IMA: Lack of neonatologists reaches acute level

In the past 20 years, the number of Israeli births has risen by half to 160,000 a year, but the number of neonatologists is only 100 – just 65 percent of the number needed.

May 12, 2010 08:43
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baby with mother 311. (photo credit: Ariel Jerozolimski)

The Israel Medical Association warns that hospitals in both the periphery and the center of the country are closing their premature infant units due to the lack of specialists in neonatology (doctors who treat newborns, especially premature ones).

In the past 20 years, the number of Israeli births has risen by half to 160,000 a year, but the number of neonatologists is only 100 – just 65 percent of the number needed to fill the required job slots.

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Dr. Shmuel Zangen, head of the department for special care of neonates and premature babies at Ashkelon’s Barzilai Medical Center and head of the Israel Neonatology Society, said that over 40 of the 100 neonatologists will retire in the coming decade.

Neonatology is not a popular field because it is very demanding around the clock and does not offer the perks of private practice.

About half of all newborns need the intervention of a neonatologist, said Zangen, but there isn’t enough manpower to treat them properly. Thus on-duty pediatricians without a specialty in neonatology are forced to treat not only their regular patients but also premature babies.

In government hospitals in the periphery, neonatal units are on the verge of collapse, said Dr. Tzaki Ziv-Ner, chairman of the Government Hospitals Association. In Western Galilee Government Hospital in Nahariya, for example, there are only two neonatologists in charge of 6,000 deliveries a year. In the past few months, it has had to call in neonatologists from other state hospitals to help out, said Ziv-Ner.

“Without immediate intervention by the Health and Finance Ministries, there is a real danger that neonatal units in peripheral hospitals will shut down, and the only solution for premature babies at risk will be to rush them to hospitals in the center of the country,” he warned. “This would bring the risk to premature babies in the central region as well.”

IMA chairman Dr. Leonid Eidelman said that the manpower standards for neonatologists were set way back in 1985, even though the practice of neonatology has become much more demanding since then.

He said that neonatology has already been recognized by the government as a “medical sub-specialty in acute stress,” but that the incentives given to young pediatricians are not yet significant enough to make it attractive. These must be boosted, he concluded, by the hospitals and the Finance and Health Ministries, especially in the periphery, “before a tragedy occurs.”

The Health Ministry commented that it was aware of the shortage of neonatologists, and that incentive pay is given to pediatricians who go to study the field.

“But not every delivery requires a neonatologist – only when a premature baby is expected. “The ministry will continue to initiate discussions with the Treasury for raising the number of neonatologists in general and in the periphery in particular,” the ministry spokeswoman said.

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