist here too.
Knowing your place can be hard to understand, especially when emotions and pain are involved.
This is the part people struggle with most. And it’s not just foreigners. Our nephew here in France actually had to have his appendix removed after it burst. This was after visiting the ER several times in the weeks prior. His dad asked for a cheap blood test during those visits to check what was going on but the request was dismissed.
He was scolded by a doctor who said something like, “Sir, this is a public system. We can’t do tests willy nilly every time a kid comes in with stomach pain.” Oof. Our nephew suffered more than he should have.
In France, you are expected to “know your place” in the medical hierarchy… and that place is below the doctor. But doctors aren’t always right. They aren’t infallible. They don’t know our bodies better than we do.
If you’re used to being assertive, collaborative, or proactive in healthcare settings, this can feel infantilizing, frustrating, and even unsafe. It can feel like you’re being dismissed instead of heard.
When I saw a doctor for my own issue, there was another instance that left me in tears. And I’ve heard mannnnny more stories like this from French people I’ve talked to and by reading doctors’ reviews online. I also think it’s more common if there’s a big age gap between the patient and the doctor too. In my case, the male doctor had two or three decades on me. Would he have acted the same way with a man his age? Hmm.
I’ll freely admit that these days, when I go to the doctor, I’m overly friendly, subservient, and quiet. I sometimes have to explain why I’m sweating bullets. It’s a stress response I’ve developed from bad experiences even if the current doctor is fantastic.
None of this is an attack on French healthcare, so please don’t misunderstand me. I think the system has a lot going for it and is one of my top reasons I love living in France. Healthcare is a human right and France gets that. I’ve had many great doctors’ appointments where I’ve been heard and doctors are collaborative, patient, and kind. But again, this doesn’t mean the system is perfect or that different power dynamics aren’t at play.
It does mean that approaching things from an American perspective as a whole often backfires and it’s so important to understand the different dynamics at play or you’re going to be frustrated.
Advocacy exists, just not the way you think.
Here’s the nuance that matters. Advocating for yourself in France doesn’t look like making demands or requests. It looks like persistence, precision, and patience. And I’m not saying Americans are all pushy and aggressive making all these demands at the doctor in U.S. Not at all, it’s just that the dynamic is different, and we need to be aware of that. Being respectfully assertive which is fine in most cases in the U.S. might not be seen the same way here.
In France, focus on doing this at the doctor:
* Clearly describing symptoms without dramatizing or self-diagnosing
* Returning if something doesn’t improve, sometimes multiple times, and dealing with unfortunate long waits in many cases
* Asking why something is the way it is gently, not FOR something like you are owed it. Yes, this can feel like you’re tiptoeing around your doctor, but you have to know how to finesse the situation and play the game.
* Sometimes changing doctors quietly is the best way to go if someone isn’t a good fit.
It’s less about asserting yourself and more about navigating the system strategically. Which is a dance that can feel exhausting, I get it, especially if you’re already worn down, in pain, sick, tired, struggling with the language, waited months for the appointment, etc.
For Americans, especially those used to collaborative care, the French system can feel adversarial. And when you’re scared, in pain, or vulnerable, that loss of control can feel deeply unsettling. Trust me, I get that too.
Many foreigners abroad experience medical culture shock (no gown at the gyno, for one) and it’s not because France lacks good care (it doesn’t)… but because the power dynamics are so different.
Neither system is 100% right or wrong. And for the record, the U.S. gets SO much wrong.
The American system empowers patients — sometimes to their benefit, sometimes to their detriment. The French system trusts doctors — sometimes wisely, sometimes excessively.
Understanding this difference doesn’t mean you have to like it. But it does help you survive it — and get better care within it.
And yes, there are good and bad doctors everywhere. Not every American doctor is collaborative and not every French doctor buys into this hierarchy. There’s always nuance, so I hope you understand where I’m coming from.
The bottom line
If you walk into a French doctor’s office expecting American-style advocacy to work, you will likely leave frustrated, unheard, or labeled difficult. If you walk in understanding the cultural rules, you stand a better chance of being taken seriously.
So play by the rules. Politely make sure you’re heard. Get good care. And if it doesn’t go to plan, find a new doctor. There are many of them out there.
***
Have you experienced what I’m talking about here with medical care in France?
P.S. Here’s another post you might like about healthcare differences in France vs. the U.S.
P.P.S. In case you’re curious, veterinary care in our experience has been absolutely amazing for the 10 years we had Dagny. (She went into heart failure a week after I lost my mom and passed away just a few months later and I’ve never been the same.)
Whether it was our home vet (who I still visit actually), a specialist nearby or an emergency vet we had to see on vacation somewhere, vet care was always collaborative, thorough, affordable, and kind. I always felt heard and respected. I can’t say enough good things about veterinary care in France and will be forever appreciative of the amazing care our sweet Dagny received for her entire life, especially at the end.
Dammit, I’m tearing up just writing this so I’m going to stop there. But yeah, grateful doesn’t even convey the amount of love I have for our vet and vets in general. Dagny, I love you and miss you every day.
A few years back I had to see a docteur on a samedi, so not my médecin généraliste, as I had dreadful pain in my ear and jaw. He told me it was a tooth infection and prescribed antibiotiques. Over the weekend it worsened and as an ancienne infirmière I knew that it was not my teeth as I had developed a horrible redness all over my face which I was pretty sure was the zona. I phoned the secrétaire on the lundi matin and argued as she told me that I hadn’t given the antibiotiques enough time. I told her I needed antivirals and I wanted to see my docteur straight away. He took one look at me, recoiled, and gave me an ordonnance for the zona. So rest assured, you can certainly argue with the secrétaire !!!
Good for you for knowing your body! I hope you made a full recovery 🙂
I did, merci, but it was horrible !! I must point out though, as you have said, I didn’t argue with the docteur, you just don’t do that ! But I do understand that it can be frustrating for others who are not used to the système
Great post and spot on (as always!). I have lived in France for forty years and I am careful not to suggest tests or medicines to my doctors. Once I suggested trying a different medicine and the doctor snapped, “I’m the doctor here.” I changed doctors. Another time the doctor wrote out a prescription for aspirin for my child and I said, but isn’t that risky? I knew they don’t give aspirin to young children in the US and she said, “Why not?” Gee!
Oh man, glad you’ve learned the ins and outs of the system, Carrie. The snappy behavior is totally uncalled for. i’m sorry you experienced that too. The doctor could have responded a little differently while still asserting his or her place but without being rude. Le sigh…
Dear Diane,
Have you heard of any French doctors writing prescriptions for injectable weight-loss medicines there? Are they even a thing in France? I have been on a weight-loss journey by using the injectable Zepbound (tirazeptide) and would wish to stay on this medication in order to lose 30 more pounds. Thanks for any information you can share!
MCSJ
Hi there, I don’t know of anyone who takes a GLP1 in france personally, but from what I do know, it’s much more regulated here. Only recently have some GPs been legally able to offer them and I’m not even sure how widespread that is. As far as I know, you need to make an appointment with an endocrinologist which can be difficult to get. And only if you are diabetic or your blood work shows a medical need are you then assessed for a GLP1. They aren’t given out as freely here like we hear about in the US for people who just want to lose weight (and aren’t diabetic or obese).
I am taking Mounjara now (Zepbound) prescribed by my endocrinologist. In Paris. So far no problem getting it.
Could this be different in Paris? I have lived here eight years and have not experienced anything like this. I have an American attitude, though I didn’t know it. I see a doctor as consultant I have hired to advise me. I and my husband have not changed that since we moved here and haven’t had a any problems. We believe we have had excellent doctors here. Our MT is sector three, non conventionné. She makes excellent referrals ( though one time she did say she did say she had to prepare the doctor for my husband. He has a Ph..D. in biology and frequently finds mistakes in doctors’ information.) No one has appeared disturbed by us. We’ve met some excellent and friendly doctors.
We also use the American Hospital, which is not necessarily better than the French hospitals, but now I’m wondering if they are better prepared for us.
During our year outside of Paris, we had a wonderful section 1 MT, who even allowed us to take the Covid vaccine home and inject each other.
One night, we had dinner with a local specialist and wife, also a doctor, who enjoyed the greater equality between patient and doctor than in the US where money put the physician in a superior position.
Could my experience be dependent upon my location in Paris?
We are in Paris also, and perhaps by luck, were referred by a pharmacist to a wonderful GP. Have had a small clinic procedure in a French clinic with anesthesia and an out-patient operation with anesthesia at the American hospital. All great experiences (with good food!). Our doctors and specialists seem to always want to tell us about their visits or internships or relatives in the U.S. No bad attitudes so far.
I wonder if the doctors in cities and villages outside of Paris are more stressed because they are overwhelmed with the number of patients? When we visit our friends in Normandy, they tell us about the medical “deserts” and how they may have to travel quite a way to a larger city for a specialist.
Hi Ellen, the medical deserts and the overwhelm I’m sure factors into it. Waiting times where I live can be atrocious and practitioners are stressed. But on the other hand, I’ve seen several doctors over the years where there have been full waiting rooms so I am all ready to be efficient with my carte vitale and carte bleue in hand and the doctor proceeds to tell me to take my time, sit down and chat, and regals me with his stories from his trips to the US. It’s happened 3 times I can remember. So you just never know!
Hi Beverly, thanks for sharing your experience! I think the fact that you’re in Paris may factor into it although I’m sure there are docs with big egos and terrible bedside manner there too (because you can find doctors like that anywhere and of course not just in France). I think the power dynamic may have been less pronounced in your experience because you’ve had good luck with doctors but also the American Hospital is outside the French system, and many practitioners have 1) studied outside of France or aren’t French themselves and 2) are used to seeing non-French patients. It can all play a role! Thx for reading 😉
How do French doctors respond to recommendations from American doctors? I’m getting ready to move to France. I have some health issues where multiple treatments have tried and failed. My American doctor (being a typical American doctor, I guess) is happy to write me a letter, explaining my medical history to his new French colleague, which I can then get translated into French.
How is THAT going to go over? I’ve had a bit of experience with the French system. It was mixed. I can definitely see what you’re saying. (Don’t argue with doctors and don’t argue with chefs.) One doctor I saw in France (who was actually really nice and caring) huffed and puffed about American doctors and their over-testing and how it’s all just done for money and to prevent lawsuits.
Funny thing is—I kind of agree with the French doctor on that! No, it’s not ALL done for money (the prescribing doc typically is not going to be the one getting paid for the tests they order) nor for legal protection (it’s not as easy to sue doctors in America as people think it is), and of course a lot of it is simply cultural: American doctors consider tests the highest standard of care.
I’m digressing though….with my long-standing health issue, I really, really, RRREEEAAALLLYYY don’t want to have to start all over again with everything that’s been tried and failed, when I have a treatment plan in place that actually works.
How likely is a French doctor to listen to what an American doctor says? Or will that just create MORE pushback? Make them MORE defensive that how dare that over-testing American quack tell THEM what to do–oh, la, fucking, la! Hmph! 😉
Or will they just take it like, great, no need to start from scratch? Obviously, it depends on the doctor. I’ve had some pretty imperious American doctors in my life. But I wasn’t an immigrant; I spoke the language fluently—and I knew when to walk away and find a different doctor. Any tips on that? Obviously, if they scream in your face and hang up, it’s over. (I’m so sorry that happened to you and your loved one!) But any tips for knowing when the relationship might still be salvageable (esp if it’s going to take a long time to get in to see another doctor)?
I am not looking forward to this part…as much as I know the French healthcare system is among the best in the world. But it could really jeopardize my health and functioning to start all over again with a treatment plan that’s already been tried. Couldn’t I just go to the vet instead? 🙂
“Couldn’t I just go to the vet instead?” – Love that!
I didn’t have any trouble with my MT accepting and continuing my American treatment. There are differences in the medication available in France. Some of the more expensive US variations are better but not available here. I’ve adjusted. I’m not going back to the US, so I’m more willing to compromise than I would be if the world were different. French doctors have been good to me.
I had received advice on how to dress and present myself to doctors if I expect to be treated as an equal. Most was similar to the advice for seeing American doctors, but more subtle. Dress well, conservatively, good quality but no obvious labels. Give a well educated impression. This is most important for the first meeting. The advice was for Paris. Know the meaning and pronunciation of relevant terminalogy, but don’t be the first to use it. After the first appointment, it’s not as important, but never wear jeans. Look like a business partner. I learned a lot of this from French doctors, mostly specialists.
BR, I literally LOL’d at your vet comment. Thank you for that. I wish we could all go see my vet hahahah!
To answer your question, you’d think that a note written from one professional to another would be seen as proactive and helpful. I think most doctors would appreciate it because it cuts down on the work they have to do and can just pick up where you left off in the US. The vast majority of doctors anywhere I think would be cool with this. But that said, you might end up seeing an old school doctor with a big ego who has to do everything him/herself from step 1.
I know when my husband saw a new GI doctor, he wanted to redo all the testing himself and not just trust the work of a colleague Tom had seen prior. So you just never know what approach to take. All you can do is go in prepared.
I think a new doctor would be especially appreciative if you have an obscure or complicated case or condition that maybe they themselves aren’t overly familiar with. But then again if it’s something well known, they may think the French way is best and push back on what your US doctor said. But regardless, I’d like to think the vast majority of French doctors know how to have a respectful, calm conversation in whatever direction they go with your care, in an environment that feels constructive and open to questions and a conversation.
Honestly, I think it’ll be fine and no reason to worry. I might just say approach it more like, “I know you’re busy so to save you time, here’s how my US doctor has been treating xyz in case it helps you” and NOT “Here’s what mY US doctor wants you to do / you need to prescribe this/etc.”
Hope that helps!
Thanks, Diane. Unfortunately, my medical situation has changed. Recent testing came back showing I need surgery. I’m just hoping to God I can get this surgery before I leave the U.S., because I don’t want to look like the stereotype of: “Another American coming to France to leech off our healthcare.”
Then, just yesterday, my insurance company rejected my doctor’s initial orders for the surgery, so he’s appealing. This could take months or years, or it could be denied permanently. (I have pretty good insurance in terms of how much cost they cover, but they’re infamous for rejecting doctors’ orders indefinitely, hoping you’ll just give up. I actually had to sue them once to get them to cover what the policy states they cover.)
Oh, this is NOT good….not good at all…. To top it off, while I’m already studying with a French tutor, I’m still a complete beginner. I suspect this may hurt me more than anything else. I know not to argue, and I know how to dress. I know to be quiet. “Bonjour,” “merci,” and “s’il vous plaît” started coming out of my mouth pretty naturally right away. But I sometimes did not get any response, no “bonjour” in reply, only a glare. A couple people just started screaming at me in French. It made me question if I really want to move there, but this is an opportunity that’s just too good to pass up.
It caused the most problems when I had to visit a doctor while I was there for the job interview. I had not realized that tourists are expected to speak anything more than some basic French, and just be formal and polite. I was quickly informed otherwise. “We are in France. We do not speak English here.” Peachy. I mean, if I get the job, yeah, of course; I signed up with a French tutor immediately—but as a tourist??
Fortunately, the doctor did speak English and was willing to do so with me and he was very kind. I received excellent care. But checking in was awful. The front desk overheard me say, “Bonjour. Je suis désolée, je ne parle pas français,” so they accused me of lying to them, that I really did speak French but I was pretending not to be able to. I’m not sure how it would benefit me in any way to pretend I don’t speak French if I really did. By the time my tourist visa was up, I desperately wished I spoke French!
It’s not a “normal” medical problem either, with one obvious solution, like a diabetic needs insulin. Oh, merde, merde, putain merde !
At least it happened now, while my departure date is still a good ways off. I don’t care if I’m still in recovery when I leave and I have to be carried onto the plane on a stretcher, so long as I can get this surgery while I’m still here. That should resolve the problem and I can arrive in France healthy and just start my life in France on the right foot.
I mean, I still won’t be fluent in French. I doubt I’ll ever be fluent in French. So that’ll be really bad for…probably the whole time. But at least I won’t be dealing with an unusual medical problem that abruptly changed right before I arrived and then I’ll look like the stereotypical “American leech.”
I don’t know….I wonder if things change when you live there. So many foreigners who live in France just rave about how wonderful it is and how lovely the people are, but I came away understanding why so many people think the French are rude as hell. But maybe that’s just towards visitors who don’t speak French. Or maybe I was doing something else wrong and I didn’t know it. I began spending a lot of time just hiding in my room, avoiding people. I almost cut my trip short, turned down the job and went home early, thinking, my God, these people are THE WORST!
But I didn’t like being judged, so I don’t want to judge them until I’ve actually LIVED THERE. It’s not as though we treat foreigners well here. At least nobody will shoot me, or disappear me to El Salvadoran prison.
In part, I imagine, this cultural attitude reflects the hierarchy rooted in the formality that is so French (and German), that still seems to be in place despite these crazy times. I think that’s a wonderful and special way of being that if America had it, was lost long ago. That is one of the things that really endears me to France. Respect is still a thing!
I am fortunate to have insurance in the USA, but I always wish there will be a major transformation in how medicine is practiced here. That being sad, there are some wonderful American doctors. I have a birth defect and have had five spinal surgeries. I’m so grateful to have had capable doctors and surgeons involved in that. Despite everything, the US does have a lot of innovation. And socialized medicine as they have in Europe and Canada even if superior in terms of care, does have its problems. No system is perfect