Family Medicine Program in Iran: SWOT Analysis and TOWS Matrix Model
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Abstract
Background: We aimed to determine strength, weakness, opportunities and threats analysis and intended to present strengths, weaknesses, opportunities and threats matrix model for appropriate implementation of Family medicine program in Iran.
Methods: This was a descriptive-analytical and cross-sectional study. All attending physicians in 30 health care centers of Tehran University of Medical Sciences, Tehran, Iran were asked to present and prioritized their views about strengths, weaknesses, opportunities, and threats factors of family medicine program in Iran in 2015. Then, the prioritization of these factors was showed by weighted score of each factor. Finally, the respondents determined four groups of TOWS model including SO, ST, WO, and WT strategy for development of family medicine in Iran.
Results: Totally, the respondents expressed 44 factors as strengths, weaknesses, opportunities, and threats of family medicine program and prioritized these factors and suggested 30 TOWS matrix strategy for efficient implementation of this program.
Conclusion: There were many internal and external factors that impress the implementation of family medicine program. There is a gap between the ideal and the current situation of this program. We suggest the health care system policy makers notice the TOWS matrix strategies determined for improvement of family medicine program in Iran.
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2. Pederson KM, Anderson JS, Sondergaard J (2012). General Practice and Primary health Care in Denmark. J Am Board Fam Med, 25: S34-38.
3. Starfield B, Shi L, Macinko (2005). Contribution of primary care to health systems and health. Milbank Q, 83(3):457-502.
4. Gill JM, Bagley B (2013). Practice transfor-mation? Opportunities and costs for primary care practices. Ann Fam Med, 11(3): 202-54.
5. Sinsky CA, Willard-Grace R, Sehutzbank AM et al (2013). In search of joy in practice: a report of 23 high-functioning primary care practices. Ann Fam Med; 11(3): 272-8.
6. Donahne K, Newton WP, Lefebvre A, Plescia M (2013). Natural history of practice trans-formation: development and initial testing of an outcomes-based model. Ann Fam Med, 11(3): 212-19.
7. Shaw K, Ohman-Strickland PA, Piasecki A et al (2013). Effects of facilitated team meeting and learning collaborative on colorectal cancer screening rates in primary care practices: a cluster randomized trial. Ann Fam Med, 11(3): 220-28.
8. Culler SD, Parchman ML, Lozano-Romero R (2013). Cost estimates for operating a primary
care practice facilitation program. Ann Fam Med, 11(3): 207-11.
9. Ismaeili R, Hadian M, Rashidian A, Ghaderi H (2014). Family medicine in Iran: facing the health system challenges. Glob J Health Sci, 7(3):260-6.
10. Wun Y, Lam TP, Lam K, Goldberg D, Li D, Yip K (2011). Introducing family medicine in a pluralistic health care system: how patients and doctors see it. Fam Pract, 28(1): 49-55.
11. Beasley JW, Hankey TH, Erickson R et al (2004). How many problems do family physicians manage at each encounter? A WReN Study. Ann Fam Med, 2(5): 405-10.
12. Lankarani KB, Alavian SM, Haghdust AA (2010). Family medicine in Iran: success de-spite challenges. Lancet, 376(9752): 1540-41.
13. Takian A (2009). Implementation of family medicine in Iran: identification of facilitators and obstacles. Ph.D Thesis, London School of Hygiene & Tropical Medicine. Doi: 10.17037/PuBS.00878723.
14. Shalileh K, Mahanian A (2010). Family physi-cians′ satisfaction in Iran: a long path ahead. Lancet, 376(9740): 515.
15. Amiri M, Raei M, Chaman R, Nasiri E (2012). Family physician: the mutual satisfaction of physicians and health care team members. RJMS, 18(92): 23-30.
16. Majdzadeh R (2012). Family physicians imple-mentation and preventive medicine: opportu-nities and challenges. IJPM, 3(10): 665-69.
17. Majiidi A, Noori N, Shahandeh KW, Jamshidi E, Majdzadeh R (2014). Are people in Tehran prepared for the family physician prpgram? IJPM, 5(8): 984-91.
18. LeBaron SWM, Schultz SH (2005). Family medi-cine in Iran: the birth of a new specialty. Fam Med, 37(7): 502-5.
19. Khayatzadeh-Mahani A, Takian A (2014). Family physician program in Iran: considerations for adapting the policy in urban setting. Arch Iran Med, 17(11): 776-78.
20. Monograph on the Internet: Anonymous (2012). Operational guide for family physician project implementation. Version 2. Ministry of Health, Tehran, Iran, PP.: 1-14.
21. Allender S, Cavill N, Parker M, Foster C (2009). Tell us something we don′ t already know or do! - the response of planning and transport professionals to public health guidance on the built environment and physical activity. J Pub-lic Health Policy, 30(1): 102-16.
22. Crabtree BF, Miller WL, Tallia AF, Cohen DJ, Bloom BD, Mcllvaia HE et al (2005). Deliv-ery of clinical preventive services in family medicine offices. Ann Fam Med, 3(5): 430-35.
23. Monograph on the Internet: Anonymous (2016). SWOT analysis: Discover new opportunities, manage and eliminate threats. Mindtools: es-sential skills for an excellent career. www.mindtools.com
24. Gandolf S (2013). The High-Level Self-Exam that Boosts Your Bottom Line on February 28, 2013 in case studies, medical advertising agency, SWOT.
25. Kendrick S (2012). The TOWS Matrix: Putting a SWOT Analysis into Action.
26. Proctor T (2000). Strategic marketing manage-ment for health management: cross impact matrix and TOWS. J Manag Med, 14(1): 47-56.
27. Dargahi H, Darrudi AR (2019). Performance as-sessment of health care centers in South Tehran Health Network. Manage Strat Health Syst, 3(4): 267-75.
28. Shariati M, Moghimi D, Rahbar MR et al (2014). Family medicine in health care system map of Islamic Republic of Iran 1404. Health Care Research National Institute, Ministry of Health, Tehran, Iran, PP:.1-25.
29. Hajinejad A, Eslamfard F (2013). Formulating strategies for the development of treatment tourism in Shiraz, Iran using a strategic plan-ning approach. JRUMS, 12(8): 641-54.
30. Jannati A, Maleki M, Gholizadeh M, Narimani M, Vakkili S (2010). Assessing the strategies & weaknesses of family medicine program. Jour-nal of Knowledge & Health, 38(4): 22-35.
31. Nasrollahpour Shirvani M, Ashrafian Amiri H, Motlagh M et al (2010). Evaluation of func-tion of referral system in family physician program in Northern Province of Iran. Journal of Babol University of Medical Sciences, 11(6): 46-52.
32. Managheb SE, Jafarian J, Firouzi H (2007). The effect of communication skills training based on Calgary-Cambridge guideline on knowledge, attitude and practice of family physicians of Jahrom University of Medical Sciences. Pars Journal of Medical Sciences, 6(16): 74-85.
33. Raeissi P, Ghorbani A, Tabarraie Y (2012). Fac-tors determining satisfaction with family prac-titioners program from the perspective of ru-ral insurance card holders affiliated with Sab-zewar University of Medical Sciences. Journal of Health Administration, 15(49): 69-76.
34. Takian A, Rashidian A, Kabir MJ (2010). Expe-diency and coincidence in re-engineering health system: an interpretive approach to formation of family medicine in Iran. Health Policy Plan, 26(2): 163-73.
35. Gene-Badia J, Ascaso C, Escaramis Babiano G et al (2007). Personalized care, access, quality and team coordination are the main dimen-sions of family medicine output. Fam Pract, 24(1):41-7.
36. Dieleman M, Cuong PV, Anh LV, Martineau T (2003). Identifying factors for job motivation of rural health workers in North Vietnam. Hum Resour Health, 1(1): 10.
37. Mehralhasani MH, Jafari Syrizi M, Pourhosseini SS, Yazdi Feyzabadi V (2013). Performance challenges of family medicine policy and rural insurance in Kerman Province of Iran. Health and Development Journal, 1(3): 16-25.
38. Nasiripour A, Motaghi M, Navvabi N (2014). The performance of referral system from the perspective of family physicians of Kashan University of Medical Sciences 2007-2012. Journal of Health Promotion Management, 3(3): 58-68.
2. Pederson KM, Anderson JS, Sondergaard J (2012). General Practice and Primary health Care in Denmark. J Am Board Fam Med, 25: S34-38.
3. Starfield B, Shi L, Macinko (2005). Contribution of primary care to health systems and health. Milbank Q, 83(3):457-502.
4. Gill JM, Bagley B (2013). Practice transfor-mation? Opportunities and costs for primary care practices. Ann Fam Med, 11(3): 202-54.
5. Sinsky CA, Willard-Grace R, Sehutzbank AM et al (2013). In search of joy in practice: a report of 23 high-functioning primary care practices. Ann Fam Med; 11(3): 272-8.
6. Donahne K, Newton WP, Lefebvre A, Plescia M (2013). Natural history of practice trans-formation: development and initial testing of an outcomes-based model. Ann Fam Med, 11(3): 212-19.
7. Shaw K, Ohman-Strickland PA, Piasecki A et al (2013). Effects of facilitated team meeting and learning collaborative on colorectal cancer screening rates in primary care practices: a cluster randomized trial. Ann Fam Med, 11(3): 220-28.
8. Culler SD, Parchman ML, Lozano-Romero R (2013). Cost estimates for operating a primary
care practice facilitation program. Ann Fam Med, 11(3): 207-11.
9. Ismaeili R, Hadian M, Rashidian A, Ghaderi H (2014). Family medicine in Iran: facing the health system challenges. Glob J Health Sci, 7(3):260-6.
10. Wun Y, Lam TP, Lam K, Goldberg D, Li D, Yip K (2011). Introducing family medicine in a pluralistic health care system: how patients and doctors see it. Fam Pract, 28(1): 49-55.
11. Beasley JW, Hankey TH, Erickson R et al (2004). How many problems do family physicians manage at each encounter? A WReN Study. Ann Fam Med, 2(5): 405-10.
12. Lankarani KB, Alavian SM, Haghdust AA (2010). Family medicine in Iran: success de-spite challenges. Lancet, 376(9752): 1540-41.
13. Takian A (2009). Implementation of family medicine in Iran: identification of facilitators and obstacles. Ph.D Thesis, London School of Hygiene & Tropical Medicine. Doi: 10.17037/PuBS.00878723.
14. Shalileh K, Mahanian A (2010). Family physi-cians′ satisfaction in Iran: a long path ahead. Lancet, 376(9740): 515.
15. Amiri M, Raei M, Chaman R, Nasiri E (2012). Family physician: the mutual satisfaction of physicians and health care team members. RJMS, 18(92): 23-30.
16. Majdzadeh R (2012). Family physicians imple-mentation and preventive medicine: opportu-nities and challenges. IJPM, 3(10): 665-69.
17. Majiidi A, Noori N, Shahandeh KW, Jamshidi E, Majdzadeh R (2014). Are people in Tehran prepared for the family physician prpgram? IJPM, 5(8): 984-91.
18. LeBaron SWM, Schultz SH (2005). Family medi-cine in Iran: the birth of a new specialty. Fam Med, 37(7): 502-5.
19. Khayatzadeh-Mahani A, Takian A (2014). Family physician program in Iran: considerations for adapting the policy in urban setting. Arch Iran Med, 17(11): 776-78.
20. Monograph on the Internet: Anonymous (2012). Operational guide for family physician project implementation. Version 2. Ministry of Health, Tehran, Iran, PP.: 1-14.
21. Allender S, Cavill N, Parker M, Foster C (2009). Tell us something we don′ t already know or do! - the response of planning and transport professionals to public health guidance on the built environment and physical activity. J Pub-lic Health Policy, 30(1): 102-16.
22. Crabtree BF, Miller WL, Tallia AF, Cohen DJ, Bloom BD, Mcllvaia HE et al (2005). Deliv-ery of clinical preventive services in family medicine offices. Ann Fam Med, 3(5): 430-35.
23. Monograph on the Internet: Anonymous (2016). SWOT analysis: Discover new opportunities, manage and eliminate threats. Mindtools: es-sential skills for an excellent career. www.mindtools.com
24. Gandolf S (2013). The High-Level Self-Exam that Boosts Your Bottom Line on February 28, 2013 in case studies, medical advertising agency, SWOT.
25. Kendrick S (2012). The TOWS Matrix: Putting a SWOT Analysis into Action.
26. Proctor T (2000). Strategic marketing manage-ment for health management: cross impact matrix and TOWS. J Manag Med, 14(1): 47-56.
27. Dargahi H, Darrudi AR (2019). Performance as-sessment of health care centers in South Tehran Health Network. Manage Strat Health Syst, 3(4): 267-75.
28. Shariati M, Moghimi D, Rahbar MR et al (2014). Family medicine in health care system map of Islamic Republic of Iran 1404. Health Care Research National Institute, Ministry of Health, Tehran, Iran, PP:.1-25.
29. Hajinejad A, Eslamfard F (2013). Formulating strategies for the development of treatment tourism in Shiraz, Iran using a strategic plan-ning approach. JRUMS, 12(8): 641-54.
30. Jannati A, Maleki M, Gholizadeh M, Narimani M, Vakkili S (2010). Assessing the strategies & weaknesses of family medicine program. Jour-nal of Knowledge & Health, 38(4): 22-35.
31. Nasrollahpour Shirvani M, Ashrafian Amiri H, Motlagh M et al (2010). Evaluation of func-tion of referral system in family physician program in Northern Province of Iran. Journal of Babol University of Medical Sciences, 11(6): 46-52.
32. Managheb SE, Jafarian J, Firouzi H (2007). The effect of communication skills training based on Calgary-Cambridge guideline on knowledge, attitude and practice of family physicians of Jahrom University of Medical Sciences. Pars Journal of Medical Sciences, 6(16): 74-85.
33. Raeissi P, Ghorbani A, Tabarraie Y (2012). Fac-tors determining satisfaction with family prac-titioners program from the perspective of ru-ral insurance card holders affiliated with Sab-zewar University of Medical Sciences. Journal of Health Administration, 15(49): 69-76.
34. Takian A, Rashidian A, Kabir MJ (2010). Expe-diency and coincidence in re-engineering health system: an interpretive approach to formation of family medicine in Iran. Health Policy Plan, 26(2): 163-73.
35. Gene-Badia J, Ascaso C, Escaramis Babiano G et al (2007). Personalized care, access, quality and team coordination are the main dimen-sions of family medicine output. Fam Pract, 24(1):41-7.
36. Dieleman M, Cuong PV, Anh LV, Martineau T (2003). Identifying factors for job motivation of rural health workers in North Vietnam. Hum Resour Health, 1(1): 10.
37. Mehralhasani MH, Jafari Syrizi M, Pourhosseini SS, Yazdi Feyzabadi V (2013). Performance challenges of family medicine policy and rural insurance in Kerman Province of Iran. Health and Development Journal, 1(3): 16-25.
38. Nasiripour A, Motaghi M, Navvabi N (2014). The performance of referral system from the perspective of family physicians of Kashan University of Medical Sciences 2007-2012. Journal of Health Promotion Management, 3(3): 58-68.
| Files | ||
| Issue | Vol 48 No 6 (2019) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v48i6.2928 | |
| Keywords | ||
| Family medicine program SWOT analysis TOWS matrix strategy Attending physicians Iran | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
DARGAHI H, DARRUDI A, ZALVAND R. Family Medicine Program in Iran: SWOT Analysis and TOWS Matrix Model. Iran J Public Health. 2019;48(6):1140-1148.
