Strategic changes and challenges of private dental clinics and practitioners in Israel: adapting to a competitive environment.


Journal

Israel journal of health policy research
ISSN: 2045-4015
Titre abrégé: Isr J Health Policy Res
Pays: England
ID NLM: 101584158

Informations de publication

Date de publication:
01 Oct 2024
Historique:
received: 12 12 2023
accepted: 25 09 2024
medline: 1 10 2024
pubmed: 1 10 2024
entrez: 1 10 2024
Statut: epublish

Résumé

In the 21st century's digital age, health organizations face challenges from reduced public healthcare spending, creating a competitive market that impacts healthcare management. The struggle is hardest for small organizations, such as private clinics. Competing under unfavorable conditions, these small businesses must run as independent, profitable units in a government-regulated market where they are subject to numerous restrictions yet receive no financial support. In a world of increasing dependence on digital technologies, these small businesses must adopt competitive business models and be adaptive and flexible in embracing change. This qualitative study is based on a thematic qualitative analysis of 20 in-depth, 45-minute-long interviews with dentists and owners of private dental clinics in various specialties. The study employs the strategic change model to examine how dentists who run private dental clinics implement new strategies and technologies to adjust to changes and create a competitive edge. Six main categories emerged from the analysis of the interviews: changes in the organization's environment; instituting and assimilating changes; obstacles in embracing change; added value obtained from embracing the change; quality of care and service; and cost-benefit considerations. The categories were map and evaluated in light of the strategic change model. The analysis indicated that digital strategies have been only partially adopted, suggesting an absence of a cohesive, long-term strategic vision for the organizations. The study explored the actions, perceptions, and challenges of adapting to a competitive digital market in dental private clinics. Based on these insights, recommendations have been provided for global change management, aiming for a sustainable and stable healthcare system that benefits the broader community.

Sections du résumé

BACKGROUND BACKGROUND
In the 21st century's digital age, health organizations face challenges from reduced public healthcare spending, creating a competitive market that impacts healthcare management. The struggle is hardest for small organizations, such as private clinics. Competing under unfavorable conditions, these small businesses must run as independent, profitable units in a government-regulated market where they are subject to numerous restrictions yet receive no financial support. In a world of increasing dependence on digital technologies, these small businesses must adopt competitive business models and be adaptive and flexible in embracing change.
METHODS METHODS
This qualitative study is based on a thematic qualitative analysis of 20 in-depth, 45-minute-long interviews with dentists and owners of private dental clinics in various specialties. The study employs the strategic change model to examine how dentists who run private dental clinics implement new strategies and technologies to adjust to changes and create a competitive edge.
RESULTS RESULTS
Six main categories emerged from the analysis of the interviews: changes in the organization's environment; instituting and assimilating changes; obstacles in embracing change; added value obtained from embracing the change; quality of care and service; and cost-benefit considerations. The categories were map and evaluated in light of the strategic change model. The analysis indicated that digital strategies have been only partially adopted, suggesting an absence of a cohesive, long-term strategic vision for the organizations.
CONCLUSIONS CONCLUSIONS
The study explored the actions, perceptions, and challenges of adapting to a competitive digital market in dental private clinics. Based on these insights, recommendations have been provided for global change management, aiming for a sustainable and stable healthcare system that benefits the broader community.

Identifiants

pubmed: 39350258
doi: 10.1186/s13584-024-00645-5
pii: 10.1186/s13584-024-00645-5
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

55

Informations de copyright

© 2024. The Author(s).

Références

Schwab K. The fourth industrial revolution. New York: Currency; 2017. pp. 11–7.
Marques ICP, Ferreira JJM. Digital transformation in the area of health: systematic review of 45 years of evolution. Health Technol. 2020;10(3):575–86.
doi: 10.1007/s12553-019-00402-8
Frist WH. Connected health and the rise of the patient-consumer. Health Aff.2014;191–3.
Naamati Schneider L. Strategic management as adaptation to changes in the ecosystems of public hospitals in Israel. Isr J Health Policy Res. 2020;9:65. https://doi.org/10.1186/s13584-020-00424-y .
doi: 10.1186/s13584-020-00424-y pubmed: 33234166 pmcid: 7685193
Naamati-Schneider L. Intra-organization conflicts of interest in hospitals adapting to a changing ecosystem. J Health Organisation Manage. 2021. https://doi.org/10.1108/JHOM-09-2021-0325 .
doi: 10.1108/JHOM-09-2021-0325
Schmid A, Cacace M, Götze R, Rothgang H. Explaining health care system change: problem pressure and the emergence of hybrid health care systems. J Health Politics Policy Law. 2010;35(4):455–86. https://doi.org/10.1215/03616878-2010-013 .
doi: 10.1215/03616878-2010-013
Denis JL, van Gestel N. Leadership and innovation in healthcare governance. In: Kuhlmann E, Blank RH, Bourgeault IL, Wendt C, editors. The Palgrave international handbook of healthcare policy and governance. London: Palgrave Macmillan; 2015. pp. 425–40. https://doi.org/10.1057/9781137384935_26 .
doi: 10.1057/9781137384935_26
Ginter PM, Duncan WJ, Swayne LE. The strategic management of health care organizations. Wiley; 2018. pp. 37–121.
Domb Herman H, Dadosh H, Dekel D, et al. The child dental care reform in Israel – service uptake from 2011 to 2022. Isr J Health Policy Res. 2024;13:41. https://doi.org/10.1186/s13584-024-00630-y .
doi: 10.1186/s13584-024-00630-y pubmed: 39210477 pmcid: 11363510
Shahrabani S, Benzion U, Machnes Y, Gal A. The use of dental services for children: implications of the 2010 dental reform in Israel. Health Policy. 2015;119(2):117–26. https://doi.org/10.1016/j.healthpol.2014.11.007 . https://doi-org.mgs.hac.ac.il/ .
doi: 10.1016/j.healthpol.2014.11.007 pubmed: 25465981
Braithwaite J, Matsuyama Y, Mannion R. How to do better health reform: a snapshot of change and improvement initiatives in the health systems of 30 countries. Int J Qual Health Care. 2016;28:843–6.
pubmed: 27655787
Braithwaite J, Testa L, Lamprell G. Built to last? The sustainability of health system improvements, interventions and change strategies: a study protocol for a systematic review. BMJ Open. 2017;7:e018568. https://doi.org/10.1136/bmjopen-2017-018568 .
doi: 10.1136/bmjopen-2017-018568 pubmed: 29133332 pmcid: 5695467
Topol E. The creative destruction of medicine: How the digital revolution will create better health care. New York: Basic Books; 2012. ISBN-13: 978-0465025503.
Naamati Schneider L. Public–private: unequal competition: Israeli public hospitals vs. the private health-care system following government reforms. Int J Organ Anal. 2020. https://doi.org/10.1108/IJOA-06-2020-2237 .
doi: 10.1108/IJOA-06-2020-2237
Ciurea AV, Avram E, Mohan AG. Leadership in the private medical clinic. Rev Gen Manag. 2017;25(1):18–30. http://www.managementgeneral.ro/pdf/1_2017_2.pdf
Kouzes JM, Posner BZ. The leadership challenge. 4th ed. San Francisco, CA: Jossey-Bass; 2007. pp. 25–50.
Kash BA, Spaulding A, Johnson CE, Gamm L. Success factors for strategic change initiatives: a qualitative study of healthcare administratives’ perspectives. J Healthc Manag. 2014;59:65–80.
pubmed: 24611428
Zuckerman A. Advancing the state of the art in healthcare strategic planning. Front Health Serv Manage. 2006;23:7.
Bin-Nun G, Ofer G. Ten years of the National Health Law: 1995–2005. Kiryat Ono. Israel: The National Institute for Health Policy Research; 2006. [Hebrew].
Levi B, Davidovitch N. The Healthcare System in Israel: an Overview. State of the Nation Report: Society, Economy and Policy. 2022.
Bin-Nun G. Equality, equitability, and everything in between: the case of the health system in Israel. In: Shafran S, Weiss Y, editors. Encounters in the world of health. Jerusalem, Israel: Magnes; 2019. pp. 328–38. [Hebrew].
Orenstein L, Chetrit A, Oberman B, et al. Factors associated with disparities in out-of-pocket expenditure on dental care: results from two cross-sectional national surveys. Isr J Health Policy Res. 2020;9:30. https://doi.org/10.1186/s13584-020-00387-0 .
doi: 10.1186/s13584-020-00387-0 pubmed: 32552866 pmcid: 7298819
Ministry of Health Israel. Spokesman Messages: The Government has Approved Extension of the Dental Health Services Basket for Children Until Age 12. 2019. https://www.health.gov.il/English/News_and_Events/Spokespersons_Messages/Pages/default.aspx?WPID=WPQ6&PN=5
Ministry of Health Israel. Spokesman Messages: Extension of the dental health reform until age 15. 2020. https://www.health.gov.il/English/News_and_Events/Spokespersons_Messages/Pages/08012017_3.aspx
Mann Committee. Oral and dental health in Israel: Goals for 2020. Committee chaired by Prof. Jonathan Mann. [Hebrew]. https://www.health.gov.il/publicationsfiles/2020_18052016.pdf . [Accessed 2023].
Berg-Warman A, Kermel-Schiffman I, Sadeh S, Zusman SP, Natapov L. Health Plan Preparation for Policy Reform in Elder Dental Care. RR-938-23. Myers-JDC-Brookdale Institute. 2023. [Hebrew].
Berg-Warman A, Schiffman IK, Zusman SP, et al. Oral health of the 65 + age group in Israel-2020. Isr J Health Policy Res. 2021;10:58. https://doi.org/10.1186/s13584-021-00494-6 .
doi: 10.1186/s13584-021-00494-6 pubmed: 34696813 pmcid: 8543889
Raphael C. Oral health and aging. Am J Public Health. 2017;107(Suppl 1):S44–5. https://doi.org/10.2105/AJPH.2017.303835 .
doi: 10.2105/AJPH.2017.303835 pubmed: 28661797 pmcid: 5497890
Bruno A, Dell’Aversana G, Zunino A. Customer orientation and leadership in the health service sector: the role of workplace social support. Front Psychol. 2017;8. https://doi.org/10.3389/fpsyg.2017.01920 .
Horev T, Mann J. Oral and dental health: The responsibility of the state towards its citizens., Jerusalem. Israel: Taub Center; 2007. https://www.taubcenter.org.il/en/research/oral-and-dental-health-the-responsibility-of-the-state-towards-its-citizens/
Keasberry J, Scott IA, Sullivan C, Staib A, Ashby R. Going digital: a narrative overview of the clinical and organizational impacts of eHealth technologies in hospital practice. Aust Health Rev. 2017;41(6):646–64. https://doi.org/10.1071/AH16233 .
doi: 10.1071/AH16233 pubmed: 28063462
Naamati-Schneider L, Zaks O. Public Hospitals in crisis: Managerial and strategic adaptation. In: Vrontis D, Thrassou A, Weber Y, Shams SMR, Tsoukatos E, Efthymiou L, editors. Business Under Crisis, Vol. 2. Palgrave Studies in Cross-disciplinary Business Research, In Association with EuroMed Academy of Business. Cham, Switzerland: Palgrave Macmillan; 2022. https://doi.org/10.1007/978-3-030-76575-0_3
Mickenautsch S. What is the impact of the COVID-19 pandemic on dental practice business and treatment approaches? J Minimum Intervention Dentistry. 2024;17(1):10–8.
Seif A, Jarry CR, Chauvel AM. The new ‘Golden Age’of Dentistry: A highly Desirable Profession with Unprecedented Global opportunities in Industry Settings. J Calif Dent Assoc. 2024;52(1):2324979. https://doi.org/10.1080/19424396.2024.2324979 . https://doi-org.mgs.hac.ac.il/ .
doi: 10.1080/19424396.2024.2324979
Livny A, Hasidim N, Chackartchi T, Mann J, Haim D, Vered Y, Findler M, Tobias G. Understanding attitudes of the use of Dental Applications among parents of kindergarten aged children. Dent Res Oral Health. 2024;7:23–9.
Miyazaki T, Hotta Y. CAD/CAM systems available for the fabrication of crown and bridge restorations. Aust Dent J. 2011;56(s1):97–106. https://doi.org/10.1111/j.1834-7819.2010.01300.x .
doi: 10.1111/j.1834-7819.2010.01300.x pubmed: 21564120
Joda T, Bornstein MM, Jung RE, Ferrari M, Waltimo T, Zitzmann NU. Recent trends and future direction of dental research in the digital era. Int J Environ Res Public Health. 2020;17(6):1987. https://doi.org/10.3390/ijerph17061987 .
doi: 10.3390/ijerph17061987 pubmed: 32197311 pmcid: 7143449
Joda T, Waltimo T, Probst-Hensch N, Pauli-Magnus C, Zitzmann NU. Health data in dentistry: an attempt to master the digital challenge. Public Health Genomics. 2019;22(1–2):1–7. https://doi.org/10.1159/000501643 .
doi: 10.1159/000501643 pubmed: 31390644
Alauddin MS, Baharuddin AS, Mohd Ghazali MI. The modern and digital transformation of oral health care: a mini review. Healthcare. 2021;9(2):118. https://doi.org/10.3390/healthcare9020118 .
doi: 10.3390/healthcare9020118 pubmed: 33503807 pmcid: 7912705
Jampani ND, Nutalapati R, Dontula BSK, Boyapati R. Applications of teledentistry: a literature review and update. J Int Soc Prevent Communit Dent. 2011;1(2):37–44. https://doi.org/10.4103/2231-0762.97695 .
doi: 10.4103/2231-0762.97695
Haidar ZS. Digital dentistry: past, present, and future. Digit Med Healthc Technol. 2023. https://doi.org/10.5772/DMHT.17 .
doi: 10.5772/DMHT.17
Kamath P, Kamath P, Saldanha SJ, Shetty TB, Rodrigues SJ, Pai UY, et al. A brief exploration of Artificial Intelligence in Dental Healthcare: a narrative review. F1000Research. 2024;13:37. https://doi.org/10.6084/m9.figshare.23803026 .
doi: 10.6084/m9.figshare.23803026
Peek N, Sujan M, Scott P. Digital Health and Care in Pandemic Times: impact of COVID-19. BMJ Health Care Inf. 2020;27(1). https://doi.org/10.1136/bmjhci-2020-100166 .
van der Zande MM, Gorter RC, Bruers JJ, Aartman IH, Wismeijer D. Dentists’ opinions on using digital technologies in dental practice. Community Dent Oral Epidemiol. 2018;46(2):143–53. https://doi.org/10.1111/cdoe.12345 .
doi: 10.1111/cdoe.12345 pubmed: 28983942
Guba EG, Lincoln YS. Competing paradigms in qualitative research. In: Handbook of qualitative research. 2nd ed. pp. 163–194.
Tsabar Ben Yehoshua N. Traditions and streams in qualitative research: strategic approaches and advanced tools. Tel Aviv, Israel: Mofet Institute; 2016.
Zhang Y, Wildemuth BM. Unstructured interviews. In: Wildemuth B, editor. Applications of Social Research Methods to questions in information and Library Science. Westport, CT: Libraries Unlimited; 2009. pp. 222–31.
Josselson R. Interviewing for qualitative inquiry: a relational approach. New York (NY): Guilford Press; 2013.
Morse JM. Ethics in action: ethical principles for doing qualitative health research. Qual Health Res. 2007;17(8):1003–5.
doi: 10.1177/1049732307308197 pubmed: 17928474
Saldaña J. The Coding Manual for qualitative researchers. London: Sage; 2021.
Nowell LS, Norris JM, White DE, Moules NJ. Thematic analysis: striving to meet the trustworthiness criteria. Int J Qual Methods. 2017;16. https://doi.org/10.1177/1609406917733847 .
Gross D, Gross K, Wilhelmy S. Digitalization in dentistry: ethical challenges and implications. Quintessence Int. 2019;50(10):830–8. https://doi.org/10.3290/j.qi.a43151 .
doi: 10.3290/j.qi.a43151 pubmed: 31538146
Matthews DC, McNeil K, Brillant M, Tax C, Maillet P, McCulloch CA, Glogauer M. Factors influencing adoption of new technologies into dental practice: a qualitative study. JDR Clin Transl Res. 2016;1(1):77–85. https://doi.org/10.1177/2380084415627129 .
doi: 10.1177/2380084415627129
Kokuytseva T, Ovchinnikova O. Digital transformation as a source of innovative growth for small and medium enterprises in Russia. In: Thrassou A, Vrontis D, Weber Y, Shams SMR, Tsoukatos E, editors. The changing role of SMEs in global business. Palgrave Studies in Cross-disciplinary Business Research, In Association with EuroMed Academy of Business. Cham, Switzerland: Palgrave Macmillan; 2020. pp. 131 – 54. https://doi.org/10.1007/978-3-030-45831-7_7
Ricciardi W, Pita Barros P, Bourek A, Brouwer W, Kelsey T, Lehtonen L. Expert Panel on Effective Ways of Investing in Health (EXPH). How to govern the digital transformation of health services. Eur J Public Health. 2019;29(s3):7–12. https://doi.org/10.1093/eurpub/ckz165 .
doi: 10.1093/eurpub/ckz165 pubmed: 31738442 pmcid: 6859522
Sallam M, Salim N, Barakat M, Al-Tammemi A. ChatGPT applications in medical, dental, pharmacy, and public health education: a descriptive study highlighting the advantages and limitations. Narra J. 2023;3(1):e103–103. https://doi.org/10.52225/narra.v3i1.103 .
doi: 10.52225/narra.v3i1.103 pubmed: 38450035 pmcid: 10914078

Auteurs

Lior Naamati-Schneider (L)

Health Systems Management Department, Hadassah Academic College, Jerusalem, Israel. liorna@hac.ac.il.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH