IMA conference on the Physician shortage: How we got to this situation?

The shortage of thousands of doctors in Israel: the situation, exchange of ideas and possible solutions.

At a conference held in Tel Aviv on the 18^th May on the shortage of physicians in Israel, Dr Eidelman, Israeli Medical Association President, stated that the physician shortage is worsening, and that this phenomenon is affecting the work in all hospital departments. "Hour after hour patients pay the price for this shortage." The IMA has placed the issue of the physician shortage as a top priority in the negotiations with the Treasury.

Representatives from the Ministry of Finance were invited to take part in the conference, however they refused to participate.

During the conference Dr. Eidelman stated that "Doctors feel the impact of a drying health system every day. The shortage is at our expense and at the expense of patients: patients die due to the shortage of doctors. They die because the doctor was tired from doing 10 shifts a month, and because the doctor does not have time to examine them sufficiently. Clinic physicians have five minutes for each patient: to review the patient's medical file, identify the illness, decide on a treatment and to explain this to the patient. "

Member of Knesset Dr. Rachel Adato, also spoke at the conference, she said that "the current governments claims to add 960 beds in six years, in order to save the public health - is like pouring sand in our eyes.  At the end of the day, the Ministry of Finance are the ones who run the health system, and for them Health is always the last priority.”  MK Dr. Adato demanded that the Prime Minister, Benjamin Netanyahu, intervene immediately to resolve the crisis.

Director General of the Ministry of Health, Prof. Ronni Gamzucalled on a system to plan for the next 10-15 years.  Prof Gamzu reported that the country has grown every year by about 130 thousand inhabitants, and in order to maintain the current rate of doctors per thousand inhabitants, it is necessary to increase the number of new doctors entering the profession.  
 
Prof Gamzu stated that in order to resolve the immediate crisis and the shortage of doctors, we require more students in the existing medical schools, the addition of the new medical school and at the same time we must also embrace students from abroad to enable them to complete their studies in Israel.

Michael Schonstein, Health labour market specialist, from the OECD, presented the international data indicating a need to redefine the image of the health workforce. According to this data, the health sector is a growing field in OECD countries, responsible on average for 9% of GDP and 10% of employment in these countries. In Israel, however, health expenditure is about 7.8% of GDP, which is lower than the Western world. According to the data presented, between 2000- 2008 Israel recorded a very low growth in the number of doctors relative to the population and significantly less than the OECD average.
 
Mr. Schonstein warned that the age of the physician workforce compared to and the rate of training is not sufficient. According to the analysis presented, we must ensure that the number of medical students coincide with the number of doctors aged 55 and above. Israel now stands on the brink of the need to replace a large population of physicians, who joined the system during the great immigration wave from the former Soviet Union. However, there are not enough new medical students to replace the ones leaving the profession. Countries facing a similar situation, examine the possibility of postponing the retirement age for physicians.

Dr. Matthias Wismar, Senior Health Policy Analyst from the WHO Observatory predicted that the labor market will continue to open allowing doctors to work and study in different countries. Certain countries rely much more than others on health professionals coming from abroad to address the growing shortages in the health workforce and meet increasing needs. 25% of U.S. physicians, 23% in Switzerland, 36% UK and 39% New Zealand - have been trained in other countries. Dr Wismar identified the most influential factors on the emigration of doctors to be wage gaps, followed by career opportunities, and working conditions.