Israeli Health Ministry Report Reveals Wide Doctor Salary Gaps, Impending Retirements

A new report from Israel's Ministry of Finance, released by the Director of Wages Efi Malkin, provides an unprecedented comprehensive overview of salaries within the public healthcare system, which employs 134,000 individuals. The report details significant pay disparities, particularly among specialist doctors, where the top 10% earn approximately 104,700 shekels monthly, while the bottom 10% earn around 17,300 shekels, a ratio of over six to one. Overall average salaries in hospitals stand at 22,560 shekels, with a median of 18,804 shekels, while in the four health maintenance organizations (HMOs), the average is slightly higher at 23,326 shekels, but the median is lower at 16,971 shekels.

The report highlights that specialist doctors in HMOs earn an average of 56,000 shekels, compared to 45,000 shekels in hospitals. Nurses start at approximately 19,600 shekels. Senior doctors in the periphery earn 33% more than their counterparts in central Israel, largely due to higher on-call duties and incentives from a 2011 agreement, though the report questions the effectiveness of these incentives in resolving shortages. The report also points to a concerning trend of about a quarter of specialist doctors approaching retirement age (men over 60, women over 55), with particularly high percentages in palliative care and pediatric surgery, raising concerns about future workforce planning.

Further disparities are noted in gender pay gaps, with women in hospitals earning 19% less than men and 40% less in HMOs, partly due to lower representation in senior roles and differences in compensation for additional work. The report also criticizes "health corporations" that supplement hospital salaries, noting that some specialists receive up to 31% of their total income from these entities without sufficient oversight, leading to potentially inflated pay. The Ministry of Finance suggests focusing future salary agreements on differential raises for younger staff, addressing shortages in specific fields like mental health, and integrating new roles like pharmacy technicians and physician associates.

The findings are particularly relevant as negotiations with doctors have recently commenced. The report aims to provide data-driven insights for these discussions, although it does not include figures from recent agreements signed in September 2024 and April 2025, which are expected to impact nurse and health professional salaries, respectively. The Ministry of Finance emphasizes the need for long-term workforce planning, considering demographic trends and medical advancements, to address the projected decline in the doctor-to-population ratio.