Israel Loses Experienced Doctors as Public Health System Struggles

Israel is facing a growing exodus of experienced doctors, particularly those over 45, according to recent research from Tel Aviv University. Between 2023 and 2025, one in five doctors leaving the country were over 45, a significant increase from 14% in the previous decade. These departing physicians possess extensive clinical experience, have handled complex cases, and trained younger generations of doctors. Losing such seasoned professionals means losing invaluable knowledge that cannot be replaced solely by increasing the number of trainees. The issue extends beyond the sheer number of doctors leaving; it concerns the expertise they take with them and the measures needed to retain remaining specialists.

While Israel has 3.5 active physicians per thousand residents, below the OECD average of 3.9, the Ministry of Health's recent workforce targets are a necessary step. However, simply increasing the number of doctors is insufficient. The article questions how many new specialists will actually work in the public system, their employment scope, and whether adequate positions, operating rooms, and staff are available to support them. Without addressing these practicalities, workforce plans may remain on paper.

Plastic and aesthetic surgery highlight this gap, as these specialists are crucial for reconstructive procedures like breast reconstruction, severe burn treatment, and trauma repair, alongside private aesthetic work. While the surgical skills are transferable, the work environments, responsibilities, flexibility, and earning potential differ significantly. The public system particularly needs these experts for complex, lengthy surgeries where private alternatives are not feasible. The article emphasizes that while public service is important, it requires more than just a sense of mission, needing fair compensation, career advancement, sufficient operating time, and professional development opportunities.

Even senior doctors reducing their hours in public hospitals can create gaps in patient care and the training of residents. The loss of experienced mentors impacts the practical learning that occurs at the patient's bedside and in the operating room. When specialists are unavailable for guidance, surgeries are postponed, or necessary infrastructure is lacking, the training of the next generation of surgeons is compromised. To address this, workforce policy must include mapping actual needs: available positions, specialist numbers per department, working hours, and pending surgeries. Incentives for public service, better pay for complex cases, clear career paths, and protected time for training and research are also essential. The shortage is especially acute in peripheral areas where access to other hospitals is limited. Active operating rooms and adequate anesthesia and nursing teams are critical, as a new surgeon is useless without the proper conditions to operate. A national plan must consider where new specialists will be employed and how to retain experienced ones, as training takes years but retention requires immediate action.