Eliana M. Aaron

The Dangers of Mixing Medicine and Politics

Physicians and politics should never mix

The Israel Medical Association chairman, Dr. Zion Hagay, wrote a letter to PM Netanyahu warning that the physician strike for 2 hours last Wednesday would be the beginning of their actions against the judicial reform. Meaning – more strikes should be expected. The IMA, by taking such a stance, has entered an ethically problematic area because this affects Israel’s already suffering patients.

The IMA had representatives go on the news outlets to say that patient care would not be affected by the strike, but even a strike for 2 hours impacts the population. The strike and its message of “everything is fine, no one is impacted” shows a disconnect with the millions of people who actively use and need the national health system. It is well and good that emergency rooms, chemotherapy, and emergency surgeries can take place during a strike, but translated to real people this means they are not actively killing people. The other 99% of people who need care are not considered.

In many parts of the country, patients wait for months to see specialists, to have urgent tests, to have consultations for suspected cancers or other major medical evaluations. Some of our clients are unable to book appointments with family doctors for acute issues, like minor injuries, coughs, infections – for 2 weeks. I am not talking about the periphery but parts of the Sharon and Center areas. In one case, a woman with an acute pelvic infection had to pay privately to see a doctor because no gynecologist or even family doctor could see her for 2 weeks. There are also many geographic areas with acute shortages of family doctors who take new patients, making it difficult for patients, especially olim to find primary care doctors.

The OECD has reported for decades that Israel faces the biggest challenge ever – the impending and current physician shortage. There are not enough doctors in Israel and the situation is getting worse as the next committee to solve the problem meets (there have been over 20 such committees in the last 2 decades). Unnecessary strikes continue to harm patients.

Pushing off “non-urgent” appointments amounts to a stab in the back for the real victims: the Israeli public who doctors have sworn to care for. No one goes to the doctor for fun. Everyone goes because they have medical needs. And many have already waited for weeks or months to get the appointment, and delaying it causes harm to the patient. “Do no harm” is the first rule of the Hippocratic Oath of doctors. And pushing off patient care so that doctors can officially join political rallies that disrupt the country, and even disrupt the ambulance routes to hospitals, is hypocritical.

Here is some news: Unlike what Dr. Hagay said – Doctors are NOT the “wall shielding democracy”, they are the healers treating the population. The wall shielding democracy are the public and the their democratically elected representatives. The current judicial system scope is currently well beyond the scope of power and influence compared to other democratic countries. And that is not democratic. The balance of power in a democracy must come from elections. Doctors can vote. They can even take vacation days to attend rallies. Physicians can even strike when appropriate.

When are physician strikes appropriate?

Limited physician strikes are appropriate when conditions for physicians are deemed dangerous or sub-par. They deserve to be paid well, they deserve humane working conditions, they should be given the freedoms to care for their patients, hospitals and kupot holim should be managed well and fairly, and if they are not a limited physician strike is appropriate because these things affect patient care.

What is inappropriate is trying to enter the political arena and gaining headlines by falsely assuring and spinning to the public that they are not affected by it, by neglecting their patients because of government legislation that is so far removed from patient care and their own practice as doctors.

Step off the soapbox, Dr. Hagay and IMA. Stop bullying and victimizing your patients, keep your political opinions away from your patients’ health, and please continue to care for the Israeli public as you have sworn to do. Leave politics to the politicians.

About the Author
Dr. Eliana Aaron has a doctorate in health policy, leadership, management from Yale University. She is a family nurse practitioner, director of EMA Care, and an expert in health policy.
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