doctors strike - Orit Stern-Ben Tovim - April 27 2011
Doctors, interns, medical students and their supporters demonstrate outside the Knesset in Jerusalem, April 27, 2011. Photo by Orit Stern-Ben Tovim
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Negotiations between the doctors and the Finance Ministry are scheduled to resume today, with the medical establishment increasingly frustrated at the deadlock of recent months

Doctors across the country launched sanctions and a one-day strike five weeks ago to protest long hours, understaffed hospitals and low pay. Until now, the doctors have refrained from taking more extreme measures in order not to alienate patients and lose their support. Roughly 17,000 doctors are involved in the dispute.

"I regret to say that we are in for a long struggle," Dr. Leonid Eidelman, the chairman of the Israel Medical Association, said yesterday. "There will be an agreement at the end of it, but it's going to take a while. We've been negotiating for nine months already, and we have yet to receive a serious proposal that would change the current situation. I've met many doctors who are angry about the current policy of dragging out the talks. Instead of getting closer, the parties are drawing further apart, and this is a very frustrating situation."

Doctors will renew sanctions today, closing outpatient clinics in general, psychiatric and geriatric hospitals north of Tel Aviv, including Sheba and Beilinson Medical Centers. The IMA said that any appointments made not for treatment purposes, including prescheduled appointments, will be canceled, Surgery and other treatments will not be affected. Strike actions and sanctions planned for the coming week are expected to be announced later today.

"We began this campaign to bring about a significant change in the health care system, and we won't stop until we see it," Eidelman said. "We won't be satisfied with cosmetic changes, and we will continue demanding genuine reform, including meaningful investment in public health care in the coming years. Right now we are trying to prevent any harm to the patients, but we are certainly considering more dramatic steps further down the road."

Eidelman has appealed to medical patients twice in recent weeks, both times in letters distributed by the IMA. "We are aware of the discomfort caused on the ground, and we apologize to the patients, but we don't have a choice because we are fighting on their behalf," he wrote. "There's not a single clause in our demands that wouldn't benefit the patients."

The Knesset Labor, Welfare and Health Committee convened an emergency meeting yesterday, despite the parliamentary recess. Deputy Health Minister Yaakov Litzman told the committee that he will demand to limit the number of hours worked by medical resident in night shifts to 18, a far more radical position than that adopted by the IMA and a significant drop from the current bar of 26 hours. "There won't be a situation in which a resident will work more than 18 hours. I won't sign any other agreement," Litzman said. "Do we let a bus driver drive for 26 hours straight?"

Eidelman said in response that an 18-hour shift "would mean that residents arrive for a night shift at 14:00, and it's unclear how this would work. It means physicians will learn to work on duty but won't learn medicine because they won't interact with other physicians and with senior colleagues. It's a problematic step."

The IMA has demanded that residents not be required to take on more than eight night shifts a month, while the treasury has requested that the night shift quota be increased for specialists - four shifts for specialists in the first three years of their specialization, and three shifts from the fourth year on.

The chair of the Knesset committee, MK Haim Katz (Likud ), asked the doctors to compile an organized list of their demands and to update him on any developments in the negotiations. Katz said that the committee would continue monitoring the crisis closely until there was a breakthrough. MK Rachel Adatto (Kadima ), a doctor herself, said that "there's a tactic of claiming the physicians don't know what they want when they have clear demands." Adatto urged her fellow MKs to mediate the negotiations.

Deputy Finance Minister Yitzhak Cohen told the MKs that the treasury was prepared to address problems in the health care system, including the heavy workloads of residents, understaffed specialties and inadequate health care services in the periphery, but would reject any solution that included introducing private health care services in governmental hospitals.

Rambam doctor attacked

Revital Hoval adds: A doctor was attacked yesterday by a patient who became angry that he had to wait for treatment in the emergency room at Haifa's Rambam Medical Center.

The patient threw a notebook at the doctor and also tried to hit him with an oxygen canister.

After the doctor and the patient struggled briefly, hospital security officials took the assailant, a 51-year-old man from the old city of Acre, into custody.

The hospital said the doctor, who is an internist doing his residency in emergency medicine, was consulting with another physician when the man, who had undergone surgery a few days before and was complaining of pain, demanded to be seen immediately.

The doctors reportedly asked the man politely to wait a few minutes and said they had summoned a specialist to examine him. The patient then attempted to throw scissors at the doctor, and when the doctor called for help, the man attacked him. After the man was detained, the doctor returned to work.

Rambam's chief of emergency medicine, Dr. Shlomi Israelit, said: "It's a miracle that this attack ended without serious injury to the doctor...This is an intolerable situation. We decided not to put the emergency room on strike immediately so as not to hurt other patients."

Rambam CEO Prof. Rafi Beyar said the hospital had instructed the doctor to file a police complaint. "We will demand that the assailant be prosecuted to the full extent of the law," Beyar said.