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Yael Stein

You don’t have to love Hadassah – but there’s a reason why they are considered the best

You don’t have to love Hadassah. But be fair.

As medical students at Hadassah 20 years ago, we could not fail to notice that most Hadassah doctors were snobs, behaving as if “they always know it all”. Our exams were much more difficult than at other Med Schools. The expectations from Hadassah Medical Students were much higher than our peers elsewhere. Then, we slaved at the departments. And we had long hour training sessions. We hated Hadassah. And Interns at Hadassah worked their legs off…

After finishing this Commando unit Medical School, most of my friends chose not to stay on at Hadassah as residents. They found nice, friendlier, easier places elsewhere, moved to the Center to lead a less stressful, more comfortable life – in which they would not be expected to bring “academic proof” for every given treatment, to cite the 20 most common DD’s for every patient, memorize each Professor’s publications to cite during rounds, and other common Hadassah games that had driven sleep from our eyes as students.

But it so happened that I stayed…

I’ve been clerk at Emergency room admin desk, technician at Sleep Lab, medical/executive assistant of Hospital Director, on-call GP physician and now Resident physician and Researcher.

After 20 years, having made Hadassah my home, I have finally realized WHY these people think they know better than others — that’s because they invest more time, they make more effort, they have extremely high academic and clinical standards of care – and you know what? In many ways they are INDEED better than others elsewhere.

Many many of Hadassah’s Doctors have invested their time and budget into becoming better. These are the top-of-the-class achievers who pushed themselves, did their PhD and 2 post-docs and lab work on the side, besides their residency, and regularly spend their evenings reading latest updates in their field or preparing presentations for journal club. They don’t go to the beach in the afternoons, they’re busy at their “private” lab research, to get an extra paper in – not only out of egotism to get their Professor degree (of course they want it) – but to be BETTER than others and to know more than their peers at the next group meeting. They have the DRIVE

Snobs, but knowledgeable snobs

Some of them have become “book characters” and really don’t see the PEOPLE who come to see them, because they’ve lost touch; but most others give all they can and more than all they have – to give those who consult with them the LATEST, most knowledgeable, most proven, most solid treatment. And if the patient can’t afford it, they find some research budget to fund it for them, or connect them with someone else who can, or find a way behind the scenes to have the person hospitalized and somehow get the treatment under cover of Kupat Holim Obligation – or at Hadassah’s expense.

Hadassah doctors have a problem – they have extremely high standards, many times too high. If they know some newest scientific invention may help their patient, they won’t find inner peace until their patient gets it, whether Hadassah covers for it or not. I have often seen Orthopedic surgeons, residents and seniors, up at 2:00, 3:00 or 4:00 AM during shifts, fighting for Operating Room space because their patient is already 48 hours without surgery and “articles prove their outcome may worsen”; Hematologists looking for newer and newer protocols; Pediatricians fighting for anything that may save the child, Gynecologists fighting to spare a woman’s womb despite massive life-threatening bleeding or try near-hopeless intra-uterine sci-fi treatment; and anesthesiologists insisting on another pre-Op cardiac study, expensive blood test, or MRI, to ensure that their surgical patients will be safer than safe or that their ICU patient does not miss any possible diagnosis.

Because the Hadassah NORM is to “do everything for the patient.”

I’ve seen specialists at Hadassah’s Angiography department coming in night after night, many times NOT being paid for these extra hours, due to the impossibly high costs of catheters and other devices they have free access to use — not half of the costs covered by Kupat Holim obligations. And have no doubt, it makes no difference who the patient is – be she or he of any origin, ethnic group or paying background – many times the specialist hardly glances at the patient, so intent are they on their job. Not that that’s necessarily good, or nice – but it’s a fact. When these doctors are at it, Hell will cool before they give up on a blocked artery, they will use 15 ridiculously expensive catheters until they open that blockage and save the patient. That is the Hadassah Norm of excellence. They will complain, yell and scream, and get the job done brilliantly. Relentless OCD Perfectionism.

And tomorrow they’ll come in and do it again, for some poor Trauma patient without Medical Insurance – because this is Hadassah. And yell and complain again – and do it brilliantly again.

And this is where a lot of Hadassah money is invested. Because besides all the Sharap stories everyone likes to wave — Hadassah gives relentlessly expensive BEST medical treatment to whoever needs it — many of those being YOUR RELATIVES, including those who cannot afford private care. I have seen it with my own eyes, regularly, day after day.

It’s not economically smart, but Hadassah Norms for excellence are relentless, and people who work here, live here, think here – are trained to think in this super-high standard way.

That is what makes Hadassah unique.

Unlike Kupat Holim or Government Hospitals demanding doctors to avoid use of expensive drugs to save money, Hadassah doctors have to JUSTIFY their use – but if justified, never will a patient, any patient, be refused the best treatment.

That’s why Memebers of Knesset bring their relatives here.  That’s why Prime Ministers and Presidents always come to be treated at Hadassah — they’re not dumb, they understand where they will get the Best Standard of Care.

There are too many lies, gloating, envy and grudge over the Hadassah crisis. Be fair.

Few Hadassah doctors indeed make a super-large salary, but they have worked hard for it, and 90% do not. Some nurses are less cordial, surely some staff members are snobbish and think they deserve more — but many of them also give a lot. The wait at the Emergency Department is impossibly long. Some Professors are less polite to patients. That’s frustrating, yes. But ALL doctors here are committed to super-high work standards. Because that’s the Hadassah way. Those who don’t like it, usually find they don’t fit in, and leave.

Your loved ones will not get this Norm of treatment elsewhere in Israel.

Do not give your hand to the ruin of Hadassah. The Hadassah women’s fund is not supposed to pay our electricity and water bills, or fund catheters and syringes! Hadassah staff have been absorbing and covering for excessive medical treatment for Jerusalem citizens and other citizens of Israel and abroad for too many years. The State of Israel MUST participate and cover some of the costs.

Perhaps you think that giving super-standard treatment is not good. Would you rather have mediocre treatment for your loved ones? The perceptions about staff overpay are wrong. Much of Hadassah’s huge costs are due to its high standards and uncovered expenses on healthcare for all.

I am proud to do medicine the Hadassah way. But like others here, I have been doing much of this FOR YOU at my own expense for too long.

About the Author
Dr. Yael Stein is a resident physician and researcher at the department of Anesthesiology at Hebrew University - Hadassah Medical Center. Her past experience includes various research, social and entrepreneurship roles, including: Researcher at the Unit of Occupational and Environmental Medicine, Co-Founder of the Jerusalem Center for Genocide Prevention, and past Chairperson of Ganei Haim Association, Jewish Pluralistic kindergartens in Jerusalem.