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JAAPA. 2017 Sep;30(9):1-3. doi: 10.1097/

The officier de santé in 19th-century France: A PA prototype.

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Helen Perdicoyianni-Paleologou is a fellow in residence in the Department of Philosophy at Boston (Mass.) College. She holds two doctorates from the University of Paris (the Sorbonne) in Paris, France, and a diploma in the history of medicine from the Université Paris V Réné Descartes, part of the Sorbonne. The author has disclosed no potential conflicts of interest, financial or otherwise.


In 1803, shortly after the French Revolution, the French healthcare system was reorganized and a new independent medical officer, the officier de santé (health officer) was introduced. Qualifications included 3 years in a medical school (compared with 6 years for a physician) and an apprenticeship with a physician. Although somewhat independent, officiers de santé were limited in their scope of practice to general medicine, prescribing medications, and minor surgical procedures. Many were deployed to medically underserved areas. After almost a century of activity in a role not unlike physician assistants, the officiers de santé were abolished in 1892. Development of a more rigorous medical education and an adequate supply of physicians meant that physicians were better deployed throughout France, and were largely the reasons for abolishing this PA prototype.

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