February 21, 2024

Israel’s healthcare system needs saving – editorial

Israel’s medical system is at risk of collapsing, and judicial reform may be hurrying the process along.

Former president of Ben-Gurion University and dean of its Faculty of Health Sciences Prof. Rivka Carmi warned of the ramifications of judicial reform on Israel’s already-overburdened healthcare system in an interview with this paper’s Judy Siegel-Itzkovich last week.

“If 15% to 20% of those [3,000 doctors] seeking information about leaving [Israel] go through with it, Israel’s healthcare would be devastated,” she told the Post. “As it is, there’s a severe shortage of physicians.”

Carmi isn’t exaggerating. As thousands of physicians look to leave the country in protest of the government’s judicial reform, those who stay behind will be left facing an increasingly desperate situation.

The healthcare system has been underfunded, understaffed, and underprioritized for years, a phenomenon that was exacerbated by the COVID-19 pandemic. 

The Olga and Lev Leviev Heart Center at Sheba Medical Center is one of Israel’s leading cardiology departments, according to Forbes Israel (credit: MIRIAM ALSTER/FLASH90)

The problem with Israel’s medical system begins with medical schools’ acceptance rate, long before a doctor sets foot inside a clinic.

The combination of the weighted psychometric exam, the limited number of medical programs, and the low acceptance rate leaves many who wish to study medicine without a choice – if they want to study medicine they must do so abroad.

This leaves just 2,000 Israelis studying medicine domestically and means that two-thirds of all doctors here are graduates of foreign medical programs. And that excludes those who realize they don’t want to return to Israel to work after graduating.

And why would they? In 2022, Israel’s medical system fell well below the OECD average for both hospital beds and nurses per 1,000 people, and just 7.5% of the GDP goes to the healthcare sector each year, compared to the OECD average of 8.9%.

That’s not to mention the ongoing battle to shorten the shifts worked by hospital residents from 26 hours to 18 hours. In the most recent state budget, the government promised a five-year plan to shorten shifts, with the goal of ultimately reducing them to 16 hours.

But the situation is dire, and five years is a long way away. In the meantime, the country’s medical interns and residents are being severely overworked, which impacts their own health and well-being.

Last, but certainly not least, with doctors being attacked by patients with alarming frequency, drawing multiple strikes, it is understandable that many Israeli graduates of foreign medical schools aren’t running home to work.

So while it may truly be the judicial reform that is causing some doctors to say “enough is enough,” for many others it is simply the straw that broke the camel’s back.

Something needs to change for Israel’s healthcare system

If Israel wants to continue to provide world-class healthcare to its population of close to 10 million people, drastic action needs to be taken.

Israelis who wish to study medicine shouldn’t be forced to take the same psychometric exam again and again just to be granted the chance to apply for a medical program.

These same Israelis shouldn’t feel that they’ve been forced out of their own country by the limited options for their desired path of study, and they certainly shouldn’t have to pay through the nose to study abroad just because Israel didn’t prioritize their education.

And then, after four to six years of study, either here or abroad, these trainee doctors shouldn’t be working 26-hour shifts, with no end in sight and with fewer resources than other countries would offer them.

Israel’s doctors deserve better. They deserve to work with dignity and respect, without fear of getting punched by patients or of falling asleep at the wheel after a 26-hour shift. They also deserve a fair wage – as they would receive abroad. 

Israel’s patients deserve better, as well. They deserve to be seen by a doctor without an 11-hour emergency room wait. They deserve to be admitted to the hospital when necessary, and not to be turned away or dismissed due to overflowing wards and a lack of resources.

The government must prioritize reforming the healthcare system. They must make the acceptance process less daunting, the educational programs larger, and the incentives to stay in the country better.

Otherwise, we may just find ourselves with a system that can no longer be healed.

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