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You will not believe how dangerous the public health system in Israel is

Dr. Udi Frishman believes that the Ministry of Health has been fighting private medicine for years, and that this war is taking a terrible toll on the health of us all.

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• private medicine

• Public medicine

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Tuesday, 14 September 2021, 15:30 Updated: 15:35

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Each physician's private cemetery

to a public hospital has three functions under this order: training and guidance, research and development, and patient care.

The main role of the public hospital is to transfer the young doctor, who has just finished medical school, the period of experience, practical training and accumulation of experience.

The public hospital is the only place the doctor can experiment and get better.

And during this experience, mistakes are inevitably made, sometimes fatal.

Even if you are supervised, and even if you do everything so that mistakes do not happen - they happen.

There is no doctor in the world who does not have the same little private cemetery of his with whom he goes to sleep at night, the same patients he knows he could have saved, or whose mistakes brought about their deaths.

I too have been carrying my dead with me, for decades.

It's hard to write my own personal stories, which I'm writing here in writing for the first time.

But I think it's necessary, and I chose to introduce readers to two of them.

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I do not know what her name was. An elderly patient who was lying in the surgical ward of the hospital with bleeding in the stomach. At the same time to treat such cases a Zonda patient would be put into the stomach and rinsed with ice water. I was then on one of the first days of the experiment, perhaps even on the first day; A very young guy, completely inexperienced. I walked around the ward with the head of the ward and the entourage of doctors, and the senior doctor told me: Take, take care of her. "What should be done?", I asked, and he said briefly that I should pump ice water from the vessel with the ice and replace the water from the stomach with ice water. I will not expand on the explanations. I, a little overwhelmed and not reset, try to do what I am told, without understanding in depth what I am doing.

At one point the probe was probably pulled out so that the ice water I was flowing into the lungs of the poor woman, who was then fuzzy or anesthetized. At the end of the visit to the ward, it turned out that the patient had died: she had probably drowned in the ice water that had entered her lungs. For more than thirty years this case has accompanied me and not let go of me.

The second case was when I was alone on night shifts in the emergency room, at the end of the internship or at the beginning of the internship.

At about two or three in the morning, a man with chest pain arrived at the emergency room.

The senior doctor went to take a nap and the patient arrived.

I made him an electrocardiogram and studied the chart: it seems right to me. I sent him X-rays do chest X-ray. The man went rays, and at the entrance to his heart went arrhythmia and died on the spot.

In retrospect, when I looked at EEGs a senior physician who arrived in panic turned out To me that perhaps it could be seen as signs that indicated problems.

If I had been more skilled it would have been possible to start treatment, and I certainly would not have had to send him for an X-ray on foot and alone, without supervision, without an accompanying medical staff.

My inexperience turned out to be fatal.

(Photo: Business Library Publishing)

Sad and perhaps a little horrifying to say but these are not exceptional cases. In public hospitals there are interns and interns at the beginning of their careers, or young doctors, and they inevitably make mistakes. But it is the role of the public hospital that doctors need to gain experience somewhere.

But if you can, and if you do not have the connections and personal acquaintance that will take you out of the risks of the public hospital, you may very well want to go for private treatment.

The choice of doctor is also significant in another aspect: empathy. For a patient who is about to undergo a complex surgery that may not have come out of it - the empathy of the doctor treating him, the sense of security, the personal connection, has a meaning that may affect the results of the surgery and recovery.

This is also another reason why people want to choose a doctor, something that is almost impossible to do in public hospitals today, where everyone is busy, everyone is "running", and the personal connection is often pushed aside.

It is important to emphasize: medicine in public hospitals as a whole is good medicine, and patients are not experienced.

But there are world orders that cannot be changed, and alongside the many advantages of the public system there are also disadvantages that we must know and come to terms with, such as the fact that instruction and training is only done in a public hospital.

When Olmert flew to New York

So far we have talked about the importance of choosing the timing and choosing the doctor. The choice of the medical center, the hospital, is also significant. Hospitals are not the same. Some have more equipment, and better equipment, and some have less. Some have more experience dealing with a specific disease, and some have less. Some have a good team, and some have an even better team. The right to choose a hospital gives you better medicine, and this can be fully realized only in private medicine. This is evidenced by the story of former Prime Minister Ehud Olmert.

In October 2007, the Prime Minister of Israel, Ehud Olmert, convened a press conference. "I found the first signs of prostate cancer," Olmert told the nation, but reassured that it was a microscopic tumor that could be easily removed. In June 2009, Olmert flew to New York, where he underwent surgery at a private medical center.

Why did Olmert take a lot of money out of his pocket and fly to New York, and not perform the surgery in Israel, under the auspices of the State Health Insurance Law? The answer is: Da Vinci. It is a robotic surgical system that came into use in the early 2000s, allowing for surgeries with minimal intervention.

Prostate surgery has two possible, relatively common complications: impotence, and incontinence (urinary incontinence). When this happens - needless to say it is very unpleasant. Surgery with the help of the robot has several advantages: there is no need to open the abdomen, recovery is easier and faster, the surgery is more accurate and most importantly: the likelihood of those complications is lower. The choice of medical center turns out to be of great significance, given the simple issue of the equipment that each center holds.

But possession of equipment is not the only thing. At that time, there was already such a robot in the country, at Hadassah Hospital. Olmert could have been operated on by Da Vinci in Jerusalem. Why then did he - and not only he, but many others in his condition - fly abroad?

What bothered Olmert was the same learning curve we dealt with at the beginning of the chapter - and it is also true of an entire medical center.

For every advanced technology, for every new form of treatment.

Both the doctor and the nurse and the rest of the medical staff have a significant difference in the level of skill between the date of use and the situation that arises when enough experience is gained.

In the beginning, the risk of complications and problems is naturally high.

Thus, even if the doctor in Jerusalem returned from internship and experience abroad, the rest of the treating staff did not gain the same experience as he did; The

choice of a medical center that possesses innovative technology, and has already had time to experience and specialize in it, is a choice that is often invaluable.

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