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Tuesday, February 26, 2008

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Israel looks for cure to doctor shortage

Israeli doctors at work

Medical schools in Israel aren't graduating enough doctors to replace the large numbers of retiring physicians. So the country is turning to the U.S. tactic of bringing in doctors from overseas. Daniel Estrin reports.

Israeli doctors and nurses prepare to move an 11-year-old Kurdish boy from northern Iraq to intensive care after his emergency surgery to repair a hole in his heart at the Wolfson Medical Center in Holon, near Tel Aviv. (David Silverman/Getty Images)

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TEXT OF STORY

Kai Ryssdal: According to the Israeli government, there are about three and a half doctors for every 1,000 people in that country. Three per 1,000 is pretty much the standard for most of the developed world.

Some newly released figures suggest that within five years, Israel's going to fall below that threshold as the number of retiring physicians rises.

The ratio's 2.6 per thousand in the United States in case you're wondering. For years we've tried to remedy that by hiring doctors and nurses from overseas. Daniel Estrin reports from Jerusalem, the tables are about to be turned.


Daniel Estrin: This is the ER of the Shaare Zedek Medical Center in Jerusalem. Dr. Zev Wimpfheimer, originally from the U.S., is one of only a handful of doctors on call.

Zev Wimpfheimer: Specifically today, there's a fair bit of pressure in emergency room. Patients occasionally do have to wait more that we'd like for them to see a physician and that has to do with manpower both of doctors and nurses.

Prognosis for staunching that shortage is not good. The current ratio is 3.4 doctors per 1,000 people. That's expected to drop to just 2.5 by the year 2025.

Yonatan Halevy is director general of the Shaare Zedek hospital. He says those numbers are scary:

Yonatan Halevy: Going below 2.8 will turn a country into an underdeveloped country. I mean, it's really underservicing the population. We won't be able to deliver the kind of medicine that we are delivering to the Israeli population today.

In the 1990s, the massive wave of Jewish immigrants from the former Soviet Union doubled the number of physicians here. Now those doctors are retiring, but they're not being replaced fast enough. Israel's four medical schools graduate just 300 doctors a year.

There are plans to expand their medical schools, but what happened to all of those stereotypical Jewish mothers pushing their kids into medical school?

Danny Ayalon: They say here, that whereas a generation ago, Jewish mothers would really beseech their children to go to medical school, now they tell them to have a startup company -- and we have the highest startup companies per capita in the world.

That's Danny Ayalon, the outgoing Israeli ambassador to the US. He now co-directs Nefesh B'Nefesh or Jewish Souls United, an organization that assists new Jewish immigrants.

They've come up with a quick fix: they'll import doctors. They'll pay $25,000 to any Jewish physician under the age of 40 from North America and England -- just to get on the plane to Israel. Once they're here, they'll get monthly stipends that can add up to $60,000.

OK... let's do the math: a doctor starting out in America makes about $130,000 a year. A doctor beginning in Israel makes about $40,000. Add $60,000 to that... nope, it doesn't add up.

So what's enticing doctors like Tamar Ellman to even consider the move?

Tamar Ellman: When I drive to Jerusalem, I think about how fortunate I am to live in this country, to be living my life in such a real way, to experience it, to feel it.

Dr. Ellman is a religious Jewish pediatrician from Philadelphia. She and her family are living in Israel on a trial basis. She says the $60,000 would help pay off some of her medical school loans, but that's not why she's here.

Ellman: If I was purely looking at it financially, I would not choose to practice medicine in Israel. I certainly could make a lot more money in America. The reason for me is that, living in Israel and practicing medicine in Israel and being able to serve my own people, my own community, that is really the drive for me.

Over 100 American and British doctors have expressed interest since the initiative was announced a month ago. A few are even making the move this summer.

But that doesn't mean they have to kiss their old wages goodbye. They're only required to practice medicine in Israel for 9 months, leaving them 3 months to generate income stateside.

From Jerusalem, I'm Daniel Estrin for Marketplace.


Ryssdal: Marketplace begins two weeks of broadcasts from the Middle East next week. Join us Monday from Cario on the Marketplace Morning Report.

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