"The time has come for Israel to prepare the health system for the long term,” says Dr. Zion Hagay, president of Israeli Medical Association and head of medical education at Kaplan Medical Center in Rehovot. “It can no longer be repaired with ‘band-aids’ and temporary fixes.”
This was the overarching message that was communicated by Dr. Hagay and Leah Wapner, general secretary of the organization, in an interview with the Jerusalem Post.
Hagay and Wapner discussed the Israeli medical establishment’s response to the corona pandemic, how the Israeli Medical Association helps and assists doctors in Israel, and its future plans. The organization, established in 1912, represents about 95 percent of the physicians in Israel, upholds medical standards in Israel, promotes public health, and advances the working conditions of physicians in Israel.
Wapner, the organization’s legal advisor, says that the arrival of the pandemic weakened what already was a strained medical system. “The first stage of COVID,” she says, “was utter surprise. But the health care system was in very bad shape because it has had poor funding for the past 20 years.” The pandemic, she says, brought the health care system to its limits. COVID demands a high percentage of medical personnel working with individual patients, and there was not enough staff to deal with the flood of patients. Despite the difficulties, she says, “we were able to deal with COVID and contain it. But it came at a price. We don’t believe it was necessary to have the number of deaths that we had. We are still having a high rate of infection.” According to Wapner, the Israeli medical system is wonderful in some areas and less capable in other ways.
Israel’s health care system is excellent for ambulatory patients, she explains, and is well-equipped to deal with patients who are home and who visit their Kupat Holim clinic. Most COVID patients have been treated at home. “If not for the Kupot Holim, good network, and infrastructure of the flow of information, we wouldn’t be able to do it. This is why we are effective in vaccination. When people want to get vaccinated, we can get them vaccinated in a very short period of time.” Wapner says that the doctors and nurses performed outstandingly and performed at the level of expectation that one would expect from health care professionals. “That is what saved us.”
Dr. Hagay echoes Wapner’s words and says that “the health system wasn’t prepared for a pandemic of this size. In recent decades, the health system in last decades is starved and under-budgeted.” Hagay adds that the country’s political leaders need to understand that investing in the country’s health care system is as important as investing in education and security. “Investing in Israel’s health care system is an investment in the security of the residents of Israel,” declares Dr. Hagay.
According to Dr. Hagay, Israel does not have enough beds in its hospitals, the health ministry budget is too low, and there are not enough hospitals in the country. He says that two additional hospitals should be built to accommodate the Israeli population– one in the north and one in the south.
Dr. Hagay notes that Israel will soon be facing a shortage of qualified doctors, as the medical professionals who came to Israel in the Russian aliyah of the 1990s begin to retire. Additionally, he notes, while Israel is still considered a young country, the number of people over the age of 70, who require more medical care, is rising. Hagay says that 60% of Israeli medical students are studying for their medical degrees outside Israel, and many do not return. To ensure that these students come back to live and work in Israel, the IMA is working on a plan that will allow Israeli medical students studying abroad to perform their practical medical studies in Israel, beginning in their fourth year of medical studies. As a result, he says, these students will gain a greater understanding of the Israeli health system and will become better integrated into the system. In addition, the Israeli Medical Association is promoting a proposal to shorten medical studies in Israel from seven years to six years, enabling students to begin their residencies sooner and begin working as doctors. This proposal will also help to add more doctors into the system.
The pandemic, says Dr. Hagay, not only affected Israel’s non-medical citizenry but had a dramatic effect on the country’s medical personnel. Many doctors have experienced symptoms of post-traumatic stress and were not prepared for the many deaths that occurred, especially in circumstances where patients seemed to be recovering from COVID and suddenly died. “Doctors had not encountered this before,” he says, “and this caused a loss of confidence in their ability to predict if a patient would recover.” The Israeli Medical Association established a support system for doctors, offering psychiatric and psychological services and subsidizing treatment.
Interestingly, Dr. Hagay says that many of the respiratory illnesses, such as pneumonia, which typically occur during the winter months, have begun to appear in the late summer of 2021, during this fourth wave of corona that the country is experiencing, “There were no winter illnesses in 2020,” says Dr. Hagay. “For some reason, they have appeared now.”
Leah Wapner says that beyond the additional funding that is required for the health system, it is essential that the medical system retains its values of caring for others. “I hope that we don’t lose our values of life, our values of health, and not succumb to values of money, budgets, and finance. I hope that we will find better ways to deal with covid, but covid is not the end of the story. We need to seize the opportunity to learn, make it a better system, get better funding to get more health care workers, use new technology, and most importantly, remember that there is a reason why it is called a caring profession. We need to care for people. I hope we won’t lose our touch, and we will keep our ethics going.”
This article was written in cooperation with Israeli Medical Association