Director, Emergency Services, Bikur Cholim Hospital
Some non-medical issue that will affect your care —
based on letters I received from readers. There has been
controversy in the literature about the long hours that
doctors put in. In my day we worked 36 hours straight and
sometimes 80-90 hours a week. The reason for this bone-
crushing schedule was the claim of continuity of care, which
was felt to be the best for the patient and the best for
teaching student physicians. However, this produced tired
doctors who made mistakes and grew to be uncaring and
insensitive.
Then Libby Zion came to an emergency department in New York
City and was given two medications that were a fatal mix. Her
father was not satisfied with getting money — he wanted
change and the New York legislature was forthcoming. Now
residents work less hours, but it is still a grueling
schedule.
In Israel residents work very hard for 24 hours straight, but
are guaranteed one day off a week and the day after being on
call. Usually this amount of sleep is not enough. Now an
article in JAMA noted that concentration fell in tired
physicians until they acted like someone who drank alcohol. I
am in favor of limiting these hours — pilots and truck
drivers have limitations on their work schedules.
Dan Naveh, the Israeli Minister of Health, was interviewed
and said that the state of our health care system is at an
all-time low. Despite the agreement to add more money to the
system, there remain problems with lack of hospital beds,
medications that are not in the health basket cannot be
bought by most patients because of the steep prices, there is
a lack of personnel such as doctors and nurses, and violence
against doctors. (I myself was a victim of such behavior.)
Kupot Cholim are making all of us pay more out of the
pocket.
Mr. Naveh is working on a plan to reverse this situation, but
the political realities do not favor this — health is
just not important enough. Mr. Naveh also complained that the
extra violence is a result of the rising violence in the
society as a whole. A sad commentary if you ask me. Write me
in care of the Yated.
A message from GlaxoSmithKline, sponsor of this
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