Walking the talk. Interview by Frances Pickersgill.
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This is the first of a series of articles that explores the implications and imperatives of the new Code of Professional Conduct (NMC, 2002) and considers it in relation to the practice and professional responsibilities of midwives. This initial article focuses on the purpose and requirements of the Code as set out in its introduction (Section 1).
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To date (1998), Israel does not have a nurses' law. Israel has 6 million inhabitants, approximately 15,000 physicians, and 33,000 nurses--a ratio of 180 nurses per 100,0000 inhabitants. Since the 1970s, drafts for a nurses' law have been formulated to set a legal framework for the profession, as is customary in many other countries. This framework would define the particularities of nursing as a profession, who may practice it, levels of training, recognized areas of specialization, and expertise in the operation of specific medical equipment and various nursing duties. Between 1993 and 1996, drafts for legislation were deliberated a number of times by committees appointed by the Ministry of Health but were not passed. Many elements opposed the drafts: the physicians and both the nurses' union and the midwives' union--the latter being a separate and an independent professional body from the nurses' organization.
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Physicians have lost their trust in managed care plans because of perceived deficits in competency, concern, choice, confidentiality, and communications. To succeed in a market-driven healthcare system, managed care plans must work to restore that trust. A variety of strategies are proposed to address physician concerns related to these 5 domains of trust. Although no single strategy will restore trust, a combination can improve the relationship with these important stakeholders.