In May 2019, the MoH issued a new circular that expanded the role and responsibilities of specialist nurses (SN), just one year after the unsuccessful attempt to issue this very same change, which was hampered by the Israeli medical association (IMA). The SN's main role is to be a "case manager", follow patients during the treatment period, continue the treatment and balance of chronic diseases, treat mild acute health problems according to the physician's instructions, provide palliative care, and promote health. The objective of this change is to strengthen the multidisciplinary team in primary care clinics.
The current circular differs from the previous one in that it is narrower in scope: it limits the expansion of the responsibilities only for nurses working in primary care clinics (PCC) in the community, their responsibilities are narrower than in the previous circular, and SN are required to follow the directions of the physician in charge of the clinic. In fact, SN follow clinical instructions guided by the physician with whom they work. Despite the new responsibilities of a SN determined by the circular, the physician remains responsible for the patient, determines the diagnosis and treatment, and also establishes the role of the SN in the treatment of each patient. The physician must approve each activity performed by the SN and has no obligation to provide the SN with all the responsibilities allowed by the circular.