His journey unveils the true cost, decisions, and trade-offs of a career many view as secure, predictable, and well-compensated. The reality, however, includes long hours, real numbers, and compromises that are often hidden from the waiting room.
From a Busy Group Practice to a Solo GP in the Village
Rami (name changed) has been practicing as a general practitioner for 11 years. After several years as a salaried doctor in a bustling group practice, he left the security of a steady paycheck behind.
Now, he runs a small surgery in the rural department of Gers, near Auch in southwestern France. His move was not just professional—it was personal. He grew up in the area and had a strong relationship with the local mayor.
This connection changed the financial picture from the very start. The mayor, eager to retain a GP in the village, offered to cover the rent of Rami’s surgery—around €550 a month. For a self-employed GP, having such a fixed cost covered is a huge advantage.
Rami swapped a higher, predictable salary for the independence of running his own practice, shorter working days, and the unusual benefit of a rent-free surgery.
A Typical Week: Long Yet Controlled
In his village practice, Rami sees patients Monday through Friday, from 9 a.m. to 6 or 7 p.m. The schedule is simple but demanding:
- Monday, Wednesday, Friday: appointments only.
- Tuesday and Thursday: open-access consultations without appointments.
These walk-in days are intense. Patients come not just from his village, but also from surrounding areas, many of whom don’t have a regular GP. This issue is growing in many parts of France, where GP shortages are becoming severe.
On paper, he works 40 to 45 hours per week. In practice, the pressure comes from the constant mental load and responsibility for an aging population with complex health needs.
A Better Quality of Life, But at a Cost
Rami insists that his life is much better now, even though his income is lower.
Back when he worked as a salaried GP, his days often stretched past 8 p.m. Family time was limited, evenings blurred into paperwork, and weekends weren’t always free. Today, he finishes earlier, keeping his evenings and weekends for himself, his partner, and his friends.
“I have my evenings and weekends back,” he says. “I didn’t realize how much I had lost them until I got them back.”
But there’s a trade-off. His income now is lower than in his salaried role, and the variety of his patients is more limited. In the group practice, he treated everyone from toddlers to adults to frail seniors. In his village surgery, about 80% of his patients are retired seniors, meaning more chronic illnesses, repeat visits, and less clinical variety. Although the medicine is still demanding, the range of conditions he deals with is narrower.
Monthly Earnings: The Real Take-Home for a GP
So, how much does he make?
Rami says he earns around €7,300 a month, after paying his social contributions to URSSAF (the French body that collects social charges from self-employed individuals). This is before income tax and personal expenses.
After 11 years as a GP, his monthly income as a self-employed doctor is about €7,300, which is roughly €1,000 less than his previous salaried position.
He works 40–45 hours per week, sees 15 to 18 patients a day, and charges €26.50 per consultation—the standard fee for a GP visit in France.
Could He Earn More If He Wanted?
Almost certainly. Rami admits that his income could increase if he cut back on holidays and saw more patients each day.
However, he chooses not to. He believes older patients need longer appointments and a calmer pace. While seeing more patients each day might bring in more revenue, it would fundamentally change the way he practices medicine.
He views this as a deliberate choice: accept lower earnings in exchange for more time, a higher quality of care, and a sustainable pace.
Costs and Overheads: What Eats Into a GP’s Income
Although Rami is in a relatively privileged position due to the council covering his rent, the list of unavoidable expenses remains long.
| Type of Cost | Approximate Amount | Comment |
|---|---|---|
| Social Contributions (URSSAF) | Variable | Paid before his €7,300 monthly figure |
| Tele-secretary Service | ~€500/month | Remote management of calls and appointments |
| Utilities (Water, Electricity) | Variable | Essential running costs of the surgery |
| Medical Software & IT | Variable | Electronic records, prescriptions, secure messaging |
| Rent | €0 (subsidised) | Normally ~€550/month, paid by the local council |
One expense Rami willingly adds is a tele-secretary, costing around €500 per month. A remote receptionist manages his calls and bookings, reducing interruptions during consultations.
This choice shows that Rami is willing to reduce his own income to improve the quality of consultations and reduce stress.
How His Numbers Compare with National Averages
In 2017, France’s health statistics body (DREES) estimated that GPs generated an average annual turnover of about €92,000. Turnover refers to the total money billed before expenses and social charges.
The actual take-home pay for a GP depends on several factors:
- Number of patients seen per day
- Length of consultations
- Amount of holiday time taken
- Rent and local overheads
- Rural vs. urban location
A doctor seeing 30 patients a day with minimal staff can bill much more than one who sees just 15 patients and pays for a secretary. However, the higher turnover may come at the cost of burnout, shorter visits, and more rushed decisions.
Why Many GPs Still Choose Self-Employment
Rami’s situation is a classic example of the French tradition of the self-employed GP. While technically independent, self-employed GPs are bound to state-regulated consultation fees but enjoy freedom in managing their schedules and workloads.
For many doctors, this model offers autonomy that salaried positions do not. They can set their own schedules, choose their practice locations, and decide how many patients to accept.
For many doctors, having control over their pace and lifestyle can be more important than a few extra hundred euros at the end of the month.
The downside, however, is the risk. Income can fluctuate due to personal decisions, illness, local demographics, and national policy changes. There is no guaranteed salary when the waiting room is empty, and benefits like paid leave or employer-funded pensions are less generous.
Key Terms: Understanding URSSAF and “Liberal” Practice
For readers unfamiliar with France, a couple of terms need clarification:
- URSSAF: The body responsible for collecting social security contributions from self-employed individuals and employers. Doctors like Rami pay URSSAF for health insurance, pensions, and family benefits.
- Liberal Practice: Refers to self-employed doctors who run their own practices and are paid per consultation or procedure, as opposed to a salaried employee. Although their fees are regulated by the state, they remain independent professionals.
What Rami’s Story Reveals for Future GPs
For medical students considering their futures, Rami’s story sheds light on the real trade-offs. A GP in a rural area with subsidized rent can earn around €7,300 a month after social charges, working 40–45 hours per week and seeing fewer than 20 patients daily. The cost? A lower income than some salaried roles, and a patient base dominated by older, complex cases.
Change a few factors—such as location, number of patients, or working hours—and the picture changes. A doctor in a big city, paying full rent and hiring staff, might see their net income decrease. Conversely, a doctor who works long hours with a higher patient load may earn more, but at the cost of increased stress and fatigue.
For patients and policymakers, stories like Rami’s emphasize why recruiting and retaining GPs in underserved regions isn’t just about salaries. Housing support, practice costs, community ties, and work-life balance matter just as much as the paycheck.
