The Task Force for the Promotion of the Status of Women in Medicine in Israel.

BACKGROUND: In this article, we offer a brief summary of the report from the Task Force for the Promotion of the Status of Women in Medicine in Israel. The task force, formed by the Israel Medical Association in 2013, published a comprehensive report in May 2015 dedicated to the promotion of equal opportunities for female doctors in the Israeli healthcare system and in the academic world. The aim of this paper is to present the work of the task force and to highlight its main principles and recommendations against the backdrop of the gender revolution in the Israeli healthcare system and worldwide.

[HOW MANY PHYSICIANS ARE ACTIVELY PRACTICING MEDICINE IN ISRAEL? ON THE DIFFERENCES BETWEEN VARIOUS METHODS OF MEASUREMENT].

INTRODUCTION: In 2018, Israel replaced the workforce surveys of the Central Bureau of Statistics with administrative data files, as the source of its reports to the OECD on the number of physicians practicing medicine and their percentage of the population. In the wake of the change, the scope of the medical workforce reported by Israel dropped by approximately 9%-15% in each one of the years from 2012-2015. Furthermore, while according to the previous measurement approach, Israeli figures were consistently equal to or higher than the yearly OECD averages, according to the new method these figures are lower than the averages of other OECD members. Essentially, according to the new data, the number of physicians practicing medicine in Israel straddles the minimum desirable amount recommended in the past by workforce planning committees in Israel. The new data are largely accordant with the feeling of distress and shortage in the medical workforce, which pervades the health system for many years, and simultaneously raise questions as to the reliability of official Israeli data as reported to the OECD - data upon which researchers, policy makers, the media and the public rely. Consequently, it is recommended to consistently improve the measurement and reporting to international organizations and to increase transparency regarding the measurement methods of various indicators in the health field.

[Part-time residency training in Israel].

Full-time work has long been perceived as a cornerstone of medical residency, the consensus being that a resident must apply the bulk of his time and attention to his professional training. Demographic and cultural changes that have taken place over the last several years, specifically the rise in the number of female doctors and the importance of leisure time to the younger generation, have intensified the need to find new and innovative ways to deal with the plight of the resident population. One idea, already in effect in many Western countries, is the institution of part-time residency programs. The possibility of fulfilling residency requirements on a part-time basis is intended to assist medical residents in integrating their professional development with their personal and family life, without compromising the quality of their training. A number of research studies conducted over the last several years in countries that allow part-time residency, among them the United States, England and Switzerland, aimed to examine the quality of part-time training. The various studies evinced a high level of satisfaction from the program both by the residents themselves and their supervisors, and in many aspects those doing residency part-time received higher appraisals than their full-time colleagues. Some of the residents polled noted that they would have totally foregone the practice of medicine had there not been an option to complete residency part-time. In light of the experience throughout the world and the changing landscape in Israel, the Scientific Council of the Israeli Medical Association decided to examine the issue and its various aspects, and weighed all the considerations in favor and against part-time residency. Recently, the Scientific Council approved the launch of a pilot program to allow part-time residency in several fields that were carefully selected according to specific criteria. Once the Ministry of Health completes the LegisLation process, part-time residency will officially begin in Israel.

The Physician on a Board of Directors: Bane or Benefit?

With the accelerated development of innovative domains such as artificial intelligence, big data, and personalized healthcare, the continuing growth of health-tech and bio-tech industries is to be expected. Concurrently, the question of the extent and nature of physicians' involvement in these rapidly evolving industries arises, especially in management and leadership capacities such as directors or chief executive officers of such companies. Against this backdrop, the Israeli Medical Association recently launched a first-of-its-kind course designed to train senior physicians as directors in health-tech companies by providing them with vast relevant financial, legislative, and professional proficiencies. Due to their medical knowledge and clinical experience, physicians bring a substantial added value to these industries. However, considering the inherent tensions and potential conflicts between adhering to the logic of a profit-making, competitive market on one hand and maintaining the doctor's oath on the other, it is inevitable that dilemmas and difficulties will emerge. Much has been written about the roles and responsibilities of boards of directors, but to date, little has focused on the unique position of physicians who serve in these roles. This article aims to examine the ways in which conflicts or dualities of interest manifest themselves for physicians who assume roles as directors and whether effective remedial strategies are available, based on the authors' own experience in the initiation of the IMA physician-directors course.

Taking the measure of the profession: Physician associations in the measurement age.

Systematic measurement of healthcare services enables evaluation of health professionals' quality of work. Whereas policy makers find measurement a useful mechanism for quality improvement, a public choice perspective implies that physicians would resent such an initiative, which undermines their professional autonomy. In this article, we compare two healthcare systems of economically developed countries - Israel and the UK. Both systems share common features such as universal coverage, strong state intervention, and enthusiasm for New Public Management. In both countries, quality measurement was introduced in acute care hospitals at around the same time. However, while the UK succeeded in establishing a framework of surgical outcome measures during the 2000s, a similar initiative in Israel failed completely during the 1990s. We also refer to subsequent quality indicator efforts in Israel, in both community and hospital frameworks, that were more successful, but in a way that reinforces our central thesis. We contend that differences in reform outcomes stem from the medical profession's reaction to government's endeavors. This response, in turn, hinges on the professional organizations' relative institutional position vis-a-vis state authorities. This study constitutes a unique investigation of the medical profession's response to critical quality measurement reforms. Most importantly, it stresses the institutional position of medical associations as the primary factor in explaining cross-case variation in government's success in introducing quality measurement.