Israel currently has about half the pathologists per capita as does the United States

Inadequate numbers of pathologists will soon threaten the quality and integrity of clinical pathology laboratory testing in the nation of Israel. That’s the assertion of leading pathologists, who point out that oncology, cancer testing, and molecular diagnostics are likely to be the most threatened by the shortage of experienced pathologists in Israel.

There are only 119 pathologists in Israel, most of whom are over the age of 50. That is one reason why health leaders in that country fear what lies ahead if pathologist understaffing is not addressed by the Israeli health system. According to a recent article in The Jerusalem Post, the decreasing numbers of pathologists—already at dangerously low levels—threatens to erode the quality of medical laboratory testing services in what has been a thriving medical community.

Here is the audience at the pathology conference conducted at Sheba Medical Center, Tel Hashomer, Israel. (Image sourced from Haaretz.com.)

Over the next five years, Israel could lose up to 10% of its existing pathologist base, which is already sparse, according to press coverage in the country. Experts say that the remaining pathologists would struggle to effectively support the needs of the medical community for medical laboratory testing services. And with no lateral opportunities in private practice, growing numbers of public hospital pathologists in Israel are leaving the profession.

Wages and Number of Pathologists in Israel Need to Be Increased

A conference organized to address the shortage of pathologists was held at the Sheba Medical Center at Tel Hashomer. During the meeting, the Israel Medical Association (IMA) called for a “reorganization” of the country’s health system, with a focus on wages and manpower, both of which need to be increased, according to Leonid A. Eidelman, M.D., Chairman of the IMA.

“The State of Israel has moved to medicine of putting out fires,” he said to the conference attendees. “There is no future if we do not bring about change.”

Apparently, however, the country’s Finance Ministry does not share the IMA’s sense of urgency. “The Treasury has dug in its heels. It doesn’t believe that the condition of public medicine is so bad that doctors are leaving the country, moving to private medicine and even leaving the profession,” said Dr. Eidelman.

One IMA recommendation is that salaries do not reduce when pathologists are away from their jobs. That would be a key reform, said Dr. Eidelman. The IMA continues its talks with the country’s Finance Ministry in attempts to secure a “special benefits package” that will slow the migration of pathologists out of public medicine in Israel.

The negotiations, however, could take months, said Dr. Edelman. Till then, the existing shortage of pathologists could negatively affect cancer treatment in Israel.

Not Enough Pathologists to Meet Needs of Israeli Oncologists

The U.S. has 4.43 pathologists for every 1,000 residents. However, in Israel, there are only 1.96 pathologists per 1,000 residents, said Yehudit Zandenbank, M.D., during the conference. Dr. Zandenbank is affiliated with the Assaf Harofeh Medical Center and is also Chairman of the Israel Association of Pathologists.

“Here, they conduct twice as many pathology tests as abroad. This opens the possibility of errors in cancer patients, which can be critical for them,” said Dr. Zandenbank. “The situation is even worse in peripheral hospitals than in [hospitals in] the center of the country.”

“Pathologists are the only ones qualified to diagnose malignant tumors,” said Judith Sandbank, M.D., during the conference. She also said that delays in receiving test results, caused by excessive workloads on pathologists, could prolong cancer treatments with possibly catastrophic results for patients. Dr. Sandbank is a pathologist at Assaf Harofeh Hospital at the Tzrifin military base.

“Pathology is not an elite specialty addressing the needs of a small percentage of the population of the country,” Dr. Sandbank continued. “It is the foundation of medicine and without us, other specialties could not function.”

Pathologists and clinical laboratory managers who are regular readers of Dark Daily know that the shortage of pathologists in Israel is not unique among developed nations in the world. This is a serious problem in several other countries and has been highlighted in other e-briefings published by Dark Daily.

In articles such as “‘Death’ of Pathology in Russia Lamented by Nation’s Leading Pathologists” Dark Daily reported on clinical laboratory and pathology shortages worldwide.

However, few countries face consequences as serious as those predicted for Israel. The Ergo Consulting Group advises clients on organizational management issues. Its representatives attended the conference and, as reported in the Jerusalem Post, they said that Israel must increase its number of pathologists by 53% or face dire consequences.

—Michael McBride

Related Information:

Errors in Treatment Possible From Lack of Pathologists

IMA: Pathologist Shortage Could Delay Cancer Treatment

THE DARK REPORT: Anatomic Pathology’s Likely Path of Transformation