Interview with Lamine Gharbi and Laurent Ramon, respectively president and general manager of the Montpellier private hospitalization group Cap Santé, whose flagship, the Saint-Jean clinic, is ranked in the Top 10 of the Point ranking.
The Saint-Jean clinic joins the Top 10 in the national Point ranking. Is it the result of an ambition, of an investment?
Lamine Gharbi : The ranking is based on medical diversity and the completeness of specialties. This means that you must have all the medical and surgical specialties, sustained activity and a large number of patients. We are here based on the notion of attractiveness, namely the patients we treat who are outside our department. This ranking is also a qualitative recognition, with all the specialties.
When you imagined the clinic, during its initial design, was this an objective, in terms of offer and image?
L.G : The investment in this clinic is 100 million euros. So it was a significant investment for our group. Originally, we obviously didn’t do this to be in the Point rankings. We did it above all to offer the population all the specialties. Performance is the success of convergence: that of an exceptional building, with 26 operating theaters, 200 patients operated on per day, an emergency service with 120 visits per day, an intensive care unit, a consultation center … etc. All this gives an establishment of significant size of more than 35,000 m2, qualitatively, quantitatively. This is what allowed us to enter through the front door in this Point ranking, with specialties for which we are first, such as shoulder and urology.
Today, there is the offer of services and care, but there is also the environment of the establishment.
L.G : We must offer patients smooth pathways, quality reception, accommodation and, above all, quality care. Our services are designed to provide optimal quality of care for our employees, so that they are placed in the best conditions to be able to perform their profession well.
How are specialty rankings a challenge?
Laurent Ramon : One of the main keys to ranking « 9e France » of the 2024 Point Awards is the presence of multispecialties within the clinic. Thus, in 10 years, this site has grown from 11 to 38 disciplines, with the arrival of more than 100 practitioners. We carry out all other surgeries and for all ages with quality plural teams also in medicine and anesthesia who work in symbiosis and in sector logic. This generates short lengths of stay and now regional attractiveness.
The disciplines that perform well in the Point ranking
In the 2024 ranking of Le Point magazine, the Saint-Jean clinic is ranked 18 times in the list of specialties. It is thus in first place for shoulder surgery, 4th for dental surgery, 6th for that of the arteries, 6th also for surgery of the testicles of children and adolescents, 7th for dental surgery and oral health of the child, 7th for that of the foot, 8th for that of the retina, 9th for kidney cancer, 10th for strabismus, 12th for surgery maxilofacial, 13th for knee prosthesis, 14th for prostate adenoma, 16th for ankle surgery, 18th for colon or intestinal cancer, 27th for adult back surgery , 30th for knee ligaments, 31st for hip prosthesis and 33rd for urinary stones.
Is this the essential step to have a recognized establishment?
L.R : Our surgeons and doctors are all trained in the Faculty of Medicine following national courses. On the other hand, they each have specific experience and classification paths, allowing them to differentiate themselves. Then they emulate each other internally, including in terms of innovation: for example, the Saint-Jean-Sud de France clinic is the second private establishment in Occitanie in terms of scientific publications. It’s not nothing. This is the reason why we are based on the logic of multispecialty expert centers integrating advanced consultations in the territories. This is above all what we are tending towards because this is what the needs of our patients are tending towards, who prefer hyper-specialization, such as shoulder surgery, the first in France, arteries, sixth, retina, eighth, stomatology, fourth, but also surgery for urological, digestive and ENT cancers and of course, historically, pediatrics with its gateway: our Pediapole.
How can Saint-Jean’s performance reflect on all the other establishments in the group?
L.G : Saint-Jean is the flagship of our group. This is the most recent. The Ganges clinic will follow this path. This recognition creates attractiveness for our doctors. There are those who will come to strengthen the teams but also those who will work on other sites. It’s a whole, it’s a qualitative network of the territory. The practitioners who are in Saint-Jean are part of the large Cap Santé family and some practice on our outlying sites such as Ganges, Pézenas or Bédarieux. Saint-Jean is certainly a showcase, but all of our sites are just as qualitative to the extent that our certification results, an examination by the High Authority for Health, carried out every four years, are excellent.
When we talk about reduction of resources, dereimbursement, does this have a risk of impact on the performance of establishments?
L.G : The news today is telling with the rejection of the PLFSS (social security financing bill, Editor’s note), which means that our establishments, but also all establishments in France, will have to work with budgets of 2024. We are precisely measuring the effects of the motion of censure. The PLFSS, which was to establish a national mandate for health insurance spending by 2025; with + 9 billion euros for public hospitals, private clinics, community medicine, this increase in the budget is postponed until we don’t know when. We are worried about 2025. Especially since 2024 is a complicated year because the increase in our budgets was of the order of 1%. We will find it increasingly difficult to invest if we do not obtain an increase in our prices. You should know that these are supervised by the State and that we cannot set the price of the operations ourselves, which is set by health insurance. The innovation that we carry is of course architectural. But it is also material. To attract and retain the best practitioners, you need robots, equipment and lots of staff. These tensions therefore risk, but this is everyone’s lot, having repercussions on our investments. We hope that there will be a amending PLFSS finance law in January to release these 9 billion. But for now, there is great uncertainty.
How do you see the future?
L.R : The criteria that are in these rankings, like that of Point, are increasingly precise and close to the needs of our patients and populations. We must therefore draw inspiration from it to be even better tomorrow. To do this we have, within Saint-Jean, a body, which is the Establishment Medical Conference (CME). It is a forward-looking and inventive unit, which innovates to always provide better, rapid, secure and, above all, up-to-date support.”scientific data”. All our teams within the clinic and the group are happy and proud of this ranking. But this first brings a collective responsibility so that tomorrow is even better, for the care of the thousands of Patients who trust us each year. Finally, I also remind you that Montpellier is the historic city of health and while of course we welcome our presence in the Top Ten France, thanks to the recognized skills of our teams, we do not forget that we are not alone with other classified establishments in the region and an efficient university hospital.
