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. 2023 Apr 17;12(1):12.
doi: 10.1186/s13584-023-00563-y.

"I'm 'just' a community pediatrician" views and challenges of pediatricians working in the community in Israel

Shulamit Pinchover  1 , Rony Berger-Raanan  2 , Maya Yaari  2 , Mary Rudolf  3 , Lisa Rubin  4 , Dafna Idan-Prusak  2 , Vera Skvirsky  2 , Tirzah Margolin  5 , Hava Gadassi  2
Affiliations

"I'm 'just' a community pediatrician" views and challenges of pediatricians working in the community in Israel

Shulamit Pinchover et al. Isr J Health Policy Res. .

Abstract

Background: There are ongoing changes around the world in the training and practice of pediatricians who work in the community. These changes are driven by the understanding that pediatricians are required to provide not only acute primary care but also to address more comprehensive concerns, particularly the 'new morbidities'. The present study examines the professional identity of Israeli pediatricians in the community in light of these changes, the barriers and challenges to their work and professional adaptations in the field.

Methods: We used a mixed-methods approach, collecting the perspectives of 137 pediatricians who work in the community through an anonymous online survey, followed by in-depth semi-structured interviews with 11 community pediatricians.

Results: The survey results show that community pediatricians in Israel have limited knowledge on a variety of developmental, behavioral and emotional issues; that they lack working relationships with medical or other professionals; and are rarely engaged with other community services. Three main themes arose from the interviews that support and deepen the survey results: perceptions of the profession (pediatrics in the community vs. community pediatrics), the stature of pediatricians in the community (during residency, the choice to work in the community, their daily work) and barriers and change in community pediatrics (isolation, limited resources and challenges arising from the nature of community work).

Conclusions: The present study sheds light on the professional identity and the day-to-day challenges and successes of pediatricians working in the community. Continuing medical education, providing a supportive framework and professional community, better resources, more time with patients, and tools and opportunities for professional development would help pediatricians who work in the community to overcome some of these challenges. The research findings reinforce the need for policy change in the field of community pediatrics with a specific community training curriculum, provision of more resources and ongoing support for pediatricians. This requires partnership between the HMOs, the Ministry of Health, the Scientific Council (Israel Medical Association, professional organizations) and NGOs in order to turn individual-level solutions into system-level and policy-changing solutions.

Keywords: Challenges; Community; Isolation; Pediatrics; Professional identity; Stature.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Percentages of pediatricians’ “not at all” or “slightly” responses to the question “To what extent do you have the knowledge and tools needed to address the following issues”
Fig. 2
Fig. 2
Percentages of pediatricians who, during the past year, consulted with the following professionals in their area regarding psychosocial issues
See this image and copyright information in PMC

References

    1. Nissanholtz-Gannot R, Michael D, Ashkenazi Y, et al. The involvement of community pediatricians in the treatment of developmental-behavioral difficulties as perceived by directors of child development centers. Isr J Health Policy Res. 2021 doi: 10.1186/s13584-021-00492-8. - DOI - PMC - PubMed
    1. Starmer AJ, Duby JC, Slaw KM, Edwards A, Leslie LK. Pediatrics in the year 2020 and beyond: preparing for plausible futures. Pediatrics. 2010;126(5):971–981. doi: 10.1542/peds.2010-1903. - DOI - PubMed
    1. Rubin L, et al. Maternal and child health in Israel: building lives. Lancet. 2017;389(10088):2514–2530. doi: 10.1016/S0140-6736(17)30929-7. - DOI - PubMed
    1. Heussler HS, Polnay L, Katz M. ‘The times, are they a-changing?’As the world enters a new millennium are we as paediatricians keeping up with the changing needs of children? Child Soc. 2000;14(4):254–266.
    1. Oberklaid F. It’s time to eliminate the mismatch between pediatric training and practice. Isr J Health Policy Res. 2021;10:70. doi: 10.1186/s13584-021-00504-7. - DOI - PMC - PubMed

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