Israeli Hospital's Initiative May Revolutionize Patient Care: Letting Public Choose Surgeons for Free

'Revolution' in Israeli medicine will start with general surgery unit at Tel Hashomer and the pilot program will expand to other surgical divisions if successful

File photo: Operating room at Tel Hashomer (Sheba) hospital in central Israel, July 2003.
Moti Milrod

It didn't trumpet its plan in advance, but the Sheba Medical Center at Tel Hashomer may revolutionize patient care in Israel with its new initiative: Giving all general surgery patients the option of choosing their surgeon, free of charge, immediately.

Specialist surgeries at Sheba (such as eyes, urological operations and pediatrics) should follow suit, if the pilot program works well.

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Sheba's general surgery department handles around 5,000 operations a year, from oncological procedures to infected appendixes to hernias.

At the big Israeli government hospitals, surgical patients get whichever surgeon is assigned to their case, and that's that. They cannot pick and choose. There have been isolated exceptions over the years: Rambam in Haifa, for instance, enables people to choose a nose, ear and throat surgeon, and the Ichilov Hospital in Tel Aviv lets patients pick a doctor to catheterize their hearts.

Israelis have universal health coverage. Following legislative changes in the last two years, it is also possible for people to choose their surgeon (at the public's expense, not their own, through "Form 17") if their healthcare fund (kupat holim) approves their operation at a private hospital.

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But that perk remained unavailable at the major government medical centers, which helped drive the booming business in private medical care.

One reason Israelis opt for private care is to get prompt attention, since appointments with specialists often need to be made months in advance.

The second driver was the option of choosing a surgeon (from finite lists), for a fee. Sheba, from now, is the first big medical center to offer the second perk for free.

Although Sheba is a government hospital, owned by the state, this initiative didn't come from the Health Ministry but rather from inside: Professor Yitshak Kreiss, the director-general of the hospital, who led the initiative along with top staff.

While the initiative is not centralized through government, other large government hospitals are very likely to follow suit, assuming the Sheba pilot is successful.

Health officials had been talking about the idea of allowing people to choose their surgeons for decades, but nothing came of it. Now perhaps market forces will push through what politics could not.

Asked how exactly lay-people are supposed to choose a surgeon – based on what information – Prof. Arnon Afek of Sheba explains that the hospital will be publishing details about its surgeons on its website. 

It will take a while before they complete uploading the information on the surgeons' abilities and expertise, he said.

What will happen if everybody chooses the same doctor? "The line for him will be longer," Afek says simply, which means that at least some people will opt for other surgeons.