Israel’s health system is beset by an alarming physician shortage. This ongoing shortage, which has reached crisis proportions for physicians and patients, is manifested, inter alia, by an insufficient number of hospital beds and widening gaps between the health services available to different segments of the population. The following report is the first to provide comprehensive data about the shortage, in order to raise public awareness, to initiate a debate about the policies which caused the shortage, and to consider possible alternatives.
This paper serves as an attempt to address the primary and most significant aspects of the physician shortage and to evaluate its effects on the health system. Hence, this study was based on a wide array of relevant sources, including:
- Official reports produced by various governmental ministries – particularly, the Treasury and the Health Ministry
- Documents released by governmental agencies, such as the Central Bureau of Statistics, the Knesset’s Research and Information Center, the State Comptroller’s Office, and the Bank of Israel
- Assorted publications issued by research centers, such as the Israel National Institute for Health Policy and Health Services Research and the Brookdale Institute
- Databases maintained by international organizations, such as the World Health Organization (WHO) and the Organization for Economic Co-operation and Development (OECD)
- Articles from professional medical journals
- Israeli law
- Previous Israeli Medical Association documents concerning health policy
As this paper will show, the shortage manifests itself in a number of different ways, and therefore, the paper deals with the issue on various, interconnected levels. For instance, on a system-wide level, the physician shortage hinders the health system’s ability to provide appropriate health services to Israel’s citizens - as required by the National Health Insurance Law (1994). As a result, on an organizational level, hospitals and other medical establishments are unable to function as necessary, and consequently, on an individual level, the doctor cannot properly treat his or her patients. Needless to say, this severely impacts the patient’s health and well-being.
Thus, the individual doctor is forced to bear the brunt of the system and organization’s failures.
Each day, he or she must cope – nearly singlehandedly – with professional, emotional, and physical challenges, which lead to stress, overwork, burnout, exhaustion, and even patient violence. Under these circumstances, medicine is losing its traditional allure as a goal, a vocation, and a profession, and the public’s faith in the country’s health system is being eroded. As a result, talented individuals choose to avoid a medical career and opt for other professions instead.
These trends, in turn, affect both the organization and the system and further impair their ability to function – which only exacerbates the shortage, and so on. In order to halt the resultant destructive and vicious cycle, the Israeli Medical Association hereby presents a number of proposals for immediate action. These suggestions are designed to strengthen the physician’s stature and to increase the number of physicians – in order to cure the public health system.