If there is one conclusion to be drawn from the latest developments at Hadassah Medical Center, it is that hospitals cannot be managed by members of the club; i.e. members of the doctors' club. Doctor-managers tend to identify too much with their club, and too little with the larger club of their customers, i.e. the general public and the patients.
Hadassah's stay of proceedings document provides endless proof, including hair-raising figures about what took place for years at the hospital, which is supposed to serve its patients, but which mainly served its managers, senior doctors (it should be emphasized: most doctors are doing sacred work and do not belong to the elite level that grabbed most of the cream), and "senior" employees.
Hadassah's management, headed by CEO Avigdor Kaplan, and its attorneys were very careful of the senior doctors' dignity when they drew up the stay of proceedings document. They preferred to share with the public the salary cost of a cleaning supervisor at Hadassah, which is NIS 19,000, the average salary cost of a senior secretary, which is NIS 18,000, and the average salary cost of an X-ray technician, which soars to NIS 25,500 (some of them earned more than NIS 100,000 a month, according to the document).
Kaplan did not bother to share with the public the salary cost of a senior doctor at Hadassah, one of those doctors who works non-stop in private practice, and he knows why: it reaches NIS 300,000, NIS 400,000, and even NIS 500,000 a month, and is one of the main factors that pushed Hadassah into unpleasant hearings in court. How convenient to focus on a cleaning supervisor, secretary, or X-ray technician.
But in a few sentences, Hadassah revealed its open and its greatest scandal: "Doctors," it says, "receive 'personal on-call shifts' to which they are not entitled."; "Doctors receive salaries for surgical procedures carried out in a second shift, even though the second shift apparently does not begin at the end of regular work hours, but in the second half of the regular work hours and sometimes at noon."; "For example, private healthcare surgeries are also carried out in the morning… which means that the doctor receives double salary for the surgery: both his salary and his salary for private practice."
"Globes" has obtained countless reports that the situation is even worse; senior doctors arrive at work and go directly to their private practice. Their public work ends with their pay check, without them being required to provide anything in exchange. This is where the great absurdity comes in: doctors took care to pocket directly the income from private practice (85% of the income, with just 15% going to the hospital), with the result that out of the NIS 254 million in private healthcare services revenue (which amounts to 20% of Hadassah's revenue), the doctors received NIS 214 million, and the hospital received NIS 40 million.
Any beginning manager understands that private healthcare has become a loss-making proposition for Hadassah, and that the huge profits have gone to the doctors. The hospital provides the equipment and space, and sends the patients, while the doctors do not even bother to provide their basic service: public healthcare.
An examination by "Globes" found that, in the past six years, income from private healthcare at Hadassah totaled NIS 1.4 billion. Of this amount, the doctors took the huge sum of NIS 1.2 billion, all of which came at the expense of public healthcare, and most of it at the public's expense. Imagine if the breakdown was different, say 50-50, which would have given Hadassah NIS 700 million instead of NIS 200 million (the NIS 500 million difference is the amount of the rescue package proposed by the government).
The double-salary issue is not just characteristic of Hadassah, as people tend to think. It is also popular in another way at government hospitals: there is one pay slip from the hospital and a second pay slip from the hospital's "research fund". Many doctors receive both pay slips for the same work hours. What exactly is the Ministry of Health doing about this? It is sound asleep.
Another tit bit: Hadassah has 1,180 doctors, and according to the stay of proceedings document, about one million patients a year. A simple calculation shows that each doctor treats 2.3 patients a day. Does this seem reasonable to you? Who says that Israel has a shortage of doctors?
The German Committee, which is due to make one of the most important decisions in healthcare, and for the economy in general (whether to institute private healthcare at hospitals), must use the example of Hadassah as a warning. The managers of the large hospitals are steamrolling the committee to allow hospitals to provide private healthcare, naturally with some restrictions, conditions, and regulations. This will not be worth the paper the hospitals sign, because the Ministry of Health's ability to enforce any regulations on private healthcare is close to zero.
The fire for the anarchy at Hadassah naturally and correctly targets Hadassah's former CEO, Prof. Shlomo Mor-Yosef, but he had partners, because the hospital had a board of directors filled with highly respected people (a partial list from Hadassah documents in recent years): Eitan Raff, Zalman Shoval, Yossi Rosen, Yossi Nitzani, Prof. Ruth Arnon, and Esther Dominicini - and there are plenty more.
Published by Globes [online], Israel business news - www.globes-online.com - on February 10, 2014
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