The first step towards solving the physician shortage is fundamentally changing everything concerning the staffing norms in hospitals and clinics. Obviously, the shortage of physicians cannot be solved without dealing with the issue of the insufficient staffing ratio.  

In order to stem the physician shortage, potential doctors must be presented with a reality in which there are available jobs. As long as the staffing ratio is not increased and new work positions are not actually allocated, there will be no new generation of doctors entering the system. The "chicken and the egg" principle applies here: an insufficient staffing ratio affects the physician shortage and vice versa.

According to comprehensive surveys conducted by the Ergo Company in cooperation with the Martens-Hofman Company as part of IMA's staffing standards project, we estimate that the public healthcare system is currently lacking thousands of positions, and is in urgent need of 1,000 new healthcare providers.

Following are the incongruities according to the intermediate findings of the IMA staffing standards project for some of the fields investigated:
 

• Anesthetics – 560 additional positions are needed, as compared to the labor agreement's staffing ratio.
• Internal medicine – 545 additional positions are needed, as compared to the labor agreement's staffing ratio.
• Pathological Anatomy (Pathologists) – 74 additional positions are needed, as compared to the labor agreement's staffing ratio.
   

There is no doubt that these specialties, as well as many others (cardiology, surgery, etc.), are significantly lacking in positions. Some of these fields are currently undergoing a verification process. 

The resources for immediate staffing of new clinical positions can be obtained by implementing the doctor-employer agreement of 2000 (primarily, a day off after on call shifts). This would enable the employment of 640 doctors in state-financed positions, as well as the incorporation of over 1,000 doctors, currently employed by Corporate Health, into state-financed positions, the allocation of state-financed positions to doctors who are currently employed by Health Funds (kupot cholim), etc.

Of course, these resources are just preliminary solutions to deal with the immediate shortage. The real solution will require additional standardized positions to be filled by new doctors, and a change in the system concerning the staffing ratio and criteria for allocating clinical positions, according to the current needs of hospitals and clinics.  

In light of the need for ongoing, regular updates of actual staffing standards, and in order to pinpoint the understaffing in specialties that were not investigated by the project, it is advisable to establish a joint committee of doctors and the Ministry of Health to determine a policy for medical staffing ratio, together with independent professional bodies.

The committee will set up a mechanism to update staffing standards regularly, add clinical positions according to the needs of each medical field in the context of an exceptions board and consider allocation of staffing standards specific to the periphery and to medical specialties in crisis. 

The general problem of physician shortage is clearly more evident in peripheral areas and specialties in crisis, and therefore the first step in solving this problem is through location-specific staffing standardization.