Bulletin: Public Health, Hospitals, and Professionals

Articles

• Stuart Altman, Should Israel Be Concerned by the High Proportion of Medical Care Paid for Privately
• Hadar Amir et al, Bedouin Women’s Gender Preferences When Choosing Obstetricians and Gynecologists
• Sue Anderson et al, The UK, Israel, and the USA:  The Impact of Healthcare Systems on Health
• Liat Ashkenazi et al, Male Nurses in Israel
• Sarah Ben-Ami and Aliza Yaffe, Palliative Care in Israel: The Nursing Perspective
• Merav Ben-Natan et al, Factors That Influence Israeli Muslim Arab Parents’ Intention to Vaccinate Their Children
• Shuli Brammli-Greenberg et al, Why and How Did Israel Adopt Activity-Based Hospital Payment
• Nissim Cohen, Street-Level Bureaucrats’ Bending the Rules in the Context of Informal Payments for Health Care
• Saralee Glasser et al, Intervention for Antenatal Depression by Public Health Nurses in an Ultra-Orthodox Community
• Anthony D. Heymann, Unsupportive Social Interactions are Associated with Poorer Self-reported Health in Israeli Patients with Diabetes
• Tamar Jacob, Implications of the National Health Insurance Law and for Physical Therapy Services
• Ilya Kagan et al, Public Health Nurses in Israel
• Ahmed Khalaila et al, Health Related Absenteeism of Family Physicians in the Negev
• Liat Lerner-Geva et al, Cultural Disparities in the Use of Medications Among Midlife Women in Israel
• Natali Levin, Medical Malpractice in Israel
• Joseph Mendlovic et al, Geographic Variation in Selected Hospital Procedures and Services
• Basil Porter et al, Community Paediatrics in Israel
• Carlos Quiñonez, Dental Reform in Israel’s National Health Insurance Law
• Mark Schweda et al, Views on End-of-Life Decision Making among Religious and Secular Persons in the USA, Germany, and Israel
• Yaffa Shir-Raz and Eli Avraham, PR Strategies of Pharmaceutical Companies in Countries Where Direct Advertising of Prescription Drugs Is Banned
• Diana Tasher et al, Child Health Care in Israel
• Chen Stein Zamir and Avi Israeli, Perceptions About Routine Childhood Vaccinations Among Jewish Ultra-Orthodox Mothers
• Cheryl Zlotnick et al, Comparing the Health Status of Youth Village Alumni in Israel to the General Population

New Article: Bisharat & Bowirrat, Challenges Faced by Arab Women Interested in Becoming Physicians

Bisharat, Bishara, and Abdalla Bowirrat. “Challenges Faced by Arab Women Who Are Interested in Becoming Physicians.” Israel Journal of Health Policy Research 4:30 (2015): 3 pp.

 

URL: http://dx.doi.org/10.1186/s13584-015-0029-4

 

Abstract

Understanding the underlying reasons for the under-representation of Arab women within the health care system in Israel is crucial for creating future strategies for intervention, in order to minimize the gaps in the health care system and thus improve the medical services and health status.

Our commentary tries to shed light on the underrepresentation and the marginalization of the Arab women in society in general and in the medical field in specific.

 

 

Exchange: Chinitz, Israeli, Filc, and Cohen, Black Market Medicine and Privatization in Israel

Chinitz, David, and Avi Israeli. “Not Everything is Black or White: Commentary on Filc D and Cohen N, Blurring the Boundaries between Public and Private Health Care Services as an Alternative Explanation for the Emergence of Black Medicine: the Israeli Case.” Health Economics, Policy and Law (early view; online first).

 

Filc, Dani, and Nissim Cohen. “If it looks like a duck, swims like a duck, and quacks like a duck, it probably is a duck: Black Market Medicine and Privatization in Israel.” Health Economics, Policy and Law (early view; online first).

 

URL: http://dx.doi.org/10.1017/S1744133115000365

http://dx.doi.org/10.1017/S1744133115000377

 

Abstract

It is thus surprising to read a paper based in a country with National Health Insurance that implies that such blurring is problematic to the point of contributing to the emergence of black medicine in that country’s health care system. The article by Filc and Cohen on which we comment here, appears to be issuing a warning that when boundaries blur mischief is likely to be afoot Given the relevance to many health systems, and the illustrative value of the Israeli case, we have decided to review briefly the contents of that article, and comment on the main components of its analysis.

 

 

New Article: Schoenbaum et al, Policy Issues Related to Educating the Future Israeli Medical Workforce

Schoenbaum, Stephen C., Peter Crome, Raymond H. Curry, Elliot S. Gershon, Shimon M. Glick, David R. Katz, Ora Paltiel, and Jo Shapiro. “Policy Issues Related to Educating the Future Israeli Medical Workforce: An International Perspective.” Israel Journal of Health Policy Research (early view; online first).

 

URL: http://dx.doi.org/110.1186/s13584-015-0030-y

 

Abstract

A 2014 external review of medical schools in Israel identified several issues of importance to the nation’s health. This paper focuses on three inter-related policy-relevant topics: planning the physician and healthcare workforce to meet the needs of Israel’s population in the 21st century; enhancing the coordination and efficiency of medical education across the continuum of education and training; and the financing of medical education. All three involve both education and health care delivery.

The physician workforce is aging and will need to be replenished. Several physician specialties have been in short supply, and some are being addressed through incentive programs. Israel’s needs for primary care clinicians are increasing due to growth and aging of the population and to the increasing prevalence of chronic conditions at all ages. Attention to the structure and content of both undergraduate and graduate medical education and to aligning incentives will be required to address current and projected workforce shortage areas. Effective workforce planning depends upon data that can inform the development of appropriate policies and on recognition of the time lag between developing such policies and seeing the results of their implementation.

The preclinical and clinical phases of Israeli undergraduate medical education (medical school), the mandatory rotating internship (stáge), and graduate medical education (residency) are conducted as separate “silos” and not well coordinated. The content of basic science education should be relevant to clinical medicine and research. It should stimulate inquiry, scholarship, and lifelong learning. Clinical exposures should begin early and be as hands-on as possible. Medical students and residents should acquire specific competencies. With an increasing shift of medical care from hospitals to ambulatory settings, development of ambulatory teachers and learning environments is increasingly important. Objectives such as these will require development of new policies.

Undergraduate medical education (UME) in Israel is financed primarily through universities, and they receive funds through VATAT, an education-related entity. The integration of basic science and clinical education, development of earlier, more hands-on clinical experiences, and increased ambulatory and community-based medical education will demand new funding and operating partnerships between the universities and the health care delivery system. Additional financing policies will be needed to ensure the appropriate infrastructure and support for both educators and learners.

If Israel develops collaborations between various government agencies such as the Ministries of Education, Health, and Finance, the universities, hospitals, and the sick funds (HMOs), it should be able to address successfully the challenges of the 21st century for the health professions and meet its population’s needs.

 

 

New Article: Shetach and Marcus, Critical Managerial Capabilities of Medical and Nursing Managers in an Israeli Hospital

Shetach, Ana, and Ohad Marcus. “The Critical Managerial Capabilities of Medical and Nursing Managers in an Israeli Hospital.” Evidence-Based HRM 3.1 (2015): 81-102.

 

URL: http://dx.doi.org/10.1108/EBHRM-12-2012-0019

 

Abstract

Purpose

The purpose of this paper is to determine the managerial capabilities that are required of medical and nursing managers, in a Christian-affiliated hospital in Israel, in order to promote the job satisfaction of their subordinates.

Design/Methodology/approach

Data were gathered via questionnaires, administered to 107 doctors and nurses of a small Christian-affiliated hospital in Israel, regarding the job satisfaction of the respondents, and their evaluation of the managerial capabilities of their medical and nursing superiors. Correlations and regressions were carried out on the data.

Findings

Overall managerial capabilities of medical and nursing managers were shown to be significantly related to how their subordinates felt about their teams and about their work. The results suggest differences between nurses and doctors. When analyzed for the two dimensions of managerial capabilities and the two dimensions of job satisfaction, the results were significant for the nurses, but not significant for the doctors. When tested for Christians vs non-Christians, the results for the nurses were the same as in the sample as a whole; whereas for the doctors, there were differences between the two religious groups.

Research limitations/implications

The sample is small and culturally specific, thus limiting the generalization potential of this study.

Practical implications

Findings of this research may have practical implications regarding hospitals’ recruitment, promotion, instruction and follow-up policies.

Originality/value

This study sheds light on the issue of hospital management and leadership within a specific cultural-religious setting, which has not been previously investigated.

 

New Article: Shalev, Medical Neutrality and the Visibility of Palestinian Grievances in Jewish-Israeli Publics

Shalev, Guy. “A Doctor’s Testimony: Medical Neutrality and the Visibility of Palestinian Grievances in Jewish-Israeli Publics.” Culture, Medicine, and Psychiatry (early view; online first).

 

URL: http://dx.doi.org/10.1007/s11013-015-9470-7

 

Abstract

This paper follows the testimony of Izzeldin Abuelaish, a Palestinian physician who bears witness to his experiences working, living, and suffering under Israeli rule. He presents his story as a doctor’s story, drawing on his identity as a medical professional to gain credibility and visibility and to challenge the limited legitimacy of Palestinian grievances. In this paper, I explore his testimony as a medical voice that at once recounts the suffering and loss endured by the Palestinian people and also struggles to negotiate the values associated with being a “reliable” witness. Consequently, I ethnographically examine the social life and reception of his story in Jewish-Israeli publics. In comparison with most Palestinian narratives, Abuelaish’s testimony achieved an extremely rare degree of visibility and sympathy, a phenomenon that calls out for analysis. I identify the boundaries that typically render Palestinian grievances invisible to Israeli publics and suggest how medicine’s self-proclaimed ethos of neutrality served as a channel for crossing them. Finally, I reflect on the political possibilities and limitations of medical witnessing to render suffering visible and arouse compassion toward those construed as a dangerous/enemy Other.

 

 

New Article: Bronfman et al, Assigning Israeli Medical Graduates to Internships

Bronfman, Slava, Avinatan Hassidim, Arnon Afek, AssafRomm,Rony Shreberk, Ayal Hassidim, and Anda Massler. “Assigning Israeli Medical Graduates to Internships.” Israel Journal of Health Policy Research 4.1 (2015)

 
URL: http://dx.doi.org/10.1186/2045-4015-4-6 [PDF]

 

Abstract
Background: Physicians in Israel are required to do an internship in an accredited hospital upon completion of the medical studies,and prior to receiving the medical license. For most students, the assignment is determined by a lottery, which takes into consideration the preferences of these students.
Objectives: We propose a novel way to perform this lottery, in which (on average)a larger number of students gets one of their top choices. We report about implementing this method in the 2014 Internship Lottery in Israel.
Methods: The new method is based on calculating a tentative lottery, in which each student has some probability of getting to each hospital. Then a computer program “trades” between the students, where trade is performed only if it is beneficial to both sides. This trade creates surplus, which translates to more students getting one of their top choices.
Results: The average student improved his place by 0.91 seats.
Conclusions: The new method can improve the welfare of medical graduates, by giving them more probability to get to one of their top choices. It can be applied in internship markets in other countries as well.

 

 

New Article: Popper-Giveon & Keshet, Choice of a Medical Career Among the Arab Minority in Israel

Popper-Giveon, Ariela, and Yael Keshet. “‘It’s Every Family’s Dream’: Choice of a Medical Career Among the Arab Minority in Israel.” Journal of Immigrant and Minority Health (early view; online first).

 

URL: http://dx.doi.org/10.1007/s10903-015-0252-7

 

Abstract
Application to medical studies and the choice of medicine as a career are influenced by many factors, some internal (academic ability, intellectual curiosity, interests) and some external (parental pressure, peer pressure, teacher and school expectations). Ethnicity plays a role in motivational orientation and belonging to an ethnic minority group may influence both internal and external motives and priorities in choosing medicine as a career. In this article, we present a qualitative study of the motives that impel Arab physicians in Israel to choose a medical career. As a theoretical framework, we apply self-determination theory (SDT) (Ryan and Deci in Am Psychol 55:68–78, 2000), consisting of three principal categories situated along a continuum: Amotivation, extrinsic motivation and intrinsic motivation. We show that extrinsic motivation is dominant among Arab physicians in Israel, demonstrating specifically the unique political context and cultural characteristics of Arab society in Israel. These findings, and the attention to the unique motivations of people from different ethnic minority groups who choose medical career, may increase the number of physicians from minority groups, a step known to decrease health gaps in multi-cultural contexts.

 

 

New Article: Shetach & Marcus, Citizenship-Behavior, Cooperation and Job Satisfaction of Medical and Nursing Teams

Shetach, Ana, and Ohad Marcus. “Citizenship-Behavior, Cooperation and Job Satisfaction of Medical and Nursing Teams in an Israeli Hospital.” Team Performance Management  21.3-4 (2015): 181-98.

 

URL: http://dx.doi.org/10.1108/TPM-11-2014-0058

 

Abstract

Purpose

The purpose of this paper is to investigate into the relationships among citizenship behavior within medical and nursing teams, cooperation among these teams within hospital units and job satisfaction of members of those teams.

Design/methodology/approach

Data were gathered via questionnaires, administered to 107 doctors and nurses of a small hospital in Israel, regarding their job satisfaction, their evaluation of the citizenship behavior within their own professional team (medical or nursing) and the extent of cooperation of their own team with the other professional team. Preacher and Hayes’s mediation analyses were carried out on the data.

Findings 

The findings show that medical–nursing cooperation mediates the relationship between citizenship behavior within the professional team (medical or nursing) and job satisfaction. When analyzed separately for doctors and nurses, results show that job satisfaction is predicted by the cooperation between the medical and nursing staff within hospital units, for nurses only. Citizenship behavior is shown to predict job satisfaction for each of the two professional sectors. Although for nurses, both factors affect their levels of job satisfaction, whereas for the doctors, cooperation affects citizenship behavior within the medical team, which, in turn, affects their job satisfaction.

Research limitations/implications

The research sample is small and culturally specific, thus limiting the generalization potential of this study.

Originality/value

 

The unique nature of teamwork within hospital departments is hereby investigated. The findings shed light on a critical issue of hospital human resource management, which has not been previously investigated, and may have practical implications regarding hospitals’ overall management policies.

New Article: Keshet et al, Underrepresentation of Arab Physicians in Israel

Keshet, Yael, Ariela Popper-Giveon, and Ido Liberman. “Intersectionality and Underrepresentation among Health Care Workforce: The Case of Arab Physicians in Israel.” Israel Journal of Health Policy Research 4.18 (2015): 13pp.

 

URL: http://dx.doi.org/10.1186/s13584-015-0004-0

 

Abstract

Background

An intersectionality approach that addresses the non-additive influences of social categories and power structures, such as gender and ethnicity, is used as a research paradigm to further understanding the complexity of health inequities. While most researchers adopt an intersectionality approach to study patients’ health status, in this article we exemplify its usefulness and importance for studying underrepresentation in the health care workforce. Our research objectives were to examine gender patterns of underrepresentation in the medical profession among the Arab minority in Israel.

Methods

We used both quantitative and qualitative methodologies. The quantitative data were obtained from the 2011 Labor Force Survey conducted by the Israeli Central Bureau of Statistics, which encompassed some 24,000 households. The qualitative data were obtained through ten semi-structured, in-depth interviews conducted during 2013 with Arab physicians and with six nurses working in Israeli hospitals.

Results

The findings indicate that with respect to physicians, the Arab minority in Israel is underrepresented in the medical field, and that this is due to Arab women’s underrepresentation. Arab women’s employment and educational patterns impact their underrepresentation in medicine. Women are expected to enter traditional gender roles and conform to patriarchal and collectivist values, which makes it difficult for them to study medicine.

Conclusions

Using an intersectionality approach to study underrepresentation in medicine provides a foundation for action aimed at improving public health and reducing health disparities.

 
 
 
 

New Article: Warshawski, Collaborative Work with Nurses in Israel

Warshawski, Sigalit. “The State of Collaborative Work with Nurses in Israel: A Mixed Method Study.” International Journal of Health Planning and Management (early view; online first).

 

URL: http://dx.doi.org/10.1002/hpm.2281

 

Abstract

Effective collaboration among health professionals is associated with patient safety, quality of care and professionals’ satisfaction. Nurse–physician collaboration has been a topic of substantial research worldwide. In Israel, few studies have examined this subject, but none has explored health professionals’ collaborative practice with nurses, although nursing in Israel is experiencing significant professional changes.

The aim of this study was to explore health professionals’ attitudes toward collaboration with nurses and how these attitudes relate to their perceptions of role overlap, role clarity and feeling of threat.

Research data were collected employing both quantitative and qualitative methods. A structured questionnaire was fulfilled by 262 participants, following which 12 personal interviews and 12 observations were conducted in hospital wards.

Participants’ attitudes toward collaboration with nurses were found statistically related to their perception of role overlap, role clarity and feeling of professional threat. Interviews and observations indicated immediate mutual assistance among professionals instead of collaborative practice. Interactions were brief and purposeful. The results highlight the absence of an organized procedure for collaborative practice with nurses. Therefore, it is necessary to act at the organization and departments, to assimilate nurses’ role and the importance of collaborative practice. Nurse leaders and nurse educators must consider pragmatic and effective means to promote and articulate nurses’ role in inter-professional clinical settings.

New Article: Eisikovits et al, The Social Construction of Disclosure: The Case of Child Abuse in Israeli Society

Eisikovits, Zvi, Jonathan Davidov, Laura Sigad, and Rachel Lev-Wiesel. “The Social Construction of Disclosure: The Case of Child Abuse in Israeli Society.” In Mandatory Reporting Laws and the Identification of Severe Child Abuse and Neglect (ed. Ben Mathews and Donald C. Bross; Dordrecht and New York: Springer, 2015), 395-413.

 

URL: http://link.springer.com/chapter/10.1007/978-94-017-9685-9_19

 

Abstract

Based on 40 in-depth qualitative interviews with professionals, including law-enforcement personnel, educators, and mental health and health-care professionals, this chapter presents a study that describes and analyzes an insider’s view of the ways in which child abuse professionals perceive and understand the disclosure of violence. We found that disclosure is a function of social processes related to the values, ideologies, ways of thinking, and interests of the various social agents involved in the process. Thus, disclosure is not an objective fact-finding process and the subsequent assignment of visibility and proper societal reaction, but rather a social construction.