Medical association slams conditions in hospitals

Internal medicine departments have begun to overflow with patients.

Hospital 311 (photo credit: Ariel Jerozolimski)
Hospital 311
(photo credit: Ariel Jerozolimski)
For many years, hospital internal medicine departments have begun to overflow with patients in the winter, coinciding with flu season.
The Israel Medical Association warned at an emergency meeting on Wednesday that the departments, which treat mostly elderly and others with complex chronic conditions, are already full this summer as well.
Some 500 additional beds are needed in internal medicine departments around the country, said IMA chairman Dr. Leonid Eidelman and heads of the Internal Medicine Society. Eidelman added that patients in the corridors face “inhuman conditions.”
Health Ministry directorgeneral Dr. Ronni Gamzu, who until recently was director- general of Tel Aviv’s Ichilov Hospital and thus is familiar with the situation, said that 70,000 hospital days are spent by patients in the corridors without the privacy and protection of being in a ward.
“I won’t acquiesce to the failure to add beds to internal medicine departments,” he declared.
The lack of beds does not refer to the actual bed itself but to space in wards, medical manpower and funding for operating the bed. Gamzu noted that beds are removed from existing departments because there are not enough internal medicine specialists to take care of patients. The director-general noted that unless more funding was received from the Treasury, more and more internal medicine physicians and other specialists would leave Israel or leave medicine entirely because they were unwilling to work under inadequate conditions.
The way to break the vicious cycle, he suggested, was to add hospital beds and manpower slots and offer improved conditions to doctors so they would want to work in internal medicine departments.
When occupancy rates rise above 80 percent, the level of hospital medicine is substandard, said Eidelman. Barzilai Medical Center in Ashkelon needs 58 internal medicine beds immediately, the IMA said. Wolfson in Holon needs 77, Soroka in Beersheba 63 and Emek 38.
Although Israel has become a member of the OECD (Organization of Economic Cooperation and Development), Israel’s number of beds ranks at the bottom compared to other member states, said Dr.
Dror Diker, head of the Internal Medicine Society. According to estimates, there are only 5,290 beds today compared to the projected need for 7,896 in 2015. Diker added that in another few months, there wouldn’t be enough doctors to fill existing slots in internal medicine departments. Of 52 doctors who started learning in internal medicine departments in the last few months, 11 have already dropped out.
The low pay, large numbers of patients, long hours and inability to have a private practice in the field have caused the situation, said Diker.
Hospital directors suggested that the only way for the government to understand the crisis faced by the hospitals was for them to refuse to admit any patients beyond the departments’ ability to cope.
Then the responsibility would fall upon the health system, which has to pay for reforms.
Prof. Yehuda Shoenfeld, head of the internal medicine B department at Sheba Medical Center (the country’s largest hospital) called on his colleagues to “work by the book. It’s impossible to diagnose and treat patients in the 3.2 days, on average, that they are hospitalized.”
Shoenfeld added that when Treasury officials are hospitalized in his department, “within 10 minutes, I get six phone calls demanding that they not be hospitalized in the corridors.”
But Prof. Moshe Mittelman, head of Tel Aviv Sourasky Medical Center’s internal medicine A department, said that even if beds inside wards were found for every patient, “we still don’t have enough medical manpower to care for all of them.”
All graduates of foreign medical schools who come to Israel to study a specialty here should be required to work for at least a year in an internal medicine department, suggested Dr. Shmuel Heyman, head of a department at Hadassah University Medical Center on Mount Scopus.