Doctors ‘work to rule’

After 10 months of negotiations conducted by the Israeli Medical Association (IMA) to save the public health system and given the lack of progress in negotiations with employers, it has been decided that doctors will work ‘by the book’. The IMA gave employers and the Treasury 6 weeks notice, stating that if an agreement was not reached, starting in July the health care system will start to work according to their current contracts and in accordance with collective agreements only. Work according to their contracts and Health Ministry regulations are rarely carried out due to the lack of medical manpower.
   
Out of responsibility to patients the IMA will continue to run the exceptions committees who deal with appeals from patients who require urgent care. According to the  ‘work to rule’ residents will only work 6 shifts per month instead of up to 14 which some currently work; residents will work shorter shifts and will complete their shift after completing the handover of department. Specialists who are not listed for shift work will not be in hospitals after 16:00 (except during a medical emergency) and will not take on more work without remuneration. In fact, hospital wards and operating rooms in hospitals around the country, at some point during the month, will likely not be on duty after 16:00. Hospital administrators and the state will have to find a solution to the created shortage of doctors after 16:00. Clalit Health Services Community Clinic physicians (Kupat Holim Clalit) will not provide services where no direct contact exists between patient and doctor outside of work hours, but will issue a final list of medical certificates (certificates of illness, student medical certificates, etc). 

The Israeli Medical Association expressed surprise that despite the fact that doctors had warned six weeks ago their intention to work according to rule, the Ministry of Finance and Employers have made no effort to prepare in advance and negotiate matters that will end the crisis. 
   Dr. Leonid Eidelman, president of the IMA said that "we are conducting a fierce struggle to save the public health care system. We were disappointed with the conduct of the Treasury, who refuses to reach an agreement that will bring about health care reform. Now everyone will see the outcome if we work according to contracts and regulations.Unfortunately, if we do not take this step today and show decision makers what happens when there are not enough doctors and positions for doctors, we will find ourselves in this reality in the future."