The residents won. The addition of 1,000 job slots for residents, aimed at reducing the number of on-call shifts for each, is an enormous accomplishment that no one even dreamed of, especially not the boys in the treasury.
The added positions will not only reduce their duty shifts, but make their work more humane, professional and sensible and improve patient care. No more horror stories about residents who don't have time to pee during a shift, or who are put in charge of three wards at once. And that's exactly what they fought for.
The Facebook page for Mirsham, the Israeli medical residents' nonprofit organization, has been very busy. On Wednesday, immediately after the historic announcement of the new residents' positions, plus generous bonuses for physicians who move to remote communities or unpopular specialties, the criticism began. We didn't get all our demands met; it's a victory for Israeli Medical Association head Dr. Leonid Eidelman but much is still unknown, wrote the residents.
Less than 24 hours later, the residents translated their fundamental hostility toward the IMA into action, when nearly 1,000 of them tendered their resignations, effective in 30 days. If they go into effect, they will bring the health system to its knees within a few days.
Perhaps it's unpopular to criticize the residents, who genuinely carry the entire health system on their backs and work like dogs to take care of us all - but the truth must be told: Guys, you went too far. It's important to know when to pause, reevaluate the situation and put the gun back in the holster. You won.
So what are they still fighting about? The need to punch a time clock, the duty for specialists to work on-call shifts for the first five years after their specialization training and, of course, salary increases.
Let's be honest: the first two demands have nothing to do with improving patient care or saving the public health system. In fact, these obligations are essential. The specialty on-call shifts - four shifts a month, two of them full and two until midnight, with generous compensation - are important for patients, who will have specialists available in the hospitals 24 hours a day rather than only during morning rounds, and for residents. Opposition to this demand does not exactly send a message of concern for patient care.
As for the time clock, the simple truth is that no one save yourselves, dear doctors, understands why you're whining about it. Punching in and out is a fact of life. The equation is simple: The majority, who work hard and put in long hours, won't be hurt by the arrangement and might even benefit. The minority that leaves the hospital in the afternoon to see private patients will have to change its ways. It's a rare situation that is so clearly a win-win. Is that worth submitting your resignations over?
That leaves only the wage demands, a legitimate issue for any union. The treasury is offering a 38.5% increase over eight years. The terms give considerably more to physicians who work harder - doctors outside the center of the country, in specialties experiencing shortages and those who do more on-call shifts. One can call this a socially just wage structure.
There is a good reason why Eidelman is getting beaten up by his own team. It's not because he turned his back on residents or looked out for senior colleagues. Just the opposite: The contract he intends to sign is a courageous and unprecedented wage agreement that is based on solidarity and mutual responsibility between physicians that takes from the strong and gives to the weak. It is courageous because it calls for a change in priorities among the country's doctors.
In light of the actions of the residents yesterday it is difficult to predict whether the target will be met, but if so we will all benefit from a healthier, more egalitarian health system.
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