Patient Centeredness - a Cultural Targeted Survey among Junior Medical Managers

Abstract

Background: Patient centeredness is a core element in healthcare. However, there is a gap between the understanding of this term by health care professionals, and patients’ capability, self-efficacy and willingness to take part in medical decisions. We aimed to expose standpoints toward "patient centeredness" among junior medical managers (JMM), as they bridge between policy strategies and patients. We tried to reveal cultural differences by comparing the views of the majority and the minority subpopulations of Israel (Arabic and Hebrew speakers). Methods: A cross-sectional survey among JMM studying for an advanced degree in health systems management at three academic training colleges in Israel was conducted in February-March 2022. The respondents completed a structured questionnaire, comprising four sections: a) perceptions towards trust, accountability, insurance coverage and economic status; b) perception regarding decision-making mechanisms; c) preferences toward achieving equity and d) demographic details. Results: A total of 192 respondents were included in the study, 50% were Hebrew speakers and 50% were Arabic speakers. No differences were found between Arabic and Hebrew speakers regarding perception towards trust, accountability, insurance coverage and economic status. JMM from both subpopulations perceived that patients' gender and age do not influence the attitude of physicians, but Arabic speaking respondents perceived that healthcare professionals prefer educated patients, or those with supportive families. All respondents perceived that patients would like to be more involved in medical decisions; yet, Arabic-speakers believe that patients tend to rely on physicians’ recommendations, while Hebrew speakers believe patients wish to lead the medical decision by themselves. Conclusions: Patient centeredness strategy needs to be implemented bottom-up as well as top-down, in a transparent nationwide manner. JMM are key actors to accomplish this strategy, as they realize policy guidelines in the context of social disparities, thus they can achieve a friendly personalized dialogue with their patients. We believe that empowerment of these JMM may create a ripple effect yielding a bottom- up perception of equity and initiating change.