The medical system is broken after all

I have often bragged about how great the medical system here is in Israel. There’s no problem with people not being able to get insurance and care is on a very high level. For regular doctor visits, I’ve never had …

I have often bragged about how great the medical system here is in Israel. There’s no problem with people not being able to get insurance and care is on a very high level. For regular doctor visits, I’ve never had to wait more than a day or two for an appointment, and there are drop in hours every morning at the clinic where my physician works.

All that efficiency was for routine care, however. When you need to see a specialist, that’s when trouble sets in. And, recently, we’ve run quite afoul of the system.

My daughter, Merav, fell over the summer and hurt her knee. Her family doctor thought it was an inflammation and sent her for physical therapy. But the first appointment she could get through Maccabi, our HMO, wasn’t for two months. And going privately is upwards of $100 a session, so not a good long-term option.

Over the course of the waiting for physical therapy, her knee grew steadily worse. She went back to her family doctor who, this time, gave her a referral to an orthopedist. She got in there pretty quickly – only two weeks this time – and he sent her for a bone scan which determined that she had a torn meniscus which needed surgery.

But first she had to go back to the orthopedist to get a referral to a knee specialist. Problem: he was busy and Merav’s knee was really hurting now and also preventing her from participating in activities at her mechina (see my previous post on what that is).

The next available appointment with a knee specialist at Hadassah Hospital (which works tightly with our HMO): another two months. So we called around and found an appointment sooner at a different hospital. They needed a bunch of paperwork from the HMO, which can only be done by fax (hey – medical institutions: ever hear of the Internet?)

But we did it and arrived at Sha’arei Tzedek Hospital for an 8:20 AM appointment. We figured it was one of the first of the day so we should be out pretty quickly. But the knee doctor wasn’t there yet. “I don’t know why they book these appointments so early,” the secretary said with unsurprisingly Israeli brusqueness. “They always do their rounds at this time.”

But after an hour of waiting, I was getting concerned so I braved the secretary’s scorn and asked again. Turns out that the doctor was called into emergency surgery. They were waiting for a replacement. It would have been nice if they had told us (especially since now the waiting room was now quite full). When would the replacement arrive? No one had any idea.

After two hours, we finally saw the doctor who, in five minutes, confirmed what we already knew: it was a torn meniscus and Merav needed surgery. Duh. “So let’s schedule it,” I said. Not so fast. “First you need a pre-surgery appointment with the anesthesiologist who will take some blood,” he replied. Ensuring that there will be no complications is a good thing. So, when would that appointment be? Another two months. And how long after that until the surgery? He didn’t know. “Ask at the desk.”

We asked at the desk. “Ask the doctor,” a different brusque secretary barked back. “We already did,” Merav told her. “Well, I have no idea,” she replied. I remembered then that the doctor had suggested we could pay privately and that might speed things up. “Can you help us with that?” I asked. “Only Dr. Litvick can do that,” she said. “And he’s the one who’s still in emergency surgery.”

She gave us Dr. Litvick’s secretary’s number (another secretary to sweet talk unsuccessfully) but, given that we had been in the hospital now close to three hours, I figured maybe he was done with the emergency. He had an office on the 7th floor. Up we trudged.

“He should be back in 15-20 minutes,” his secretary said. “Take a seat.” And there we sat for another 45 minutes. We were both hungry and tired. “Let’s go,” I said finally to Merav. “We can always call him.”

We left and Merav, who had “checked in” on Facebook while we were waiting, ran into three friends who were volunteering at the same hospital. She chatted for a while and then we decided to give Dr. Litvick one more chance.

He was back, but with a patient. We waited another 30 minutes before heading to the door a second time. “Just a second,” the secretary said, and pulled the doctor out to speak with us. His answer was further dispiriting. Our HMO wouldn’t let him take any patients privately in Jerusalem. But he could see us in Tel Aviv. And he could probably get Merav an appointment…in a couple of months.

Total time in the hospital: close to five hours. Success rate: 0.

I wish I could tell you that we have an answer, but we’re kind of back to square one. Jody is picking up the ball now and will try to figure out how to pay privately with a different doctor in a different hospital in Jerusalem. There’s one specialist who comes highly recommended. But when we tried to make a “regular” appointment with him, his first available slot was (wait for it) June 2012.

When, over the summer, the social justice protesters decried the medical system in Israel as “broken,” I scoffed. No more. We will ultimately prevail, I’m sure, although it may take more crook than hook. As always, I’ll keep you posted.

About Brian Blum

Brian has been a journalist and high-tech entrepreneur for over 20 years. He combines this expertise for ISRAEL21c and Israelity as he writes about hot new local startups, pharmaceutical advances, scientific discoveries, culture, the arts and daily life in Israel. He loves hiking the country with his family (and blogging about it). Originally from California, he lives in Jerusalem with his wife and three children.
  • Jill Shames

    Totally unacceptable! When this kind of thing happens, and it definately does, it is becuase the outer edges of the system have not advanced to where the central elements are trying to lead them.

    Part of the problem is too many people in these systems are “roshei katan”, unable or unwilling to think broadly. For instance, since I live in a certain city, they will insist on scheduling an appointment for me with a doctor in the same city months from now rather than checking to see if a doctor in the neighboring city has appointments DAYS from now.

    I strongly support calling Macabi and advancing via phone (have coffee, a bagel and a good book ready) until you reach someone who is serious about customer retention/customer service. Keep telling your story and asking for a supervisor until you reach someone who will part the waters of Bureaucratic Nonsense for you. I have had good luck with this in the past and wish you and Merav only the best.

  • Dr. Reuven Rosenberg

    Dear Brian: Thanks so much for pointing this out to the public. As a chiropractor and integrative practitioner I hear the frustration from patients who have been through the medical ringer. This is not to point a finger at the doctor’s who are mostly very fine people and who genuinely care about their patients. The western medical system is broken. People are not getting the results they need in a timely manner. In the meantime there is frustration, pain, and an interruption from the activities of daily living. Often the chiropractor is the last stop on the merry go round of medical treatment after all other options have been exhausted. There is often a patient before me who is very angry, bewildered, and frightened about their health future. I’m glad to say that I’m able to help them in most cases and also what they should be asking of their MD. Thanks for giving me an opportunity to express my thoughts. I hope your daughter has a complete recovery.

    Be well,

    Dr. Rosenberg

  • Brian Temecula

    It could be worse. I don’t have medical insurance, and therefore no ability to see a real doctor. In my country, if you don’t have medical insurance, you really don’t have any options. Yes, I can go to a clinic, but it is not free, I am not seen by a real doctor, and the care is sub-standard. I live in the USA.

  • danielle

    Yeah, I know the feeling. We are in Meuhedet, and here also the wait time for physiotherapy is two months. I went privately to a physiotherapist and called almost everyday at the physiotherapy clinic to check for cancellations. So I got some short term relief until the Meuhedet physiotherapy sessions could start.
    As for specialists, we go through Sharap (Sherut Refui Prati) at Hadassah. they have an arrangement with Meuhedet. Expensive? Yes (but less than going completely privately). But you get surgery within a few weeks and things go smoothly. My husband needed orthopedic surgery two years ago, and my dad has had already 4 eye surgeries there. It is definitely worth it.
    One more thing- Sharey Zedek doctors usually do not accept patients privately. In Hadassah they do.

    Good luck, and Refua Shlema!

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