BGU | MY PATH, Haim Doron, MD

a year ahead. Another difficulty in operating doctor-nurse teams was that conflicts sometimes developed between team members. These usually were related to competition over status issues and allocation of authority, and they arose because of not focusing on best practices in teamwork. While I do not know just how much weight should be given to these issues, the fact is that today, more and more voices are being heard in favor of physician-nurse teamwork; and I believe with all my heart, that in the future strengthening family medicine will encompass a teamwork setup. I did not stop at introducing a doctor-nurse team structure. I also guided introduction of broader teamwork encompassing a social worker and even the secretary of the clinic. I am most pleased that this clinic-wide teamwork concept is partially implemented to this day in the form of monthly staff meetings. Before I added medical social workers to the team, they were employed only at hospitals. I introduced social work into community medicine. I brought Baruch Ovadia, who was the chief social worker at the Ministry of Immigrant Absorption, to head Clalit’s social services. Each social worker employed by us covered twelve clinics and participated in each clinic’s monthly staff meetings together with the doctor-nurse team and the clinic administrator. The In-Service Training for Clinic Physicians It was clear to me that the in-service training that clinic doctors were receiving was insufficient. I introduced 24 days of in-service training for doctors per calendar year within Clalit, organized in close cooperation with the Clinic Doctors’ Committee. We established a joint framework together with the school of medicine in Jerusalem. It was called the University Institute for Medical In- Service Training. We mandated the Institute to be responsible for executing the 24 days of in- service training every clinic physician was entitled to -- primary physicians, specialists, and so forth. The Institute developed various types of in-service training: a regular day off in the doctor’s clinic work schedule for in-service training at a hospital internal medicine department; intensive courses focused on specific topics; and so forth. I feel duty-bound to cite the pioneering role played in this regard by my predecessor, Dr. Tova Yeshurun Berman, who first paved the way for medical in-service training at Clalit. Integration between Hospital and Community Already, in my days as regional doctor for the Negev, the integration of clinic and hospital was a key point in managing medical personnel and raising the level of medicine in the community. I believed that the role of the physician in the hospital out-patient clinic shouldn’t simply be in examining the patient before and/or after hospitalization. I hoped that the doctor in the hospital clinic would serve in an advisory capacity in all the medical realms for the individual in the community. The opening move for such integration was to declare that out-patient doctors would provide services in both the hospital and the community. Prior to this, as just one example, the Remez regional clinic in Rechovot operated totally disconnected from Kapan Hospital in Rechovot. Immediately after this change was introduced in the Negev, the first buds of change appeared in other regions, as well. When we opened Clalit’s Carmel Hospital, we didn’t open an on site out- patient clinic; rather, we declared that the large Lin Community Clinic would be the designated out-patient clinic for the Carmel Hospital; and Lin would serve both as a community and hospital clinic. The same setup was introduced in the Emek, Petach Tikva, and other places around the country.

Another mechanism for integrating hospital and community operations was to send doctors specializing in various fields at the hospital to see patients in community clinics where there

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