doctors scalpels surgeons cartoon 521.
(photo credit: Avi Katz)
THE RECENT LONG AND BITTER ISRAELI doctors’ strike ended after six months with
an agreement that the government described as a “historic” cure for the ailing
public medical system. In fact, the contract that ended the strike will have the
I am a veteran of the Israeli medical system since 1982,
when after qualifying as an orthopedic specialist in the US, I immigrated with
my family. I am a veteran of four doctors’ strikes. In my first strike in New
York in 1975, we unsuccessfully demanded shorter working hours. This demand was
only achieved in the wake of the tragic death of 18-year-old Libby Zion at the
hands of two sleepdeprived doctors at the end of a 36-hour work shift.
1983, there was a 14-week-long doctors’ strike in Israel and we achieved a
significant increase in our salaries. However, these increases had been wiped
out by inflation by the time the doctors went on strike again in 2000. The
doctors and the government were unable to reach an agreement and we entered into
Eight years later, in 2008, the mediator finally
published his findings.
The government’s response was that it did not
have the money to pay for the agreement. The government has still not fulfilled
the “binding” arbitration, which included promises to create 600 additional
positions for doctors and a pay raise.
Before the turn of the century
Israeli medicine lived off a steady supply of immigrant doctors. The country got
these doctors free of charge.
In the 1990s, 50 percent of all licensed
physicians had received their education in the former Soviet Union. Because the
salaries they had received in their home countries were so low, these doctors
did not protest their Israeli salaries, which for a resident is currently $7.20
But now things have changed. There are relatively few new
immigrant doctors. The government, following American economic models, has
promoted private medicine and has not invested in public
Despite Israel’s growing population, there has been no increase
in the number of hospital beds or in the number of doctors working in public
hospitals. The public hospital system is only kept functioning day by day by the
heroic efforts of residents.
Here are my conclusions after carefully
reading the government’s “historic” contract, which was only presented to the
Doctors Union membership after it had been signed by the leadership: 1) Where is
the big pay increase? Over the course of the nine years of the contract,
doctors’ salaries will increase gradually by 32 percent.
When this figure
is adjusted for anticipated inflation then the real increase in salary over nine
years is in the range of 0.5 to three percent – if inflation stays
2) What happened to the salary increases still due from the 2000
strike? That increase is now deferred again and will appear in doctors’ salaries
in installments beginning between 2012 and 2016.
3) The government
promises 1,000 new public doctors’ positions over the next four years. This is
after they have not added positions for decades. No new positions will be added
in the center of the country for the next 18 months in spite of immediate needs
4) A goal of reducing doctors on call to the American standard of
six per month has been set. This same goal, however, was stated in previous
agreements and was never fulfilled.
5) What about the new residency
requirement that never ends? Until now senior doctors did not have to do night
calls once they finished residency. The contract now states that senior doctors,
if requested by the hospital, are required to do residents’ night calls twice a
month for the first five years after residency.
They are also liable to
be called to do two half-shifts a month until 11 p.m. up to the age of 47.
Unlike a resident, when a senior doctor finishes a 24-hour resident shift,
he/she does not get a day of rest. This means on the day after the night shift
the senior doctor will carry out operations or procedures without having slept
the night before. I would not like to be his/her patient.
6) What happens
to the right to strike if the government does not keep their commitments as has
been the case in the past? There is no right to strike or carry out work action
7) The government states that there is a 300,000 shekel
incentive for a doctor to move to work on the periphery, but does not fund this
8) What are the good things about the contract? There are
modest incentives for doctors to work on the periphery and in fields lacking
Following this “historic” agreement, 1,000 residents resigned.
The Labor Court declared their resignations illegal because they were
Now the residents have begun to resign individually. They are
smarter than my generation of doctors, who allowed themselves to be exploited
Next year I will retire with a rank of full academic
professor from Hadassah Medical Center after 30 years of work, and am looking
forward to a pension of $2,100 a month. My daughter, an internal medicine
resident, has submitted her resignation.
A good leader corrects
situations before disaster strikes. Although Deputy Minister of Health Yakov
Litzman (United Torah Judaism) has charge of the ministry, the official Minister
of Health is none other than Benjamin Netanyahu – maybe he should shoulder the
responsibility for the country’s health system. •
The writer is a professor of
orthopedics at the Hadassah-University Medical Center in Jerusalem.