The Israel Medical Association announced Monday that it was launching a “mission
to save public medicine” by demanding additional manpower and budgeted beds in
hospitals, an increase in physician salaries in the periphery and incentive pay
in specialties with too few doctors.
During a press conference at its
Ramat Gan headquarters, IMA chairman Dr. Leonid Eidelman said the money that 80
percent of the population pays health funds for supplementary insurance should
instead enable it to choose specialists and surgeons without paying more through
private medical services.
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Eidelman argued that a doctor’s basic gross
wage (without overtime and duty work) was only NIS 42 per hour and should be
raised by 50%.
Retired doctors must also get more money, he said,
claiming that some of them earn only a minimum wage. In return, many doctors
would be willing to work full-time in the public medical system.
Finance Ministry’s claim that the majority of hospital doctors leave their
workplace at midday to see private patients (in a framework known as “SHARAP”)
“has never been investigated, and even now the Health Ministry has never taken a
position on the issue,” Eidelman continued.
The IMA will not hesitate to
take all legal measures to get what it wants. "We are not talking about small
changes but major ones to save public medicine," the IMA chief
Doctors who move to outlying areas to work get a bonus of only
NIS 500 to NIS 2,300 for making the move, said deputy IMA chairman Dr. Yisrael
Eilig, compared to doctors in the center of the country, where they can work
privately after hours. Incentive pay will solve the problem of specialties with
too few doctors, added Dr. Yitzhak Ziv Ner, another IMA deputy.
community clinics, doctors are allowed only a few minutes to see each patient,
said Dr. Moshe Kastiner, although they should be given more time – 12 to 15
minutes – for older and sicker patients.
This alone would require 500
more physicians in the system, Kastiner said.
Prof. Avinoam Reches,
chairman of the IMA’s ethics bureau, said it opposed the Treasury’s demand for
physicians to punch a time clock.
“We teach medical students that
doctoring is an altruistic profession without a time clock,” Reches said. “If
they have to check in and out, a culture of ‘doing only what you have to’ will
set in instead of doing everything you can.”
Doctors who take time away
during regular work hours for which they receive pay should be punished, but a
time clock system should not be forced on them,” Reches said.
Ministry commented that wage increases would be directed to physicians working
in the periphery, those in specialties with manpower shortages, and young
doctors and hospital residents, and not to senior physicians.
statement following the IMA press conference, a spokesman said the Treasury
would pay for overtime for doctors in exchange for punching a time clock to
encourage more work in the public sector. This, the statement said, would
encourage public medicine rather than the private sector. Only physicians who
devote their time to work in public institutions would get increases, and only
if they agree to have their working hours monitored.
According to the
statement, more than 80% of the doctors in the public sector have a second job
they attend to during regular working hours, while physicians have already
received a 24% wage increase as a result of arbitration whose last increment was
put in place only a month ago.
“There is no reason to demand anything
beyond this amount when the whole public sector has received a salary increase
of [just] 6.24%,” the statement said.
To improve service, specialists
will be required to work nights, holidays and weekends to ease the burden on
medical residents in hospitals, the Treasury said. The doctors’ demands for
SHARAP privileges in public hospitals was meant to increase their combined
income by “billions of shekels” while making use of public facilities for
services that are provided at no cost.
“This will hurt mostly the weaker
socioeconomic groups,” the Treasury maintained.
“This is a government
decision for the government to take, and not up for discussion with any
According to the Treasury, medical residents in the public sector
earn a gross monthly salary of NIS 18,654. A specialist earns NIS 23,705, and a
senior physician NIS 34,428, while the average public physician’s salary is
The average national wage is NIS 8,340.
Ministry did not comment and said it had not been consulted by the Finance
The IMA said it was “very disappointed” by Finance Ministry’s
“The Treasury has proven that it doesn’t understand the
seriousness of the situation in the public health system and lacks the will to
act to save it,” the IMA said. “Instead of trying to mislead the public and
tossing slogans, we expect it to take significant steps to save the health
system from collapse.”
Also on Monday, MK Rachel Adatto (Kadima), a
physician by training, presented a motion of no confidence in the government due
to hospital crowding and the general crisis in the health system. The motion was
filed on behalf of both Kadima and the opposition.
Adatto said that Prime
Minister Binyamin Netanyahu, who is formally the health minister, has totally
ignored his responsibilities and endangered the health of hospital patients who
lie in beds in the corridors and are seriously ill but not treated in intensive
The government intends to add only hundreds of budgeted
hospital beds over the coming years, when experts have stated that over 3,000
beds are needed by 2015, she said. The prime minister declared that state
profits from new natural gas discoveries would be used to boost education and
defense, but not health, Adatto added.