Angel Yoel, Goldshtein Hadar, Barel Nevo, Fire Gil, Halberthal Michael, Niv-Yagoda Adi
Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
School of Medicine, Faculty of Medical and Health Sciences and the Coller School of Management, Tel Aviv University, Tel Aviv, Israel.
Isr J Health Policy Res. 2025 Jan 13;14(1):3. doi: 10.1186/s13584-025-00666-8.
Israel is unique in offering a formal subspecialty in Medical Administration and mandating it for physicians applying for senior roles. Data on the prevalence and characteristics of these specialists are limited.
The national registry of licensed physicians was used to identify all living physicians who completed the Medical Administration subspecialty by December 31, 2022. Data on year of medical licensing, city of residence, and list of additional recognized specialties along with their respective date of completion were extracted. Websites of key public health organizations were sampled to identify qualifications of persons in senior leadership positions.
Since 1987, 277 physicians have completed the Medical Administration subspecialty, with a significant increase in annual certifications from 4.5 in 2015 (interquartile range [IQR] 4-6) to 13 (IQR 10.5-15) in 2022 (p < 0.001). Specialists completed the subspecialty a median of 18 years (IQR 13-21) post-licensing, with 269 physicians (97.1%) holding additional specialties, primarily in Internal Medicine, Pediatrics, Family Medicine, or Public Health. Compared to the general physician population, some base specialties like Public Health are over-represented while others, like Anesthesiology, are under-represented. Only 40 (14.4%) specialists reside outside major metropolitan areas. Nineteen (61.3%) general hospital CEOs, 2 (20%) psychiatric hospital CEOs, 13 (35.1%) Ministry of Health and 4 (7.8%) Sick Fund executives are specialists in Medical Administration (p < 0.005).
The steady growth in the number of specialists in Medical Administration demonstrates the sustainability and scalability of this model, which may serve as a template for other healthcare systems. However, the limited representation of these specialists in senior roles of some organizations, and their concentration within certain specialties and regions, indicates areas for policy attention to enhance leadership diversity and reduce healthcare disparities.
以色列在提供医学管理方面的正式亚专业并要求申请高级职位的医生具备该专业资质方面独具特色。关于这些专科医生的患病率和特征的数据有限。
利用国家执业医生登记册来识别截至2022年12月31日完成医学管理亚专业的所有在世医生。提取有关医学执照颁发年份、居住城市以及其他认可专业列表及其各自完成日期的数据。对主要公共卫生组织的网站进行抽样，以确定担任高级领导职务人员的资质。
自1987年以来，已有277名医生完成了医学管理亚专业，年度认证数量从2015年的4.5例（四分位间距[IQR]为4 - 6）显著增加到2022年的13例（IQR为10.5 - 15）（p < 0.001）。专科医生在获得执照后完成该亚专业的时间中位数为18年（IQR为13 - 21），其中269名医生（97.1%）拥有其他专业资质，主要是内科、儿科、家庭医学或公共卫生专业。与普通医生群体相比，公共卫生等一些基础专业的占比过高，而麻醉学等其他专业的占比过低。只有40名（14.4%）专科医生居住在主要大都市地区以外。19名（61.3%）综合医院首席执行官、2名（20%）精神病医院首席执行官、13名（35.1%）卫生部官员以及4名（7.8%）疾病基金管理人员是医学管理方面的专科医生（p < 0.005）。
医学管理专科医生数量的稳步增长证明了该模式的可持续性和可扩展性，这可能为其他医疗系统提供一个模板。然而，这些专科医生在一些组织的高级职位中代表性有限，且他们集中在某些专业和地区，这表明在政策方面需要关注这些领域，以增强领导多样性并减少医疗差距。
