Doctor and patient (illustrative)..
(photo credit: INGIMAGE)
An emeritus professor of internal medicine at the Hadassah Medical Organization – which has openly allowed its senior doctors to carry out in-house private medical services (Sharap) – suggested that allowing both public and private medicine to be practiced in the same hospital may blur the boundaries between public and private care.
In the June issue of The Israel Medical Association Journal , Prof. Jochanan Benbassat, a former senior staff member at Hadassah University Medical Center in Jerusalem’s Ein Kerem neighborhood, warned about the ethical considerations of Sharap.
The doctor received private patients before retiring, but said that the developments in Israeli healthcare have changed his mind about the practice.
Doctors have long attempted to obtain permission to see private patients in public hospitals, but the Sharap system has never been as large as it is at present, he said.
Critics of the system have argued that it has led to issues regarding the fair allocation of healthcare resources and physicians’ commitment to the needs of the patient at hand.
It also violates the principle of equity in which all patients are treated equally – even if they did not pay for their treatment – and gives the impression that public care is inferior to private care, Benbassat said.
There are legal Sharap arrangements in the capital’s hospitals, as well as at Laniado Hospital in Netanya.
Proponents argue that it keeps senior specialists at hospitals in the late afternoons and evenings instead of forcing them to run private institutions.
Benbassat suggested that Sharap may “erode patients’ trust in the healthcare system and degenerate into black-market medicine, providing legitimacy to discrimination among patients.”
He suggested that a better method would be to mount a complete separation between public and private healthcare.