Drowning in 'Absurd' Forms, Israel's Family Doctors Are Crying for Help

Myriad of patient well-being forms take up physicians' time, making it difficult for them to fulfill their duties.

A pile of forms attesting to patients' good physical and mental health sits on Prof. Shlomo Winker's desk. Winker, head of the Israel Family Physician Society, had asked the society's members to send such forms to him after he received several complaints from members that not only has the number of such forms grown unbearable, but they are also unbearable invasions of patients' privacy.

The forms are myriad: For example, one from a company wanting to take its employees to a Dead Sea hotel, another before allowing a prisoner a conjugal visit, and one asking the doctor's opinion as to the life expectancy of a couple who wanted to adopt a child.

"When I am asked about a patient's psychological stability, must I report that he takes psychiatric drugs? After all, more that eight percent of adults are taking them."

The filling out of such forms also takes up physicians' time, making it difficult for them to fulfill the last labor agreement they signed, requiring them to see five patients an hour.

The forms also place heavy responsibility on the doctor, including possible legal repercussions.

If employers of people like kitchen workers and security guards require certificates of good health, occupational physicians should issue them, not family physicians," Winker says.

Instead of the certificates, the society wants its members to sign a computer-generated print-out of the patient's medical information. "If organizations can't understand the print-out, let them hire a doctor to explain it to them." Winker said.

One such certificate that is angering family doctors is now required by the Wingate Institute and teachers' colleges.

"Especially now that psychiatric hospitalizations are not the responsibility of the health maintenance organizations, the family physician does not even know a person's history of psychiatric hospitalization," Winker said.

He has asked the dean of Tel Aviv University's Faculty of Medicine, Prof. Joseph Makori, to withdraw the requirement for such certificates, and the issue has come up for discussion in the committee of medical school deans. Nursing school officials at Kfar Sava's Meir Hospital told Haaretz this week they were going to reconsider the requirement in light of the society's position.

Spokesmen for Wingate Institute and the Seminar Hakibbutzim teachers college said the demand for a certificate of mental and physical health comes from the Education Ministry. The ministry responded that the certificate was essential for future teachers "because the ministry must recognize certain problems that have an effect on teachers' work, such as outbursts of anger and mental disturbances."

Winker uses the word "absurd" to describe the state adoption service's form that requires family physicians to predict the life expectancy of patients.

But the medical adviser to the adoption service, Prof. Meir Brezis says: "These are very sensitive cases of couples who are childless, sometimes due to illness, who want to adopt, and it is important to assure that they will be able to care for the child in the future and not meed numerous medical treatments, so the child won't undergo two separations, one from the biological parents and another from the adoptive ones."

However, at a meeting in early July of family physicians, Brezis and the head of the Health Ministry's general health department, Dr. Michal Dor, the latter supported Winker's position. Prior to the meeting, the head of the adoption service, Orna Hirschfeld, said she would consider changing the form, which has not been updated for several years.

The Social Affairs Ministry, which is responsible for the adoption service, said the good of the child was the focus of the adoption process and the state, as temporary guardian of the child to be adopted, was responsible for assuring the fitness of the adoptive parents, according to the Hague Convention on the Rights of the Child.