Why Israeli Patients Carry Their Own Medical Files |
Last week, after a specialist visit at Ichilov Hospital, I found myself doing what millions of Israelis quietly do every year: photographing medical documents, uploading PDFs, chasing approvals, and carrying files between systems that do not speak to one another.
To obtain a simple MRI and physical therapy referral, I had to navigate hospital portals, HMO applications, administrative offices, and outdated authorization forms known as “Tofes 17.” I paid a refundable deposit — a “pikadon” — while waiting for approvals that should have been automatic. Once again, I became my own medical courier.
This is not an exceptional story. It is routine. And it is a disgrace for a country that prides itself on being the “Start-Up Nation.”
Israel is rightly admired for its technological innovation. We lead in cybersecurity, defense systems, artificial intelligence, and medical research. Yet in basic healthcare delivery, we remain trapped in fragmented systems that waste time, money, and human energy.
Hospitals, health funds, imaging centers, and specialists operate in silos. Their databases communicate poorly, if at all. Patients are expected to do the integration. We carry documents, upload files, chase signatures, and follow up endlessly. We become unpaid case managers for our own care.
I write this not only as a psychoanalyst and counterterrorism expert who has spent decades studying institutions under stress, but also as a senior citizen and an olah who lives alone in Israel. I am fluent enough in Hebrew to lecture and teach, yet navigating the health system still requires constant translation — linguistic, bureaucratic, and emotional.
For those without nearby family to advocate, organize documents, or chase approvals, the system is simply not user-friendly. It assumes........