Professionalism in the Practice of Medicine

82 Pages·2017·1.98 MB·English

?
w )ר”ע( תואירבה תוינידמו תואירבה יתורש רקחל ימואלה ןוכמה
o
n The Israel National Institute for Health Policy Research
e
w
e
r
a
e
r
e
h
W
International Workshop Report
–
e
n
i
c Professionalism in the Practice of
i
d
e
M
f Medicine – Where are we now?
o
e
c
i
t
c
a Chair: Ora Paltiel
r
P
e
h
t
n
i
m
s
i
l
a
n
o
i
s
s
e
f
o
r
P

׀
t
r
o
p
e
R
p
o
h
s
k
r
o
W
l
a
n
o
i
t
a
n
r
e
t
n
I
December 2016
Dead Sea, Israel
The Israel National Institute for Health Policy Research
International Workshop Report
Professionalism in the
Practice of Medicine -
Where are we now?
Chair: Ora Paltiel
December 2016
Dead Sea, Israel
Professionalism in the Practice of Medicine 3
Table of Contents
Page
Workshop Program 4
List of Speakers 8
Meeting Report 10
Abstracts 24
Biographies 40
Article: Medical Professionalism in the New Millennium:
A Physician Charter, Project of the ABIM Foundation,
ACP-ASIM Foundation, and European Federation of
Internal Medicine 76
List of Participants 80
4 International Workshop Report
International Workshop
Professionalism in the Practice of Medicine -
Where are we now?
December 11-12, 2016
Sunday, December 11th, 2016
09:00-10:00 Gathering & Welcome Coffee
10:00-13:00 OPENING SESSION AND GREETINGS
Chair: Orly Manor, Chair, Board of Directors, NIHP
Moshe Bar Siman Tov, Director General, Ministry of Health

Workshop Chair and Introductory Lecture: Ora Paltiel -
Professionalism: What are the issues and why do they need to be
discussed? Hadassah-Hebrew University
Defining Professionalism: International Views
Pali Hungin - Professionalism: Coping with the changing role of the
doctor, President, BMA, UK

Jo Shapiro - Professionalism: Culture of trust as a key to safety and
quality, Brigham and Women’s Hospital, Harvard University, USA

Shimon Glick - Professionalism: Changing views in time and space,
Ben-Gurion University

Discussion
13:00-14:00 Lunch
14:00-16:10 Professionalism as a Learned Competency
Chair: Shmuel Reis, Hebrew University-Hadassah
Shiphra Ginsburg - Understanding and fostering professionalism
in medical education, Mount Sinai Hospital, University of Toronto,
Canada
Professionalism in the Practice of Medicine 5
Ruti Stashefsky Margalit - Simulation as a tool to enhance medical
professionalism, MSR - Sheba Medical Center
Panel: Representatives of Israeli faculties of medicine - How do
we/should we train physicians in Israel in professionalism?
Chair: Shiphra Ginsburg, Mount Sinai Hospital, University of
Toronto, Canada
Peter Gilbey - Galilee, Bar-Ilan University
Shimon Glick - Ben-Gurion University
Nathaniel Laor - Tel-Aviv University
Lior Lowenstein - Rambam Health Care Campus
Shmuel Reis - Hebrew University-Hadassah

Discussion
16:10-16:30 Coffee Break
16:30-18:00 Complaints, Complaints, Complaints. Do they Enhance
Professionalism?
Chair: Avi Israeli, Ministry of Health
Shimon Glick, Chaim Hershko, Boaz Lev - Former and current
ombudsmen, Ministry of Health

Panel: Physicians representing HMO’s
Yair Birnbaum - Clalit
Avi Porath - Maccabi
Gershon S Segal - Leumit
Yoav Yehezkelli - Meuhedet
19:45 Dinner & Evening Program
Nissan Perez - Early Photography & Medicine, A brief history,
Photography historian and curator
6 International Workshop Report
Monday, December 12th, 2016
09:00-10:30 Professional Conduct: Regulation or Self-Regulation.
The Carrot and Stick
Chair: Drorith Hochner-Celnikier, Hadassah University Hospital
David Katz - Professionalism and professional self-regulation: The
UK experience, University College London, UK

Tami Karni - The IMA: How it handles “lapses” in professionalism,
Ethics bureau, IMA

Discussant: Jo Shapiro - Alternative ways of handling unprofessional
behavior

Discussion
10:30-11:00 Coffee Break
11:00-13:00 Professionalism in the Digital Age
Chair: Haim Bitterman, Assuta Ashdod Public Hospital
Shmuel Reis - Professionalism in the digital age: Required additional
competencies, and how they should be acquired, Hebrew University-
Hadassah
Orit Karnieli-Miller - Our undivided attention? Challenges to
professionalism in day-to-day medical encounters, Tel-Aviv
University

Discussant: Pali Hungin
Panel: Generation X, Y and Z- How we differ from our teachers
and our students
Chair: Ziv Gil, Technion, Israel Institute of Technology
Sameer Kassem - Carmel Hospital
Orna Reichman - Shaare Zedek Medical Center
Rotem Tellem - Tel-Aviv Sourasky Medical Center

Discussion
13:00-14:00 Lunch
Professionalism in the Practice of Medicine 7
14:00-16:30 CLOSING SESSION: THEORY TO PRACTICE
Chair: Ora Paltiel, Hadassah-Hebrew University
Vignettes
Roundtable Chairs:
Amnon Lahad - Hebrew University
Dafna Meitar - Tel-Aviv University
Dorith Shaham - Hadassah-Hebrew University
Reporters:
A. Mark Clarfield - Ben-Gurion University
Mordechai Muszkat - Hadassah Mt Scopus
Reena Rosenberg - Clalit

Wrap up: Shiphra Ginsburg
Coffee to Go
8 International Workshop Report
List of Speakers
Mr. Moshe Bar Siman Tov, Director General, Ministry of Health
Dr. Yair Birnbaum, Chief Medical Officer, Clalit Health Services
Prof. Haim Bitterman, Director, Assuta Ashdod Public Hospital
Prof. A. Mark Clarfield, Head, Medical School for International Health,
Ben-Gurion University
Prof. Ziv Gil, Department of Otolaryngology Head and Neck
Surgery, The Head and Neck Center, Rappaport
Faculty of Medicine and Research Institute,
Technion, Israel Institute of Technology, Haifa
Dr. Peter Gilbey, Head, Faculty Development Unit, The Faculty of
Medicine in the Galilee, Bar-Ilan University
Prof. Shiphra Ginsburg, Department of Medicine and a Scientist, Wilson
Centre for Research in Education, University of
Toronto, CA
Prof. Shimon Glick, Former Ombudsman, Ministry of Health
Dr. Chaim Hershko, Former Ombudsman, Ministry of Health
Prof. Drorith Hochner-Celnikier, Head, The Department of Obstetrics and
Gynecology, Hadassah University Hospital,
Mount Scopus
Prof. Pali Hungin, President, British Medical Association, UK
Prof. Avi Israeli, Chief Scientist, Ministry of Health
Dr. Tami Karni, Chair, Ethics Bureau, IMA
Dr. Orit Karnieli-Miller, Senior Lecturer, The Department of Medical
Education, Sackler School of Medicine, Tel-Aviv
University
Dr. Sameer Kassem, Head, Department of Internal Medicine A2,
Carmel Medical Center, Clalit Health Services,
Haifa
Prof. David Katz, University College London, UK
Prof. Amnon Lahad, Chairman, Department of Family Medicine,
Hebrew University, and Clalit Health Services,
Jerusalem district. Chair, of the Israeli National
Committee for the Health of the Communit
Prof. Nathaniel Laor, Chairman, Department of Medical Education, and
Departments of Psychiatry and Philosophy,
Tel-Aviv University
Professionalism in the Practice of Medicine 9
Dr. Boaz Lev, Ombudsman, Ministry of Health
Prof. Lior Lowenstein, Associate Professor in Gynecology, Deputy
chairman of the department of Gynecology,
division director of Gynecology in Rambam
Health Care campus
Prof. Orly Manor, Chairwoman,Board of Directors, NIHP & Prof. of
Biostatistics, the Hebrew University-Hadassah
Dr. Dafna Meitar, Senior Teacher and Manager, Department of
Medical Education, Sackler School of Medicine,
Tel-Aviv University
Prof. Mordechai Muszkat, Head, Department of Medicine, Hadassah
University Hospital Mt Scopus
Prof. Ora Paltiel, Director, Braun School of Public Health and
Community Medicine, Hadassah-Hebrew
University, Workshop Chair
Dr. Nissan Perez, Photography Historian and Curator
Prof. Avi Porath, Chief Physician of Maccabi Healthcare Services
Dr. Orna Reichman, Head, Vulvo-Vaginal Clinic, Shaare Zedek
Medical Center
Prof. Shmuel Reis, Academic Head, Center for Medical Education,
Hebrew University-Hadassah
Dr. Reena Rosenberg, Director, Family Medicine Department, Central
District, Clalit Health Services
Dr. Gershon S Segal, Regional Physician, Judean Region, Leumit
Health Fund
Prof. Dorith Shaham, Head, ‘Adam veRefuah’ Program of Medical
Humanities, School of Medicine, Hadassah-
Hebrew University
Dr. Jo Shapiro, Director, Center for Professionalism and Peer
Support, Brigham and Women’s Hospital, USA
Dr. Ruti Stashefsky Margalit, Director of Research, MSR, Sheba Medical Center
Dr. Rotem Tellem, Geriatrician and Head of Palliative Care, Tel-Aviv
Sourasky Medical Center
Dr. Yoav Yehezkelli, Director, South District, Meuhedet Health
Services
10 International Workshop Report
Meeting report:
O. Paltiel1, L. Lowenstein2, J. Demma3, O. Manor1,4
1. Braun School of Public Health and Community Medicine, Hadassah-Hebrew University,
Jerusalem.
2. Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa,
Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
3. Department of Surgery, Hadassah-Hebrew University Medical Center.
4. National Institute of Health Policy Research, Gertner Institute, Tel Hashomer, Israel.
Published in the Israel Journal of Health Policy Research (2017) 6:19, 3 April 2017.
https://ijhpr.biomedcentral.com/articles/10.1186/s13584-017-0144-5
Abstract:
Medical professionalism refers to attributes, values, behaviors, responsibilities and
commitments of physicians that are congruent with the public’s expectations. An
international workshop on medical professionalism took place at the Dead Sea, Israel,
on December 11-12, 2016. The meeting brought together local medical professionals,
physicians and others, as well as international experts, to discuss definitions of
professionalism and wrestle with current challenges facing the profession including its
perceived status and physician satisfaction, unprofessional behavior and its relation to
health care quality and patient safety, and professionalism as a learned competence.
Individual medical schools reported on educational efforts to promote professionalism
in their curricula. Patient complaints as an improvement mechanism were explored
on a national and health plan level. I was found that complaints regarding physician
behavior are rare in the Israeli context and need to be dealt with expeditiously at a
local level in order to be effective tools for change. The meeting provided a venue
to understand local and international strategies and mechanism for regulation and
self-regulation, highlighting the role of the Israel Medical Association. A major focus
of the meeting was on intergenerational differences in attitude and practice and the
necessary adaptation of medicine to the digital age. We provide an overview of the
topics addressed, synopsis, evaluation and lessons learned in this first-ever national
meeting on medical professionalism in Israel.
Introduction:
Professionalism, according to the Merriam-Webster’s Learner’s Dictionary, is defined
as “the skill, good judgment, and polite behavior that is expected from a person who
is trained to do a job well” (1). In 2002, the American Board of Internal Medicine