Abstract
BackgroundMany countries have devoted considerable efforts in an attempt to improve the performance of their health care systems. National Medical Associations (NMAs), along with other stakeholders, play a part in the promotion of such activities. The purpose of this paper is to explore the nature and level of participation of NMAs in activities of quality improvement in medicine, with a specific emphasis on Israel.MethodsThe authors conducted a survey among NMAs around the world inquiring as to their involvement in three central aspects of quality improvement: clinical guidelines, quality measurement and continuing medical education (CME). In addition, they conducted a review of the literature in order to gather more information and complete the data collected in the survey. The findings were processed and analyzed comparatively.ResultsMost of the NMAs surveyed participate in quality improvement activities at least to some extent. NMAs' main involvement is in the regulation of CME and they are involved to a much lesser extent in the preparation of clinical guidelines and in quality measurement. In Israel, the Israeli Medical Association (IMA) has a dominant role in both the preparation of clinical guidelines and the regulation of CME credits.DiscussionIt is possible that the expertise maintained by the profession, coupled with the organizational power of the NMA as a union, is viewed as beneficial for regulating educational activities in medicine such as CME. Conversely, the issuing of clinical guidelines is usually regarded as a typical scientific activity, and therefore often rests in the hands of professional medical societies. Quality measurement is regarded as a distinctive administrative tool and is usually found in the province of governments. Based on the typology that we introduced in our previous paper, we discovered that the extent of NMAs’ involvement in quality improvement coincides with the mode of governance of the health care system.ConclusionsThe nature and level of participation of NMAs in activities of quality improvement varies widely. Collaboration of NMAs in this field with other stakeholders is not uncommon, and may contribute to the further development of quality improvement in medicine.
Highlights
There is growing interest in the various forms of task sharing between governments and other stake holders in health care systems, among them national medical associations (NMAs) [1,2,3,4,5,6]
Half of the 12 National Medical Associations (NMAs) that participate in quality improvement, do so only to a minimal extent, and are usually involved in CMEb (Figure 1)
Why are NMAs involved in continuing medical education (CME) predominantly more than they are involved in other areas of quality improvement? Should they be taking a more active role in other quality improvement activities?
Summary
There is growing interest in the various forms of task sharing between governments and other stake holders in health care systems, among them national medical associations (NMAs) [1,2,3,4,5,6]. We seek to document its place in another key area - that of quality improvement. This realm, like that of public policy which we hope to explore in a third and final article, is a later addition to the ambit of professional activity. We seek to determine in which activities of quality improvement different NMAs participate, and to what extent. The purpose of this paper is to explore the nature and level of participation of NMAs in activities of quality improvement in medicine, with a specific emphasis on Israel
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