Is there a doctor in the house? Availability of Israeli physicians to the workforce

Abstract Background Israeli policymakers have expressed serious concerns about being able to meet the growing demand for physician services. For this reason, the Israel Ministry of Health (MoH) undertook studies based on 2008 and then 2012 data to obtain an accurate assessment of the size, specialty...

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Main Authors: Pamela Kuflik Horowitz, Annarosa Anat Shemesh, Tuvia Horev
Format: Article
Language:English
Published: BMC 2017-05-01
Series:Israel Journal of Health Policy Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13584-017-0157-0
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author Pamela Kuflik Horowitz
Annarosa Anat Shemesh
Tuvia Horev
author_facet Pamela Kuflik Horowitz
Annarosa Anat Shemesh
Tuvia Horev
author_sort Pamela Kuflik Horowitz
collection DOAJ
description Abstract Background Israeli policymakers have expressed serious concerns about being able to meet the growing demand for physician services. For this reason, the Israel Ministry of Health (MoH) undertook studies based on 2008 and then 2012 data to obtain an accurate assessment of the size, specialty mix, demographic and geographic composition of the physician workforce. This paper highlights the findings from these studies about the number and percentage of licensed physicians in Israel who were not available, were only partially available, or were about to leave the Israeli healthcare workforce. Methods The two studies cross-linked administrative files of the entire physician population in Israel. The two sources were the MoH registry of licensed physicians, which contains demographic, medical education and specialty information, and the Israel Tax Authority income file on employment data. A third source, used only for the study of 2008 data, was the CBS Population Census Data 2008 which was based on a large representative sample of the population (14%), along with the updated Population Registry, which provided data on physicians whose occupation was in medical care as well as the number of work-hours. By linking the files we could also assess the population of licensed Israeli physicians living abroad. Results Only 74% of licensed physicians of all ages in 2012 were active in the Israeli workforce. Of physicians under the age of 70, 87% were living and working in Israel. Female physicians tended to retire from the workforce earlier than males and were more likely to work fewer hours during their working years. The rate of physicians who worked longer hours declined in both genders as age rose. About 10% of licensees had been living abroad for at least a year and the majority of these were older. Approximately 7% of licensed physicians, ages 30–44, were abroad and most are presumed to be doing additional clinical training or gaining research experience. In some specialty fields young physicians were not replacing retirees at a compensatory rate; anesthesiologists, a specialty in short supply in Israel were more likely to be living abroad than other specialists. Conclusions Assessment of the medical workforce pool and personnel planning require not just the number of licensed physicians but also information about the employment mix of license holders and their level of professional activity in Israel. For planning future workforce needs, it is important to keep in mind that the average female vs. male physician has lower clinical productivity due to shorter hours and earlier retirement and that a group of young physicians will predictably be abroad at any point in time; however major “brain drain” is not evident. Furthermore, extrapolating from the findings in the current studies, we believe that a potential shortage of physicians within Israel can be mitigated by better administrative support of physicians, use of physician extenders, and careful attention to improving physician satisfaction in certain specialties.
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spelling doaj.art-e983589bc255410dab4f22cf576077b52022-12-21T17:49:47ZengBMCIsrael Journal of Health Policy Research2045-40152017-05-01611910.1186/s13584-017-0157-0Is there a doctor in the house? Availability of Israeli physicians to the workforcePamela Kuflik Horowitz0Annarosa Anat Shemesh1Tuvia Horev2Administration for Strategic and Economic Planning, Ministry of HealthAdministration for Strategic and Economic Planning, Ministry of HealthDepartment of Health Systems Management, Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the NegevAbstract Background Israeli policymakers have expressed serious concerns about being able to meet the growing demand for physician services. For this reason, the Israel Ministry of Health (MoH) undertook studies based on 2008 and then 2012 data to obtain an accurate assessment of the size, specialty mix, demographic and geographic composition of the physician workforce. This paper highlights the findings from these studies about the number and percentage of licensed physicians in Israel who were not available, were only partially available, or were about to leave the Israeli healthcare workforce. Methods The two studies cross-linked administrative files of the entire physician population in Israel. The two sources were the MoH registry of licensed physicians, which contains demographic, medical education and specialty information, and the Israel Tax Authority income file on employment data. A third source, used only for the study of 2008 data, was the CBS Population Census Data 2008 which was based on a large representative sample of the population (14%), along with the updated Population Registry, which provided data on physicians whose occupation was in medical care as well as the number of work-hours. By linking the files we could also assess the population of licensed Israeli physicians living abroad. Results Only 74% of licensed physicians of all ages in 2012 were active in the Israeli workforce. Of physicians under the age of 70, 87% were living and working in Israel. Female physicians tended to retire from the workforce earlier than males and were more likely to work fewer hours during their working years. The rate of physicians who worked longer hours declined in both genders as age rose. About 10% of licensees had been living abroad for at least a year and the majority of these were older. Approximately 7% of licensed physicians, ages 30–44, were abroad and most are presumed to be doing additional clinical training or gaining research experience. In some specialty fields young physicians were not replacing retirees at a compensatory rate; anesthesiologists, a specialty in short supply in Israel were more likely to be living abroad than other specialists. Conclusions Assessment of the medical workforce pool and personnel planning require not just the number of licensed physicians but also information about the employment mix of license holders and their level of professional activity in Israel. For planning future workforce needs, it is important to keep in mind that the average female vs. male physician has lower clinical productivity due to shorter hours and earlier retirement and that a group of young physicians will predictably be abroad at any point in time; however major “brain drain” is not evident. Furthermore, extrapolating from the findings in the current studies, we believe that a potential shortage of physicians within Israel can be mitigated by better administrative support of physicians, use of physician extenders, and careful attention to improving physician satisfaction in certain specialties.http://link.springer.com/article/10.1186/s13584-017-0157-0Physician outflowWorkforce planningPhysician work-hoursPhysician shortage
spellingShingle Pamela Kuflik Horowitz
Annarosa Anat Shemesh
Tuvia Horev
Is there a doctor in the house? Availability of Israeli physicians to the workforce
Israel Journal of Health Policy Research
Physician outflow
Workforce planning
Physician work-hours
Physician shortage
title Is there a doctor in the house? Availability of Israeli physicians to the workforce
title_full Is there a doctor in the house? Availability of Israeli physicians to the workforce
title_fullStr Is there a doctor in the house? Availability of Israeli physicians to the workforce
title_full_unstemmed Is there a doctor in the house? Availability of Israeli physicians to the workforce
title_short Is there a doctor in the house? Availability of Israeli physicians to the workforce
title_sort is there a doctor in the house availability of israeli physicians to the workforce
topic Physician outflow
Workforce planning
Physician work-hours
Physician shortage
url http://link.springer.com/article/10.1186/s13584-017-0157-0
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