Tuesday, November 03, 2015

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Review–Hadassah Gastroenterology Clinic

by Reb Akiva @ Mystical Paths

Americans think highly of their medical system.  It’s shiny, has lots of very expensive hi-tech equipment, and every treatment available.  Or at least that’s the way it’s sold.  Reality often comes in the forms of “not covered”, “deductible”, “expense limit”, “beyond reasonable and customary”, “pre-existing condition exclusion”.  And there is a fair debate whether doctors are making some treatment choices to avoid lawsuits, bump up income or cover equipment costs, or at the urging of pharmaceutical sales representatives and rewards for dispensing.  While America has the highest per capita medical SPEND in the world, it does not have the highest life expectancy nor the highest successful outcomes in medical treatment in many cases.

So how’s Israel hold up in comparison?

Recently having turned 50, my doctor offered me a happy birthday along with instructions to poop in a cup and have a camera stuck up my… “You want to do what???”

Per doctors instructions I made an appointment for a “scoping”, both ways (upper and lower), at the Haddassah Ein Kerem Gastroenterology Clinic, or rather officially “Hadassah's Gastroenterology and Liver Diseases Institute”.

Appointment procedures were straightforward, although appointments for a routine procedure were only available weeks to 2 months in advance.  I didn’t mind as I approached this with trepidation, but it’s part of the Israeli medical system to run at near capacity thereby maximizing resource usage to minimize the per-patient cost – thereby making the patient wait for non-emergency services.  One can shortcut the system by paying for “private” services (and private insurance is available to help do this), private meaning not paid by the national health system or national health HMOs.  But I was in no hurry.

I received an instruction pack in the mail together with a prescription for “cleansing products” (that’s internal cleansing).  Detailed instructions were provided, what to eat in the days before the test, when to take the medicine.  Also when to arrive, what to bring (a driver to get you home), etc.  Very professional.

A week before the test I received a call from the clinic.  They are doing a medical study of a new technique for better internal viewing during such testing, and wanted to know if I was interested in participating.  I asked them to consult my doctor if this was appropriate and safe for me, and if he approved to call me back.  They actually did call my doctor, who said it was a good idea, and called me back.  I asked them if they’d been doing the trial for a while, and if they’d had any negative impact from it.  They said they had been doing it for a while, and negative impact rates were unchanged from the normal test result rates.  I agreed to participate.

We arrived on time at the Hadassah Ein Kerem hospital complex.  Hadassah’s hospital complex is large, includes a nursing and medical school, has a number of  recently added buildings, and fortunately added a (pay) parking garage (as parking used to be problematic).  Security was tight, given the current attacks going on in Jerusalem and throughout Israel this is not a surprise, with car inspections at the complex entrance and personal inspections and metal detector at the building entrances.

On a side note, Hadassah Ein Kerem hospital is one of the stranger locations in Jerusalem.  There are Jewish, Israel, Arab, and ‘Palestinian’ doctors, nurses, and staff.  And of course there are Jewish, Muslim and Christian patients – side by side in the same rooms.  Terror victims are being treated there, as are some of the terrorists.  While people glance nervously at each other, everyone seems focused on either doing their job, getting through their treatment or visiting their loved ones. I detected no hints of animosity or confrontation while there, and I was on the look out for it.

The Gastroenterology clinic is located in what Hadassah calls their “Sharett Institute”.  I’ve been to the Institute before with other family members, and finding it is ridiculous.  It’s an attached building sandwiched between two others, and you have to up a set of stairs, around the corner, down a set of stairs, then find just the right elevator bank.  Getting lost trying to find it seems to be common, and there are signs everywhere, but when they point around, up, then left, then down, the right, then…  well, annoying.

Every medical service has it’s paperwork and process.  On arrival to the clinic they sent me over to the billing desk.  I presented my appointment and referral paper.  The clerk glanced at it and said “wrong papers.”   So began a back and forth between this clerk and a clerk at my (national) HMO.  20 minutes, 6 phone calls and 3 faxes later the paperwork steps had been met and I could return to the clinic desk.  Welcome to the “system”, bring a smile.  They printed out some stickers, gave me some forms and stickers and send me in.

I was parked in a modern new hospital room and instructed to put on the standard hospital gown…and wait my turn.  And wait, and wait.  A few nurses came by, repeatedly checking my paperwork and asking my name (to verify I’m the expected person), and asking a few questions (allergies, medications, etc).  Eventually after several hours they invited me to hop up on the bed and be rolled away.  They covered me nicely, protecting what little modesty and dignity a person can have in such a situation, and rolled me to the procedure room.

20151103_112940The procedure room was a spotless bank of monitors and medical machines.  Several tables on large extendable arms awaited.  Modern and new, the room provided technological confidence.  After a bit the doctor arrived, looked through my paperwork, asked again who I was (mistake avoidance procedures), and asked a number of questions.  Have I ever had surgery in the areas they were going into?  Any specific problems they should know about, or things they should look for (I actually had one I asked for – a stomach problem I asked, and she said she’d check for it.)  Then she reviewed the record on the computer.  The doctor seemed around 50, spoke with a Russian accent (Israel gained thousands of Russian doctors in the 80’s and 90’s as the Jews were able to leave Russia), seemed very professional.  The anesthesiologist arrived, again check the records, and did a painless job of inserting an IV.  They arrived with the scope, connected to a particular machine, and draped it over a holder marked “clean”.  A similar holder was on the other side of the table marked “used”.

The anesthesiologist began his injections, said “you should start to feel something”, I did start to feel… and woke up an hour later.

(Photo – my stomach!)

I awoke an hour later, feeling none the worse for wear.  I was well wrapped and had oxygen (a safety precaution).  After some time to come back to myself, and being checked several times, I departed with several reports in hand, together with pictures (yay!). 

Professional, modern, clean, experienced, safety precautions.  Everything you would expect in a modern first world medical facility.

I give Hadassah Ein Kerem’s Gastroenterology and Liver Diseases Institute two thumbs up or 5 stars.

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