P132Occupational physician ratios in israel - trends, status and solutions

IntroductionThe medical specialty of occupational medicine was established in Israel in 1990. Despite the gradual growth in the number of Occupational Health Physicians (OHP) over the years, their ratio to the number of workers in Israel was never systematically analysed. The objectives of this study were to determine the trends in OHP/workers ratio in Israel and the required future actions in order to attain the standards of developed countries.MethodsPhysicians' sociodemographic data was obtained from the Israeli Association of Occupational Medicine, and Maccabi Health Services and via personal communication (telephone calls and mails). Data regarding the working population was obtained from publications of the Ministry of Health and the National Insurance Institute.ResultsAs of March 2014, there are 157 registered OHPs in Israel, 104 active specialists and 25 residents. Among the specialists 78 work in Health Maintenance Organisations (HMOs), 18 in the public sector (other than HMOs) and 8 in the private sector. Despite the increase in the number of workers every year, the number of OHP has remained unchanged in the past 10 years averaging 90-100 physicians. The ratio of OHP/workers in the HMOs is 1:48,000.ConclusionsThe ratio of OHP/workers in Israel is equivalent to that found in developing countries like Mongolia (1:33,000) and Brazil (1:24,000) and 8-10 times lower than ratios in other developed countries such as Finland (1:1,000), Netherlands (1:4,000), Germany (1:3,300), France (1:4500) and Sweden (1:5,700).SummaryIn order to amend the current status, we suggest that the number of residents per year should be doubled with the necessary resources and that employer payments for the financing of occupational health services should be implemented. It is our opinion that regulatory authorities are not exempt from providing their share of financing.