The Doctor's Strike

Today ends the two day warning strike of Israel's physicians. It's not a complete strike since for ethical reasons we must work a weekend schedule. I didn't strike because as luck would have it, I was on call.

The deputy minister of health Ya'acov Litzman has come out against the strike and the union and has tried to paint us as money hungry and blood thirsty. In an interview to the media he stated that during the last strike 11 years ago, less patients died. Strictly speaking, the latter claim is true. Furthermore, it has been true in every physicians strike everywhere else in the world. The reason for the drop in mortality is obvious and clear: During a strike only emergency operations are performed. The vast majority of operations are elective. So when these operations are postponed the accompanying morbidity and mortality are as well, until after the strike. So Litzman, strictly speaking is correct. What makes Litzman's comment troubling is his implication that we harm our patients either intentionally or because of malpractice. So I will say it loud and clear, the deputy minister of health, Yaacov Litzman is a horse's ass.

I now address his first claim, that we are money hungry. True, none of us live under the poverty line, none of us have trouble feeding our families. But the monetary compensation is woefully inadequate for the years of training, the separation from our families, the brutal call schedule, the personal and professional responsibility, the personal price we pay in our own health for working under such overwhelming stress. My friends in other professions were at the peak of their careers ten years before me. Such a "late" start directly affects our pension in terms of accrued benefits. So yes, we demand higher pay that will reflect the investment in time and effort that it takes to become a physician.

But we have other demands, which are really the primary issues at stake in this strike. Because the treasury ministry is squeezing the health ministry dry. We demand that more beds be alloted to serve the growing and aging population. We demand that the formula for physicians per bed be recalculated to alleviate the shortage of manpower. But this formula must be recalculated for the nursing and non-medical staff as well, because there is a nursing shortage no less acute than the physician shortage. And finally, we demand that the hospitals and medical services in the periphery be given priority in manpower and funds so that we can provide the same level of healthcare as in the center of the country.

I have no doubt that the talks will break down, and that next week the strike will be resumed. I have no doubt, because of our experience from the previous strike, when we foolishly agreed to not strike for ten years in return for binding arbitration. The "binding" arbitration dragged on for 8 years and even then, treasury didn't pay up. It took another two years for the courts to force treasury to uphold their end. During this time the public health system has become more ill.

This time, hopefully, will be different. I believe our current head of the Medical Association is more savvy than his predecessor, and we won't make the same mistakes.

For some sense of proportion, many countries, including the United States are suffering physician shortages. I direct the reader to Life in Medicine: A Reality Check by my blogging colleague Anesthsioboist.