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The Israel Medical Association is launching its first strike in a decade at 7 A.M. tomorrow.

The 48-hour doctors' strike will include all public general and psychiatric hospitals, as well as Hadassah University Hospital and Shaarei Zedek Medical Center in Jerusalem.

The Leumit and Clalit health maintenance organizations, whose patients include 61.5 percent of Israelis, are launching a strike this morning, and have yet to decide whether to strike tomorrow, too.

All medical institutions on strike will be operating in weekend mode, non-urgent surgery will be postponed, and specialists will not be receive patients. Emergency rooms, maternity wards, in-vitro fertilization clinics, and dialysis and oncology departments will receive only urgent cases.

The IMA instructed hospitals to have only doctors who are on overnight duty or on call work tomorrow.

Yesterday, IMA representatives met with Finance Ministry officials to discuss malpractice insurance for physicians, one of the issues that has been brought up in the parties' eight months of negotiations.

The Health Ministry called on the IMA and the treasury to continue negotiations, which will be conducted parallel to the strike. The deputy finance minister and the Health Ministry director general will be involved.

Yesterday, some 17,000 physicians began informing their patients that they would have to postpone visits, treatments and non-urgent operations. In most cases, no new dates were set.

Each hospital will have an exceptions committee with an anesthesiologist, the chairman of the local physicians committee and another surgery-related physician, which will hear requests to urgently reschedule treatments postponed due to the strike.

The head of the national exceptions committee, Professor Azriel Perel, head of the anesthesiology division at the Sheba Medical Center in Tel Hashomer, said the committees were already hearing exception requests.

"A strike is unnatural for a physician entrusted with the health and life of the public and the community," said Dr. Radi Shahin of the Rebecca Sief hospital in Safed. "We have come to this state due to helplessness and desperation. It's a protest against doctors' impossible working conditions. Every hospital is short on physicians, and many of the best go abroad and never come back. They lack time to teach interns or to expand our knowledge, and the long working hours have an effect. The public needs to know that this strike is for them, for improving working conditions and increasing the number of doctors at hospitals, and getting budgets for more equipment and more hospital beds."

The hospitals yesterday held meetings to prepare for the strike, and Hadassah and Shaarei Zedek canceled medical treatments scheduled through their private practices.

"We've haven't gone on strike in nearly 11 years, and the treasury used our commitment to leave the healthcare system hanging," said IMA chairman Dr. Leonid delman. "This system is crumbling."

Eidelman sent warning letters to the authorities over the weekend, telling them the negotiations were at an impasse.

The last great strike took place in 2000, when Ehud Barak was prime minister. It lasted four and a half months.

There are large gaps between the stances of the physicians and the treasury, and they start with the basic statistics on how much physicians actually earn. The treasury claims physicians earn NIS 26,322 a month on average, while the physicians say the figure is NIS 24,000, including a NIS 7,000 base salary, NIS 5,500 in benefits and NIS 11,500 for overtime.

The physicians are demanding their hourly wage be raised by 50 percent; the IMA says the current figure is NIS 42. They want a foundation for retiring physicians, a quarter of whom currently receive a pension of less than NIS 4,500 a month. They want the number of slots for physicians updated for the first time since the 1970s, and they want higher salaries for physicians in particularly underfunded fields, including hematology, pediatric oncology, surgery, geriatrics and anesthesiology. They also want a lighter workload, and want appointments with family doctors to be 15 minutes, not 10 or 12.

The treasury so far proposed two agreements - a five-year contract that includes a 5-percent raise, plus a 6.5-percent raise for physicians in the periphery and in the above fields; or a 10-year contract with an 8-percent raise for all physicians and a 10.4-percent raise for physicians in the periphery or in the above fields.