The crisis in the Israeli medical system has reached a critical juncture. Even as a tsunami threatens to engulf parts of the medical establishment, everyone involved continues to hold fast to positions that they consider just, while defending their own values and conduct. Is the Rashomon-like gridlock destined to descend into crisis, or are the various sides prepared to reach a solution before that happens? 1. The medical residents are the cream of Israeli society. They are young people who studied hard throughout their youth and passed rigorous medical school entrance exams. They seek neither to abandon their patients nor to seek greener pastures abroad. The residents have expressed great anger, bitterness and disappointment with their working conditions and feel insulted by how they are treated. We must embrace them! 2. The Israel Medical Association is the body that has represented the doctors throughout the exhausting negotiations of the past year. The heads of the IMA have attempted to navigate a middle path amidst the demands of the interested parties. They signed the best agreement they could reasonably expect to obtain, and perhaps for the first time ever instituted differential salaries for medical specialists. Get the Israel Hayom newsletter sent to your mailbox! 3. The Finance Ministry, the salaries' director and the budgets department hold the public purse in their hands and are trying desperately to stay within budget. In a dynamic typical of negotiations with doctors' organizations, they offered as much as they possibly could, with the intervention of the prime minister and deputy health minister. 4. The Health Ministry tried with all its might to maintain stability within and strengthen public health care, without being a genuine party to the exhausting negotiations. Health Ministry Director-General Roni Gamzu used his authority to prepared the medical establishment for a state of emergency should the doctors actually resign. 5. The Organization of Hospital Physicians is a new association that came into being as a result of the current crisis. It has been doing everything in its power to influence the situation and perhaps find creative solutions to end the crisis. 6. Is punching a time clock really a threat to doctors' autonomy? I prefer to view it as a kind of emancipation. In any case, doctors work very hard. This way, their work can be quantified and compensated accordingly. And those who split their time between working in the public heath system and private clinics can walk out of their workplaces with their heads held high. Their hours will be recorded, which hurts no one. 7. Quo vadis (where are you going)? Neither doctors nor their employers have an interest in battered patients. Compassion, dedication and love of the profession are fundamental traits of doctors. Belligerent threats should be put aside and a clearly-defined timeline laid out for constructive and sincere discussion. Now is the time for creative solutions. For example, extending the agreement from half a year to a year, while allocating a fair budget for the residents throughout the duration of the agreement - and perhaps even reaching a consensus on changing elements of the agreement. I believe it is possible to end this crisis without leaving scars. Strengthening the infrastructure of the medical establishment, allocating additional funds for reforms being planned by the Health Ministry and hiring additional doctors to reduce the pressure on those already working in the system will help to strengthen the public medical system, which must be preserved. The writer is the director of the Assuta Medical Center and is a former director-general of the Health Ministry.
