Familiarizing Medical Students with Hospital Social Worker's Role 

Barbara Rabin (Rabinowitz), Dafna Manor

Dept. of Social Work, Meir Hospital, Kfar Saba

Patient care in a general hospital is usually provided by a multi-professional team. Treatment is most effective when each professional understands the functions of the various other members of the team. Professional literature and research have highlighted differences in perception by social workers and physicians of the proper function of the medical social worker.

Our social work department has developed a teaching program for medical students to enhance their knowledge with regard to this issue. It is presented at a single-session group meeting of an hour and a half, with structured content and goals.

Employment of Immigrant Russian Physicians 

Nurit Nirel

JDC-Brookdale Institute of Gerontology and Human Development, Jerusalem

This study examined trends in the employment of immigrant physicians from the former Soviet Union. We studied the changes in the proportion of immigrants employed as physicians between 1994 and 1998, job characteristics, positions, professional status, and improvement in employment characteristics, professional status, and in wages due to increased seniority.

The study population consisted of 7,000 physicians who had immigrated to Israel by June 1992 and had applied to the Ministry of Health for medical licensing. Of these, 726 were interviewed in 1994 and in 1998 all 726 were again approached and 84% were interviewed by telephone.

Of those interviewed in 1998, 63% were working as physicians, 21% in another occupation, and 16% were not working at all. Of those with medical licenses, 79% were working as physicians. Of those interviewed in 1994, 93% were still employed as physicians in 1998, and 88% of them had been so employed continuously. As of 1998, 85% of those interviewed had 5 or more years seniority as physicians in Israel, and half had been working for more than 5 years at their current place of employment.

The best predictor-variable for employment as a physician in 1998 was employment as a physician in 1994. The proportions of those employed by a public employer, of those earning monthly salaries, and of those with a tenured position, were greater in 1998 than in 1994.

In 1998, 70% reported being employed in a authorized staff position. Funding for the salaries of 75% of these physicians came from the budget of their place of employment, not from a grant, stipend, or temporary fund for the assistance of immigrants. These proportions increased with seniority. The proportions of specialists (22%) and residents (37%) had increased in 1998 relative to 1994 (when they were 8% and 23% respectively). In addition, since 1994 gross hourly wages had increased with seniority in real terms by more than 100%.

These findings are evidence of work stability and improvement in employment conditions of these immigrant physicians. Further, the 1998 follow-up indicated a trend toward becoming "established" and improvement in professional status. However, it also revealed models of temporary employment, not in compliance with physicians' collective work agreements, a situation that warrants examination. It is also important to examine the implications of the absorption of so many physicians for medical manpower in Israel, and for overall expenditure on health.

Risk of Transmission of Viral Disease by Needle Puncture in Health Care Workers

Yosef Mishal, Chaim Yosefy, Emil Hay, Dalia Catz, Elisia Ambon, Roza Schneider

Infectious Disease Unit, Emergency Dept. and Microbiology Lab, Barzilai Medical Center, Ashkelon (Affiliated with Ben-Gurion University of the Negev)

The accidental exposure of the health care workers (HCW) to blood and blood products constitutes a danger for transmission of blood-borne pathogens and the development of severe diseases. Most attention is focused on exposure to the viruses of hepatitis B, C and human immunodeficiency. The objectives of this prospective study were to determine the rate of exposure of our HCW to blood and blood products; to define the high risk groups; and to establish recommendations to prevent transmission or reduce the risk of exposure to these viruses.

During the year 1996, 103 injuries from needle-puncture or other sharp objects were reported to our infectious diseases control unit. Most of those injured were women. 58.4% of the events occurred in the vicinity of the patient. The source of exposure was known in 60% of the cases. 73.8% of those injured had already been immunized against hepatitis B. The departments in which most exposures occurred were the operating theater (12.5%), medical departments A (10.6%) and B (9.6%), and the emergency department (7.7%). Nurses were at highest risk, constituting 47% of those injured.

Our recommendations are that a continuous teaching program be established for the high risk groups; that HCW be urged to report every event of exposure; and to encourage HCW to undergo active immunization against hepatitis B.

Occupational Accidents and Eye Injuries

Joseph Pikkel, Yuval Gelfand, Benjamin Miller

Ophthalmology Dept., Rambam Medical Center and Technion Faculty of Medicine, Haifa

To determine the prevalence of occupation-related eye injuries, we analyzed the records of 24,632 patients treated at our emergency surgical department over a 3-year period. Occupational accidents accounted for 17.6% of such cases. A third of them (1374 patients) were referred to the ophthalmic emergency room for further examination. In 89% (1223) of these, at least 1 pathological ocular finding was detected, and 8.3% (114) of them were hospitalized. Penetrating eye injuries were found in 5.2%(72). The commonest eye injury was corneal foreign body found in 42.8%.