Endométriose et errance médicale : enjeux sociétaux et perspectives d'amélioration du parcours de soins

This thesis offers a comprehensive analysis of medical wandering in endometriosis, a chronic gynecological disease that still suffers from a significant delay in diagnosis and care. Drawing on both a detailed review of the literature and an original qualitative investigation, this work identifies the primary determinants of medical wandering: insufficient training of caregivers, inadequate structuring of expert centers, territorial inequalities, and underestimation of women’s symptoms. The thesis also explores the socio-economic and psychological impacts on affected patients. Innovative approaches, notably the integration of digital tools and artificial intelligence, are examined through the case study of the startup Gynger. These solutions are evaluated for their potential to optimize care coordination, facilitate early diagnosis, and empower patients as active participants in their health pathway. The work highlights the necessity of multidisciplinary, territorialized, and ethical models to overcome current limitations, particularly in rural and medically underserved areas. Finally, the thesis emphasizes the importance of developing inclusive public health strategies and robust clinical assessment of digital innovations. The limitations and potential biases of the research are acknowledged, notably selection and declarative bias in the patient cohort. These findings call for greater recognition of women’s health in public policy, the reinforcement of collective engagement, and the continued pursuit of research, innovation, and patient advocacy to minimize medical wandering and improve the quality of care for all women affected by endometriosis.