Israel Must Invest in Community Healthcare, Not Just Hospitals

Three years of war have left Israeli society with significant health and mental health challenges that will persist for years. Wounded soldiers, bereaved families, reservists, evacuees, and many citizens living under constant stress require continuous medical and psychological support. However, the war did not create all of these healthcare system challenges; it exacerbated existing realities such as an aging population, a rise in chronic diseases, and increasing workloads. Patient needs are rapidly changing, but community resources and services are not evolving at the same pace. This situation raises a critical question for the future of public medicine in Israel: will the country continue to treat diseases and crises after they have developed, or will it invest in a system capable of early identification and prevention? Mental health is a prominent challenge, with many individuals experiencing distress not seeking specialized clinics. Often, the first point of contact is the family doctor, who knows the patient and can identify distress even when it manifests as sleep disturbances, pain, or the worsening of a chronic condition. To enable this, family doctors need more patient time, appropriate training, and close collaboration with mental health services. The article argues that family doctors cannot be expected to identify mental distress, manage chronic illnesses, and practice preventive medicine without the necessary tools. Most public interactions with the healthcare system occur outside hospitals, yet public discourse often focuses on hospital beds and emergency rooms. While essential, a strong healthcare system begins in the community. Quality family medicine facilitates early diagnosis, prevents disease exacerbation, reduces unnecessary hospitalizations, and saves significant resources. This requires a shift in the treatment model, moving beyond placing sole responsibility on the family doctor to building multidisciplinary teams in clinics, including nurses, mental health professionals, social workers, and preventive medicine specialists. Proactive monitoring services, akin to 'child health clinics for adults,' should also be developed to identify risk factors and maintain health before diseases develop. Additionally, technologies that reduce bureaucracy and free up time for patient care should be adopted. Dr. Yael Gelerman, Chairwoman of the Israeli Association for Family Medicine, emphasizes that no change will succeed without investing in people. The growing interest of young doctors in family medicine presents an opportunity that must be nurtured through quality training, fair working conditions, and professional development. The dedication of medical teams cannot substitute for public policy ensuring manageable workloads and adequate patient time. Investing in healthcare teams is not a perk for employees but a prerequisite for the quality of care every citizen receives. Israel stands at a crossroads, facing a decision between continuing to manage burdens with piecemeal solutions or building a healthcare system suited to the new reality. The past three years of war have shown that national security is measured not only by border defense but also by the ability to ensure accessible and quality medical and mental healthcare, in routine and emergency times, in both central and peripheral areas. Strong family medicine is not just part of the solution; it is the foundation for the future of public medicine in Israel. The decisions made today will determine how tomorrow's patients are treated and what kind of society Israel will become, making this a critical moment that should not be missed.