BGU | MY PATH, Haim Doron, MD

There was a period of time when it was said with a chuckle that “if one didn’t know Spanish, they couldn’t function at the hospital in Beer Sheva.” Of course, decades later – in the 1990s – it was said in the same vein that “if one didn’t know Russian, they couldn’t function at the hospital in Beer Sheva.” To backtrack: During the years of accelerated aliyah from Latin America to Beer Sheva, a branch of the Latin American Immigrants Association was opened; and over the years, Beer Sheva became a magnet, one of the primary absorption sites for immigrants from Latin America.

On the Eve of My Next Roles

My Identification with Clalit HMO and Its Founding Principles The problem of the shortage of doctors in the Negev and other development areas was not only expressed in terms of accessibility. A core problem was that many of the doctors who agreed to come to work in the Negev were elderly and were not specialists in primary medicine. Moreover, there was a rapid turnover among these doctors, every two months, preventing or disrupting their ability to provide suitable solutions to the health problems of the population. In essence, during this period, the country had developed a two-tiered health system: Doctors who were young and trained at the highest-level from a medical standpoint worked in hospitals. Some were graduates of Hebrew University’s medical school in Jerusalem, and some were immigrants who were already well integrated. By contrast, elderly physicians, temporary substitutes from various areas of specialization without proper professional foundations in community medicine, worked in community-based medical centers. In terms of their numbers, there was even a surplus of doctors per capita in Israel, but there was a critical shortage of doctors the right age and with the proper professional foundations. Doctors in their seventies and eighties were shipped off to work in regional clinics in rural areas and on the borders without taking into account how problematic this was. I clearly recall how once a doctor with a drinking problem was sent to the Sha’ar HaNegev area, took the jeep and took off for Gaza. Of course, the Egyptians returned him. But incidents like this, indeed, took place. I was a primary physician in the Negev for fifteen years. Part of the time I was in the Beer Sheva clinic, but due to the shortage of doctors I also served moshavim and immigrant communities in other areas of the Negev. During the first eight years of my work, well acquainted with the problems at the time, I learned to appreciate the work of Clalit. 20 I was witness to the arrival of the first unadorned wooden prefabs brought by Clalit to serve as a clinic in Sederot, the development town hugging the Gaza border. And, in just such a prefab clinic, I received the first residents arriving in Dimona, a development town east of Beer Sheva in ‘the middle of nowhere.’ I also worked in two prefabs established by Clalit in the development town of Netivot in the western Negev. Thus, in these eight years, I could appreciate the presence of Clalit serving the population- at-large. 21 Clalit’s first principle was that it was different from the German Krankenkasse system 22 that refunds patients for their out-of-pocket payments for medical expenses. While labeled a “sick fund” (“ kupat holim ”) that was responsible for insuring its members from an economic 20 Here Prof. Doron is alluding to Clalit’s ethics-driven and pioneering role filling voids that other health entities couldn’t or wouldn’t fill. 21 The other sick funds were much smaller than Clalit. Moreover, the others lacked infrastructure such as having their own medical staff; or operated primarily in urban concentrations; or had a different ethos, e.g., operating primarily among specific sectors of the population such as the non-socialist middle class 22 “Sick fund” in German Thus, in the 1950s and 1960s, there was a shortage of young doctors, with suitable specialization, who were willing to work in isolated rural areas and border settlements.

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