Israel’s physician shortage has become so acute that the Civil Service Commission is allowing government hospitals to hire retiree doctors back into practice. Desperate medical centers are happy to have them, and to pay them well.
The new directive, included in a letter sent to hospital heads two weeks ago, targets specialties with the greatest shortages, including psychiatry, internal medicine, emergency medicine, rehabilitation, nuclear medicine and trauma.
About 100 posts in psychiatry are unfilled at government hospital, with a similar shortfall in clinics and hospitals operated by the country’s health maintenance organization, according to most estimates.
“At every psychiatric hospital, about 10% to 20% of psychiatric positions are unfilled, and in the community [clinics] the situation is even worse,” said Prof. Yechiel Levkovitz, the head of the Be’er Ya’akov Mental Health Center and head of the psychiatry department at Tel Aviv University’s medical school.
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“The profession has suffered in recent years from a poor image despite the potential there now is to combine the major advances in brain research with talk therapy.”
The shortage has not only hurt the quality of services psychiatrists can provide but has exacerbated the problem of teaching a new generation of psychiatrists, he said. “If new people don’t join the system there won’t be anyone to train the young generation because when we have to contend with such a severe personnel shortage, there isn’t enough time for training.”
As it is, many hospitals have contended with the overall doctor shortage in recent years by convincing physicians not to retire when they could. Doctors are allowed to remain at their jobs until age 70 and continue to accumulate more pension rights.
At Sheba Medical Center, Tel Hashomer, Israel’s biggest hospital, about 150 doctors of retirement age remain on the staff — those up to age 70 working half-time and up to age 73 one-quarter time. A few have even stayed on after age 73.
“At age 67 doctors are still strong, they contribute a lot and are very experienced,” said Prof. Yitshak Kreiss, Sheba’s director general. “Many of them provide unique medical services and continue to teach students. Nothing changes in a 67-year-old when he wakes up and he is 67 and one, so why not continue working? “
The one rule Sheba imposes on them is that they can’t fill managerial positions. “It’s important to advance the young,” said Kreiss.
What is new is not the employment of older physicians, but that the Civil Service Commission is now letting government hospitals hire them back after they have officially retired.
To lure them back, the commission is allowing hospitals to offer them salary and conditions identical to what they enjoyed just before they retired — which usually means they resume getting the highest pay of their careers. The generous terms reflect how desperate the commission is to fill jobs.
In addition to the specialties with acute shortages, hospitals in Israel’s north and south are contending with shortfalls across the board.
“Where there are problems nationwide, we in the periphery feel it even more, “said Dr. Erez Onn, director of Poriya Medical Center in Tiberias. “Our ability to persuade a doctor from the center [of the country] to come to the north with all the promises for quality of life is almost zero.”
Hospital in the periphery tempt applications with offers of managerial posts and are authorized to make 500,000 shekel ($134,000) signing bonuses. But, said Onn, it’s not enough to compensate doctors to give up lucrative private clinics and barely covers the costs of relocating.
Onn said he hoped approval to hire retired doctors would help alleviate the problem. “If I haven’t been able to hire an oncologist for two years and I can continue with some that has completed his post as a unit head, that gives me breathing room,” he said.
That said, he added: “It’s a temporary solution, an option of new choice.” He said the real solution was to allow hospitals like his to offer better packages to doctors, including help for spouses to find employment and help in schools for their children.