An American Mom’s Perspective of a French Public Children’s Hospital

As we walked out of the hospital, I started crying tears of relief. My husband squeezed my hand and said, “I don’t think that could have gone any better than it did.”

We had just left our pre-operative appointment at Necker, a public children’s hospital in Paris where our little 5-month-old would be having surgery the following month. We had been anxious about the appointments; there would be a full day of tests and meetings, including lab draws, consultations with the surgeon, anesthesia, and cardiac nurses, an echocardiogram, and an ultrasound. We expected quite a language barrier as our French was still at beginner level, and we didn’t know what to expect in terms of our engagement with the healthcare team.

We had some difficulty communicating with the team prior to the appointment, mostly due to language and partly due to the summer holidays (just try getting things done in Europe in the month of August!). Thankfully, we had heard wonderful things about the hospital – after all, it was the first pediatric hospital in the world, and arguably the best in Europe (and its where the stethoscope was invented!).

As a nurse myself, I felt that healthcare workers were genuine at heart and always wanted the best for the patient. However, stress, time constraints, patient load, and many others barriers sometimes made it feel impossible to give the patient the time and energy they deserved.

I also experienced the American healthcare system as a patient many times. I found it to be full of well-meaning and kind people who were trapped in a system that was expensive, confusing, inconvenient, and generally scared of lawsuits. Even though I had given birth in France twice, I wasn’t sure what to expect in a different health care scenario.

As the day came towards its end, I thought about the way we had been treated. Every person did their best to speak English to us. If we had needed to, we could have used an interpreter. Each healthcare provider walked us to our next appointment, instead of just pointing us to where we should go (I found this shocking).

I was especially surprised by each person’s willingness to answer questions about the surgery and the process. My husband and I both felt that had we been in the US, most of the healthcare professionals would have delayed our questions for the surgeon and stated that they couldn’t comment on it (this is often due to legalities, but it can leave the patient feeling frustrated and that their questions are seen as trivial).

On the contrary, the anesthesiologist answered questions about recovery, the cardiac nurse answered questions about incision care, and even the echocardiogram technician drew us a picture of what would happen to the heart during the surgery (I mean…wow).

Some members of the health care team shared office spaces, and this made continuity of care even better – it offered us the opportunity to ask any questions we hadn’t thought of during our appointment with them.

The last appointment of the day was with the surgeon. We had a full typed page of questions for him; though as we continued through our appointment, it was clear that most of these questions would never need asked. The surgeon was detailed in his discussion of the surgery and what we should expect. We found him warm, experienced, thorough, and patient. He spent over an hour with us.

We were never rushed and always had the opportunity to ask more questions. He paused frequently to see if we needed clarification on anything he had said, and as we left the appointment I felt in total and complete comfort with him and the cardiac team. What a blessed feeling for any parent. I hadn’t known what to expect, but this had surpassed any expectations I had.

The hospital was public, so we would pay a grand total of 0 (yes, zero) Euros for our son’s heart surgery. We also paid nothing for our day of pre-operative appointments.

We walked towards the metro to go back home from our day of appointments. Even though we would be paying nothing, I turned to my husband and marveled, “They treated us like we were private donors of the hospital.”.

It was yet another experience using the healthcare system in France that made me so grateful to be here and yet ache for the Americans who don’t get to experience it.

Imagine being told that you or your family member requires a complicated surgery or expensive treatment. Then, imagine that all of your expenses are completely wiped away, leaving you just to focus on you and your family’s health.

It is a burden lifted like I’ve never experienced. I genuinely find it hard to describe the freedom and dissolution of stress and worry when one can purely concentrate on the health of their family without a financial burden.

But wait! There’s more.

A month later we entered the hospital in preparation for the surgery. The team was wonderful, kind, communicative, and professional. This was the case throughout our hospital stay with the pre-op team, the operating team, the ICU staff, and the post-op nursing staff.

A few things stand out from our hospital stay that were extremely meaningful for us and our recovery.

1. Volunteers rounded on the units and offered to stay with our baby (we never used one for more than an hour but could have). These volunteers would hold your baby or sing or read to them – whatever you asked. This allowed us to go out to get meals or just take a break to shower, etc. We used one every single day during the recovery period and it was a game changer for our mental health.

2. A psychologist was available to talk the parents one on one or together both before the surgery, during the hospitalization, and after we returned home. I talked to one for over an hour in person in the hospital and have weekly since the surgery (via video). I can say without a doubt this has had the most significant impact on me as I also recover through both the trauma of having a child with such a tremendous surgery and the adjustment period of going home with a baby who needs extra care.

3. Volunteers rounded on the units to find parents who may want a massage or take part in a yoga class. There were specific time frames you could see a masseuse. I took part in a one-hour massage that included thirty minutes of guided mindful meditation to relax the body prior to the massage. Afterwards, I cried with gratitude. It was an emotional time, and even though it was so necessary, it felt strange to do something so good for myself.

4. There was also a children’s library, an indoor playground for (visiting) children, and a daycare provided for the siblings of sick children.

All of these services were free. Additionally, when we got home, we found out we were entitled to 12 hours of cleaning services due to the hospital stay.

I was often in surprise when these services were offered. However, the professionals offering the services always treated it like an obvious and necessary need (“Of course you need a break…” “You need to take care of yourself to take care of your family.”). The volunteers who stayed with our child were warm, kind, and even offered to come back at the same time the following day if it worked for their schedule.

Understandably, I was in an especially vulnerable emotional state; each time I was given the opportunity to take care of myself, the tears flowed. Afterwards, I felt lighter and better prepared to take care of my family.

I share this because I am humbled to have the privilege to experience a healthcare system that puts the patient first. As a nurse, I know what it’s like on the inside of our healthcare system. As an American, I know what it feels like to be a patient in our healthcare system. As a doctorate-prepared nurse, I know the process of the healthcare system and the impact such a system has on the American people.

And beyond a shadow of a doubt, my experience of the social insurance system here in France has absolutely solidified my already convinced view that this is the way to take care of people.

The French population has a high level of health – women have the second highest life expectancy here, there is a high level of satisfaction overall with the system, and there is a high level of choice for providers (Chevreul et al., 2015). Out of pocket spending is among the lowest in Europe. Health outcomes are among the best in the European Union.

The system isn’t perfect, but it’s heck of a lot better than what we experience in the United States. We have the lowest life expectancy among high-income countries, highest rates of avoidable deaths, and our health care spending continues to be far higher than any other high-income countries. We’re also the only country of these to not have universal coverage (U.S. Health Care from a Global Perspective, 2022).

I could write a whole additional article on taxes and the need for savings (or not) in France vs America. But my goal here is just to open our eyes to what we could be experiencing as patients, as parents, and as citizens of our country. I am a better mother, wife, daughter, and citizen of the world due to the impact the French healthcare system has had on my mental, emotional, and physical well-being.

I hope this article sparks thoughts and conversation. Please feel free to comment or get in touch via the contact links below.

References:

Chevreul K, Berg Brigham K, Durand-Zaleski I, Hernandez-Quevedo C. France: Health System Review. Health Syst Transit. 2015;17(3):1-218, xvii. PMID: 26766545.

U.S. Health Care from a Global Perspective, 2022 | Commonwealth Fund