Our view was that the centre we were creating should assume responsibility not just for the hospital, but also for health care in the community. Nowadays it is nothing special for a teaching hospital to reach out to provide care to the wider community, but then it was unique.
Were you sucessful?
To a degree, but not totally. You don’t always get everything you want.
What worked? What didn’t work?
We had a terrific partnership at the time between the health funds (kupot cholim – AT) and the university. At that time, virtually no Israeli graduates worked in neighborhood clinics. They graduated and went straight to hospitals. That isn’t unique to Israel- it’s a problem throughout the world. Doctors simply do not want to do primary care. There is a lot more money and prestige that goes along with working in a top hospital.There’s a real crisis.
So in order to address this issue, our idea was to create a deep connection between the Beer Sheva community and the hospital.
So what didn’t work?
Politics got involved – you’ve got the health ministry, the competing health funds – Clalit, the country’s main health fund, commanded about 95 percent of the Negev population when I started here. Today, it only commands 60 percent of the Negev market, so you’ve got to navigate all the different bodies. Makes things much more complicated.
I should say, I still think the plan for the medical school and health funds to work together was terrific. The idea was for the dean of the medical school to be in charge of all medical care in region, things wouldn’t be broken down by cities. It was Prof. Pryves idea, and I think it was a brilliant one.
Sadly it is only being carried out today (to the best of my knowledge) in Iran. Iranian doctors came here in the 1970s to study our ideas. They’ve been able to implement it because there are no politics: The Ministry gives a directive, and that’s the way it is. That makes things a lot easier.
You seem to be talking about a way to take away the “ivory tower” element of medical research. But is there a way to do top-level research without it become an exclusive, and therefore exclusivist, group?
Yes, it can be done, and it must be done. You don’t have to have every researcher see patients – not everybody has the bed-side manner you need to be compassionate – but that’s okay. You don’t necessarily need a stem-cell researcher to do patient care. But the institution has to set priorities, both for research and to make sure patients get good care. It isn’t always easy; it’s a matter of setting priorities, and that means money.
When I left Torah Vodaas, Reb Yaakov Kaminetzsky ztz” took me aside for a chat before I left the yeshiva. I thought he was going to tell me to make sure to learn Torah, or to make sure I kept Shabbat or went to shul. But he said, “Shimon, remember never to become callous to human suffering. It is easy to get used to anything. Make sure you don’t fall into that trap.”
His words have been a guiding force throughout my life. It’s a real danger for doctors – the nature of the beast is that we see many suffering people, and it’s easy to get used to it. It is definitely a challenge, but we have to make sure that we retain our compassion for all the people we come into contact with.