BGU | MY PATH, Haim Doron, MD

Introducing a Regional Model During my tenure, the medical department of Clalit was a mixed affair, orchestrating both hospital operations and clinic operations. Only later were the two separated. This policy of one director for each unit enabled me to also insert my outlook on partnering hospital work and services in the community within Clalit. All in all, I was very much in favor of regionalism, a socioeconomic concept that in my mind is decisive in health matters. 54 I introduced four regions ( merchavim ), each being an entity with one director that included the clinics and their respective regional hospital. In the Negev Region integrating the hospital and health services in the community was essential due to the shortage of doctors. In the Emek Region, the presence of pioneering figures from the early days of Clalit enabled me to entrust them with managing this sector. The Sharon and Petach Tikvah Region had the Sharon Hospital at the hub. And last, in the north, we had the Haifa and the Western Galilee Region. The director of the Negev Region was a physician, as was the case in the Sharon Region. The latter was headed by Prof. Yaakov Hart, 55 a family physician by profession who previously had replaced me as regional physician for the Negev. In the Emek Division a physician and administrative director rotated as head of the division. In the Haifa andWestern Galilee Division, the senior official was not a doctor but was an individual with the managerial credentials to successfully carry out the role. The regional model rested on the principle that the patient at the clinic was the same person sent to the hospital when need arose. Thus, the idea of continuity of treatment from the community to the hospital and then back to the community was a critical advantage. Another advantage was the feasibility of the hospital physician meeting the patient in the person’s family surroundings and community environment. When the hospital operates separately from the clinic, there are no opportunities for the attending physician to evaluate the patient’s natural surroundings or to encounter the disease in a clinic setting. Other advantages are that this model economizes. It optimizes personnel; and in periods of doctor shortages, it is essential that hospital physicians combine their hospital practices with filling shortages at clinics. Circumstances surrounding my appointments in Clalit’s Directorate I feel is is important to understand the circumstances surrounding my appointments to three key directorial positions in Clalit in the course of my medical career. My first appointment was as regional physician for the Negev in 1961, an appointment made solely on professional grounds, not political. This was sparked by my studies in London in public health, and a series of previous roles in the Negev such as responsibility for the occupational health of employees in the first industries and manufacturing plants in the Negev. Despite my opposition to the dual-management model, I was totally dedicated and engaged in developing health care in Beer Sheva and the Negev, to absorbing immigrant doctors in the Negev, and to being very attuned to the needs of Negev settlements and their pioneering members. Thus, it was natural that I was picked to serve as regional physician for the Negev. The circumstances surrounding my appointment in 1968 as head of the Medical Division of Clalit’s directorate were very different. There was tremendous tension surrounding the dual management of Clalit, and adamant opposition among the doctors to the candidacy for director- general of Moshe Soroka, who, at the time, was treasurer of the sick fund. The doctors demanded that a physician stand at the head of the institution, and even threatened 54 Alas, today, in an era where the workings of the health system since 1995 are dictated by the terms of the National Health Insurance Law, this concept has almost been lost. 55 Prof. Yaakov Hart (1944-) was born in Israel, studied medicine at Hebrew University Jerusalem (1961-1967) and specialized in Community Health. He joined the Tel Aviv University School of Medicine in 1974. Since 2015, he has been Dean and President of Netanya College.

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