Cultivating medical leaders

The health system is too important to be run by people who were not trained to be senior administrators.

By JUDY SIEGEL-ITZKOVICH
Dr. Sefi Mendlovic (photo credit: Courtesy)
Dr. Sefi Mendlovic
(photo credit: Courtesy)
Most or all of the leaders of the country’s public healthcare system – administrators in the health ministry, medical centers, hospital departments and the IDF – just “fell into” their positions as physicians without being specifically prepared for them. Too often, they spend their time “putting out fires” rather than devoting thought to long-term planning in a constantly changing field.
Fortunately, thought and funding are finally being devoted to the idea that senior professionals in the health system need to be selected, nurtured and trained when they’re younger to fill leading positions for the years ahead.
Earlier this month, the non-profit MAO Z organization and the health ministry launched the Inbar program to create a capable cadre of young professionals who will eventually replace those currently in leadership in the healthcare system.
Twelve physicians – seven women and five men (medicine is increasingly becoming a female profession), eight from the center of the country, four from the periphery and one Muslim Arab – with much potential for leadership and administrative skills in healthcare have been handpicked for this track. They will be joined annually by a dozen more who will be mentored and earn advanced degrees in medical and business administration.
The Inbar vision is to create “professional and bold leadership with values, acting together out of a mission and responsibility to strengthen the health system as a social/ economic pillar of the nation.” The annual NIS 2m. cost will be covered half by MAO Z and the other half shared by the finance and health ministries.
A member of the Inbar executive board, Shaare Zedek Medical Center (SZMC) director-general Prof. Jonathan Halevy, commented: “I believe it is the first time that a serious initiative is being implemented to train and properly prepare the next generation of senior managers and directors in the healthcare system.
The collaboration between the various stakeholders (government, academia, philanthropy and so on) and the meticulous selection of candidates guarantees the success of the program,” said Halevy, who was an internal medicine and liver disease specialist at Petah Tikva’s Rabin Medical Center before being invited to run the Jerusalem hospital 27 years ago. “I am confident that all or most of the graduates of the Inbar program will play major roles in the future leadership of Israeli medicine, and I commend all of those involved in initiating it.”
The names of 11 of the 12 participants in the first year of the project have been publicized: Dr. Anan Abassi (an Arab ophthalmologist from Nazareth who will study at Haifa’s Rambam Medical Center), Dr. Sagit Arbel-Alon, Dr. Orli Frenkel, Dr. Gili Givati, Dr. Udi Kaliner, Dr. Iris Kliers, Dr. Gil Lavie, Dr. Revital Levi-Chevroni, Dr. Hagar Mizrahi, Dr. Alon Nevet and Dr. Enav Noff-Sadeh (the 12th was not yet willing to be publicized).
Their average age is 42, as they were chosen for their proven skills; subsequent Inbar “classes” will be younger and less established, but with proven potential as medical leaders.
Committed to be involved for two years, they come from Clalit and Maccabi health services; Sheba, Rambam, Hadassah, Carmel, Soroka, Hillel Jaffe and Poriya Medical Center; and the heath ministry’s director-general’s office, its public health branch and its strategic planning office.
THE ACTING head of the Inbar’s executive committee is Dr. Sefi Mendlovic, chief of staff and medical advisor to of Health Ministry director-general Moshe Bar Siman Tov. A senior pediatrician at SZMC’s children’s emergency medicine department, Mendlovic, who holds a master’s degree in medical system administration and graduated from a senior management course at Harvard University as part of the MAO Z leadership program.
Considered a rising star in Israeli medicine, Mendlovic founded Inbar to create a future generation of leaders in the medical system. A physician in an elite reserve unit of the IDF who fought in Operation Protective Edge in Gaza last summer, the modern Orthodox doctor was a member of the IDF field hospital team that treated victims of the massive earthquake in Nepal for nearly three weeks in April.
Long devoted to idealistic projects, Mendlovic was involved for 14 years, from the time he was a medical student at Ben-Gurion University’s health faculty, in an organization called Beit Hagalgalim (House of Wheels). Founded in 1979, it provides a range of services for children and adults with impaired mobility, mainly due to cerebral palsy and muscular dystrophy, and provides weekend activities, summer camps, activity classes and job placement. “Health is not just medications,” he told The Jerusalem Post in an interview. “It is also the family, education and social support.”
IN 2009, a group including Dr. Yair Schindel, Yotam Dagan and passionate Jewish leaders in Boston was increasingly concerned by the ethical and professional standards among Israel’s public leadership. A combination of corruption and a lack of public trust in Israel’s public leadership motivated them to establish MAO Z, an Israel-based organization aimed at contributing to leadership based on professionalism and values and to advance important projects and reforms.
The MAO Z board, staff, alumni and fellows, says the idealistic organization, are committed to living by and infusing the values of integrity and transparency, personal responsibility, professionalism, tolerance, national and social unity, humility and modesty and living by personal example into Israeli society.
Mendlovic is one of 100 MAO Z graduates working in education, employment, transportation, communications, improving the status of minorities, strengthening the periphery and a promoting a highly functional municipal and central government.
“In MAO Z I was exposed to the imperative of creating leadership to make changes,” says Mendelovic.
“We conceived of Inbar as the arm of MAO Z to prepare high-level medical leaders who care and want to change things. We have full cooperation from the Prime Minister’s Office and the Civil Service Administration to plan new leadership for the future.”
Mendlovic stressed that Inbar is not a negative program that criticizes what exists, but rather a positive plan looking forward. With so many demands put on it and so many problems to deal with, the healthcare system “just won’t be able to cope in 10 to 15 years.”
In the US, medical administration is mostly localized and private, Mendlovic notes. “But Inbar is a national – even international – program, and it is a trailblazer. I don’t know of any such model abroad to create a network of highly talented young people who will develop a common language and purpose, and speak to each other in different institutions.
To provide continuous care from the community to the hospital system for people of all ages, the administrators of various health institutions need to be able to communicate on a regular basis. It’s naïve, for example, to tell a hospital patient that he should stop smoking. One has to be concerned with the person from childhood so that he won’t start smoking.”
The acting head of Inbar’s executive said that the selection of the first 12 doctors was “very strict. About 90 people were recommended by hospital directors, medical directors of the four health funds, senior health ministry administrators and others or they applied on their own. “During the initial years, we are choosing only those who have proven quality. At this stage, we will not use affirmative action to represent all groups,” said Mendlovic. “Our pilot group nevertheless turned out to be a good mix of health funds, public health, hospitals, ages, women, geographical areas and minorities. We did this without publicity,” he added, saying that in future years, he will want the program better publicized so potential candidates who were not reached will hear about Inbar.
A MANDATORY part of the program is a subspecialty in health management in one of the hospitals or medical institutions that are certified to do it. “Most hospitals in the periphery are not authorized to deliver this two- year subspecialty, as they need at least two hospital experts in the field in order to teach it. Barzilai Medical Center in Ashkelon recently was accredited to teach this specialty. Participants need to have a mentor in the hospital,” said Mendlovic.
Another part of the program is advanced degree in medical administration.
The two medical academic heads of this degree are TAU business Prof. Jacob (Kobi) Glazer and Prof. Ronni Gamzu, the former health ministry director-general who teaches at Tel Aviv University and was just named director-general of Tel Aviv Sourasky Medical Center. During the studies for the degree, the 12 participants “will meet one day a week at TAU to spend the whole day together from 8 a.m. to 8 p.m. These activities will encompass 25 people, and not just the 12, to provide variety, and they will be a cohesive group. The other 13 will be chosen by the university.
The third part of the program includes a separate schedule of sessions on ethics, community and leadership. They will learn about the local authorities in their area, the minorities among them and how the Knesset works; meet with leading senior medical administrators; and also go on tours,” said Mendlovic.
As Harvard Business School is an integral part of the Inbar program, it is indeed international. “The group will go to Boston for an intensive leadership seminar along with others in the broad MAO Z project. “I did it myself and had to present 30 case studies during that time. The leader of this seminar is Prof. Joshua Margolis, who is chairman of the second year of the business school.”
Asked if Inbar will be accompanied by academic research to determine whether it is successful in inculcating the best of young leaders in medicine, Mendlovic said that it definitely will over the long term. In addition, he wants to expand it to include nurses, medical social workers, physiotherapists and others.
“All participants must be goal-oriented and follow up their work to the end. But the other vital personal quality we are looking for,” Mendlovic continued, “is humility. We want them to epitomize values, not the language of ego. They must care about society and not just themselves.”
Although the participants receive no guarantees that they will be employed as senior health system administrators, he believes that in coming years, they will be “grabbed up” by hospitals, health funds and other institutions. “I’m not worried.
They will offer the best, and this will ensure their employment in senior positions. We have mapped 90 key positions in the system, and when the people in those positions retire, our graduates will be ready to replace them. We have set a target that in such-and-such years, half of them will be employed in intermediate positions,” he concluded.
“Later, the sky is the limit.”