Paving the way: Ariel Siegel, 38, From New Jersey to Ramat Beit Shemesh, 2010

Leaving an established profession in the US, Ariel Siegel felt it more important to live out his dreams in Israel.

By ABIGAIL KLEIN LEICHMAN
The hardest part of adjusting was learning Hebrew, Siegel admits. ‘I’ve had to acclimate to a new area of medicine in a new country with a different system, and on top of that I have to do it in a second language.’ (photo credit: Courtesy)
The hardest part of adjusting was learning Hebrew, Siegel admits. ‘I’ve had to acclimate to a new area of medicine in a new country with a different system, and on top of that I have to do it in a second language.’
(photo credit: Courtesy)
One of the biggest obstacles to aliya is concern about employment in one’s chosen occupation. But what if that occupation simply does not exist in Israel? A licensed and experienced physician assistant (PA), Ariel Siegel was fully aware that the field is not yet on the official radar here, and nevertheless followed his heart to his homeland.
“My story is the story of most PAs who come here, knowing our profession is not recognized and that we have to figure out another route. But aliya is important,” says Siegel, 38, in an interview from his Ramat Beit Shemesh home after he and his wife had tucked their four children into bed.
A year or two before moving to Israel, Siegel met twice with Health Ministry officials to press his case for recognizing PAs. In the United States, PAs are licensed to perform physical examinations, diagnose and treat illnesses, prescribe medications, order and interpret lab tests, perform procedures, assist in surgery, provide patient education and counseling and make rounds in hospitals and nursing homes.
“One person at the Health Ministry was adamant that there will never be PAs in Israel. The other doctor was much more interested in it, but didn’t see it happening in the near future, and he predicted that pursuing it would be long and drawn out,” Siegel relates.
“I preferred to figure out a way to support my family, so when I came here I did behind-the-scenes work in the healthcare field, writing and editing and working with a lawyer involved in medical-legal cases.”
The big decision After graduating from a two-year PA course at the State University of New York at Stony Brook, Siegel spent 10 years as a PA in private medical practices, working for the medical director of the liver transplant team at New York University Langone Medical Center and for a neurologist in New Jersey.
Giving up a rewarding career wasn’t easy, but the native of Monsey, New York, thought it more important to transplant his family while the children were still young. He says his religious Zionist leanings gradually grew stronger over the years. By the time he married Atara Gutfreund in 2003, he was fairly sure he wanted to live in Israel.
Atara needed more time to reach the same conclusion, so they lived for two years in suburban Teaneck, New Jersey, and then moved to Elizabeth. “She wanted to make aliya but just didn’t realize it yet,” Siegel jokes.
That latent realization surfaced during a trip to Israel for a friend’s wedding. “We were staying with cousins and felt very inspired. My wife turned to me and said, ‘Yeah, I want to make aliya.’” She was eight months pregnant with their third child when the family arrived with all their belongings in 2010.
The kids are now nine, seven, almost four and one. “It was a great experience having children here,” says Siegel. “My wife figured Israelis know what they’re doing with babies; it’s not an unusual area of medicine.”
Siegel probably could have delivered his infants himself. During his college years at Yeshiva University, he debated whether to apply to medical school or physical therapy school. He became a certified emergency medical technician and paramedic, serving shifts in the local volunteer ambulance corps.
“Then I came across the PA field, and it was very interesting to me, so I pursued it,” says Siegel. “It’s kind of common for PAs to go into this profession from a different medical area. Many PAs were first nurses or respiratory therapists or something else in the healthcare field.”
Doing the impossible Though he was resigned to giving up this career for the foreseeable future, Siegel received an email from Nefesh B’Nefesh last spring informing him that Reuth Medical Center in Tel Aviv was seeking physician assistants. A friend working at Reuth, one of the largest rehabilitation and chronic-care facilities in Israel, encouraged him to apply. In June 2013, he submitted his CV.
And that’s how Siegel is once again employed in the profession he loves, along with two other US-trained PAs, Simon Knopf and Maital Stern.
“We work in the physical medicine and rehabilitation department, an area that overlaps with things I’ve done and areas I have not done before,” he says. “I work with a staff of three truly fantastic physiatrists, treating patients who need rehabilitation following a stroke or accident, joint replacement or fractures. It’s a great environment in which to practice.”
The Hebrew language, he admits, “has been hands-down the hardest part, because I’ve had to acclimate to a new area of medicine in a new country with a different system, and on top of that I have to do it in a second language. The doctors are wonderful in working with me on it, and I’m getting better day by day.”
Director-General Dr. Nissim Ohana even arranged for a private ulpan teacher for a few months. “Reuth is very forward- thinking,” Siegel says. “They realize that because of a shortage of doctors in Israel, they need PAs. And if the PAs need help with their Hebrew, they’ll provide it.”
The profession still is not recognized by the Health Ministry, but efforts are being made to institute full licensing procedures.
“I am doing the impossible: working in a career that doesn’t exist,” says Siegel.
“We walk a very fine line not to do anything that would be considered illegal here.”
He knows of several other PAs working elsewhere in Israel. “In some places, a doctor will hire a PA even if the whole facility is not on board with it. The only place I know of that has created an orderly structure is Reuth, and it comes from the highest level of administration because they think it’s a great asset to their system.”
Strive to be a man One of Siegel’s favorite sayings from Ethics of the Fathers is “In a place where there are no men, strive to be a man” (2:5).
For him, that means giving back to the community, and so he volunteers with the Civil Guard once a month in his neighborhood. “We came here when I was already too old to serve in the army,” he explains.
Though the Siegels have no immediate family in Israel, their parents are supportive of their decision to live in the Jewish state.
“Life all fits together here as a complete whole,” he says. “My work life is not separate from my social life, which is not separate from my religious life. It’s all of one piece.”
Looking ahead, he hopes that in five years’ time he will be “working as a fully licensed PA here, raising my wonderful family.”
His struggle to have his career validated has not soured him on the Holy Land.
“Many people love to say Israel is so backward. Lots of new olim come here with a very negative attitude,” he says.
“But my experience has really been very different.”