A dozen medical consultation offices, a large meeting and social room, a bright reception hall, two waiting rooms… It is an XXL medical practice of 420 m2, or rather a “Multidisciplinary Health Center (MPS)” a system certified in 2007 to combat medical deserts, which opened in early 2024 in Cachan, inaugurated this Tuesday, September 24.
???? The MPS brings together different care specialties, can collaborate with other nearby establishments, including hospitals, and develops a project. It is not just a grouping of professionals under one roof. This system, encouraged by the public authorities, goes hand in hand with the Professional Health Communities (CPTS) which bring together doctors and care professionals in a territory (one or more cities). The department currently has 19 MPS, according to Eric Véchard, director of the Val-de-Marne delegation of the ARS.
Between the butcher’s shop and the hairdresser’s, the former post office in the La Plaine district has been given an additional floor and surrounded by wooden cladding. Inside, everything has been refurbished. General practitioners, nurses, physiotherapists, midwives, psychiatrists, psychologists, pharmacists, medical assistants, etc. 25 health professionals work there, grouped into six areas: primary medical care; nursing care; functional rehabilitation; women’s and children’s health; mental health, well-being, prevention and reception, support and coordination. The Terres de Bièvre MSP is open from 8 a.m. to 8 p.m. on weekdays and from 8 a.m. to 1 p.m. on Saturdays, with a few slots without an appointment. Its caregivers also offer teleconsultations and home visits.
Initially, the desire to work as a team
This generous offer of care in the heart of a priority political district of the city was first born from the energy of a group of caregivers. “Initially, there were 8 of us doctors, based mainly in L’Haÿ-les-Roses and Cachan, and we wanted to work as a team”relates Jacques Cittée, general practitioner and president of the CPTS of Bièvre (territorial professional health community that brings together healthcare professionals from Cachan, Chevilly-Larue, Fresnes, L’Haÿ-les-Roses and Rungis) and a stakeholder in the project. While the group was looking for a location, the doctor was put in touch with Thierry Delpech, who ran the pharmacy in La Plaine, in the shopping center where the Post Office was located. The latter had a little idea to find a positive outcome for the departure of the postal agency. Thus, in 2019, the project was born to create a health center that could accommodate doctors who wanted to come together. All that remained was to organize things, buy the premises that belonged to a private individual, finance the operation… all while the coronavirus health crisis froze all initiatives.
Time to put together the file
This is where all levels of public authorities and specialist organisations come into play. On the organisational side, the URPS (union of independent doctors) and Fémasif, an association that supports the development of multi-professional health centres, helped to put together the file, define the project and indicate which doors to knock on. On the financial side, the town of Cachan contributed by renting the building to the owner for as long as it was necessary to complete the project, thus preventing it from being resold for other purposes, and then authorised the building permit to enlarge the space.Medical desertification is a real concern, motivates the PS mayor, Hélène de Comarmond, for whom this is part of a more global health real estate strategy, citing the purchase of the former premises of the Health Insurance on rue Camille Desmoulin, to bring together the first MPS already opened in 2016, as well as the Children’s Medical Health Center and an ophthalmology center.
It was still necessary to raise 1.5 million euros to purchase and carry out the work. To lighten the bill, the Regional Council of Ile-de-France and the Regional Health Agency (ARS) each put in 250,000 euros while the Departmental Council added 100,000 euros. “We also set up an SCI and took out a loan”says Jacques Cittée. The acquisition was thus able to be made in 2022, for an opening after work in early 2024. “The fact of carrying out the work after the health crisis led us to think differently about certain developments”, says Thierry Delpech, president of the establishment, while showing around the premises. The meeting room has two entrances to accommodate consultations and/or vaccinations in the event of a new epidemic.
On the operational side, the Val-de-Marne Health Insurance contributes between 40,000 and 80,000 euros per year to the structure, within the framework of the ACI (interprofessional conventional agreement), in return for missions such as public health, training of young professionals, coordination, etc. The MSP also has a research vocation, by welcoming interns and developing partnerships with universities.
Attracting young people: a challenge in a sector where the average age of doctors is 56
As for attracting young doctors, this is already well underway. “Three young doctors have joined us since we created the structure,” indicates Jacques Cittée. A major challenge for the territory, classified as a ZIP (priority health intervention zone) like the majority of the department, and where the average age of general practitioners is currently 56 years old, recalled Frantz Léocadie, director of Health Insurance for Val-de-Marne, also mentioning the 6,500 inhabitants without a treating physician, including 544 with long-term illnesses (ALD).
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