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The number of obstetricians/gynecologists, especially in Jerusalem but also in other parts of the country, is becoming dangerously inadequate for a variety of reasons, but largely because the specialty has become a women's profession here.
This warning was sounded at a recent session of the Jerusalem branch of the Israel Obstetrics/Gynecology Society.
More than half of all medical students and 60 percent of residents today are women, many of whom want lifestyles convenient for raising their families. Many of them want to work fewer hours and prefer to work in health fund and other clinics to hospital work, where births and gynecological problems are dealt with round the clock.
Statistics were provided at the society meeting by Dr. Liat Zeltzer of Beersheba and by Prof. Chaim Yaffe, chief of ob/gyn at Jerusalem's Bikur Holim Hospital.
Prof. Shlomo Mor-Yosef, director-general of the Hadassah Medical Organization who trained for and worked for years as an obstetrician/gynecologist, headed the session on demography and manpower problems in the field.
He told The Jerusalem Post in a phone interview from New York on Monday that most women now prefer female obstetricians/gynecologists. Another problem is that the field involves a lot of malpractice suits.
"But even though they personally don't have to pay one penny - the hospital pays malpractice insurance - doctors don't like to get a bad name when something goes wrong," he said.
This is different from the US, where most ob/gyns must personally pay skyrocketing malpractice insurance premiums.
Nevertheless, all these factors make ob/gyn less attractive to both female and male Israeli medical graduates today, he added.
"I very much enjoyed the specialty, but I found something else - medical administration - that I enjoy even more," he noted.
Jerusalem has a very high birth rate due to its large population of religious Jews and Arab families. Thus the current shortage is greater there than in other parts of the country - some ob/gyn positions in the capital are vacant - and the greater shortfall expected in the coming years will be even more severe there than elsewhere.
Mor-Yosef said there will be growing shortages of many medical specialists in the years to come, as doctors who retire in these fields are not replaced.
Mor-Yosef noted that it is "relatively easy" to build or expand hospital ob/gyn departments, but they cannot function properly without medical manpower.
"The authorities and hospitals have to think of role changes. For example, midwives can be given more authority to check up on women after delivery or to carry out certain additional tasks instead of obstetricians," he says.
There are not yet corresponding shortages in midwives, Mor-Yosef continued, because they work shifts and have regular hours; obstetricians have different responsibilities and work hours.
The Health Ministry is in charge of manpower planning, said the Hadassah Medical Organization administrator, but its statistical data are not accurate. They have lists of all doctors, but do not have up-to-date information on how many are actively working in each specialty, so they cannot adequate plan for the future, he said.
"I, for example, am listed as a gynecologist, but I don't work in the field. The ministry also doesn't know how many specialists live in various parts of the country," Mor-Yosef said.
"The ministry has started to think about this problem and what to do, but it's still far away from a solution," he said. "When doctors receive their certificates, they don't have to register with the ministry as an active specialist in order to work in the field. The Israel Medical Association is very opposed to this, as it fears it would lead to a requirement of recertification every few years."
Labor unions don't like its members to be required to prove from time to time that they are still competent and updated in the field, he continued.
While financial incentives could encourage some medical residents to go into ob/gyn, it is not a sure thing. Then there are the lifestyle problems, and the fact that most would choose to work in Tel Aviv and Jerusalem instead of the periphery or other places where there are shortages.
Work conditions could be changed to make the field more attractive, Mor-Yosef concluded.
"It is urgent, as every year it is getting more difficult to find enough specialists in the field," he said.