Anyone who is familiar with the hospitals in Israel during the interns' shift hours, ie from 16:00 to 07:00 the next day and every weekend, knows that these are more dangerous and fragile times for medical treatment.
During these hours, which are in fact most of the day, the specialist doctors have already left the hospital - and the patients are entrusted with specialist doctors, including doctors at the beginning of the specialization.
They are the ones who alone should examine, diagnose, treat and sometimes even operate on patients, some in critical situations and in immediate danger of death.
In protest of the length of the shifts: the heads of the interns' organization submit the letter of mass resignation.
Photo: Dan Lavie
It is true that in addition to the interns, a minority of the departments also have specialist doctors at night, and it is also true that there is a regular set of senior doctors on standby - and for that they receive an additional fee. Sometimes they are called out of their homes to apply their experience and long-standing expertise to treat patients in a difficult situation, but sometimes the specialist doctor is "unpleasant" to wake up and call the senior doctor - thus exposing himself as insufficiently skilled. There were also quite a few cases where the senior doctor refused to come or was very delayed in reporting for treatment.
This method, which has always been used in all hospitals in Israel and in many hospitals around the world, has already caused casualties among patients.
They were treated or operated on by specialist doctors, who were very dedicated, but did not have enough previous experience or time and patience to treat patients severely.
In a long line of internal investigations in the Ministry of Health and in court rulings, this difficult systemic problem has arisen again and again, but to date the Ministry of Health has done very little to solve or reduce it.
The very partial attempts to treat the problem have been mainly in the maternity wards and emergency rooms.
Think small
This method works very poorly, and leads to severe and lasting damage to the lives of patients and the chances of recovery and survival of thousands of Israelis.
At the same time, it leads to severe attrition of interns, who work long and continuous shifts, while human life is constantly entrusted to them, and it is well known (all doctors and directors of hospitals and the Ministry of Health learn) how lack of sleep causes severe mental and physical harm.
It leads to lack of concentration and mistakes in the actions of the person who does not sleep, and in this case: the attending physician, surgeon, obstetrician or catheter.
A fundamental change is needed.
Health Minister Horowitz, Photo: Eyal Margolin / Ginny
Hence, the overtime hours of the interns, and the doctors in general, are just one of the problems in the way the hospitals in Israel operate.
It is worth noting that all parties to the struggle - specializing in the prescription organization, the Ministries of Health and Economy and the Medical Association - do not talk at all about reforming the way hospitals work, and the need for senior doctors to be available in hospitals 24 hours a day.
The struggle was decided
It is not for nothing that they are not talking about it - because in fact no one wants such a reform.
Not the interns, who in a few years will become experts, not the experts and not the senior executives.
The reason: this will mean a dramatic change in the way they work in hospitals.
Tired doctor - poor treatment.
Emergency at Barzilai Hospital, Photo: No credit
The struggle of doctors who specialize in shortening shifts has already been effectively decided.
This week, Minister Horowitz became the first in the history of the Ministry of Health to set and courageously lead the reform that will gradually shorten doctors' shifts in Israel by 2026. On the other hand, the specialized doctors who are members of the organization claim that Horowitz broke his promises. A symbolic and declarative act.
However, all parties, including the specialist doctors, no matter how militant, and the Ministry of Health, do not intend to carry out a vital reform of the work of hospitals in Israel, which will save thousands of Israelis and ensure better and safer treatment.
Everyone, on purpose, is only talking about the length of shifts and junior doctors, trout-eyed and exhausted, whose health care system has been ignoring their distress for years - which is also the hardship of us all.
But this is just one of the problems with the way we, Israelis, receive medical treatment in hospitals.
