With family doctors at the epicentre of the medical system in Israel, being able to find common ground with patients has been critical for Dr. Joanne Abrams in Israel.

By Chandrea Serebro

For over two decades, Dr. Joanne Abrams operated her own GP practice in Johannesburg, deeply connected to her community. Two years ago, she fulfilled her dream (which started out 30 years ago as the “five-year plan”) of making Aliyah with her husband to join their children already in Israel. In Netanya, Joanne found herself in an Independent Maccabi Practice, a complete shift from her South African home-based practice, in what was quite literally a whole new world.

“In Johannesburg, I treated the same families for over 20 years. They were mostly my friends, people from our community and then the wider area. I knew who was part of whose extended family, how they were related, as well as their medical history. I treated young kids who grew up and got married and then brought me their babies, too.” In stark contrast, the practice where Joanne works now is very big and began as somewhat impersonal. “There are many patients in and out of the rooms, and it has taken me almost two years to slowly learn about them, their histories, stories and the people they belong to.”

Because it is important to Joanne to practice with that personal touch, the headway she has made has been critical to her doing the best job she can, whilst finding personal satisfaction as well. This also proved necessary due to the “centralised” nature of the medical system in Israel, she says, with Family Doctors at the “epicentre”. “Here in Israel, I am managing very complex chronic conditions with input from specialists, whereas in SA, these patients would just have moved on to the specialists from the start.”

So, it is exciting and challenging, and even more so when considering the nature of the patients that Joanne is treating. In Israel, the patient population is diverse, and working in the melting pot that is Netanya has exposed Joanne to the cultural richness within her community, comprising multiple languages, different people and problems. “Medicine in Glenhazel can be very homogenous, whereas here the population of our clinic is so diverse.

With the help of Google Translate, I’ve had consultations in Russian, Yiddish, French and Italian! For me, it is an honour to treat a Holocaust survivor, a soldier wounded in the army, or a displaced person from Sderot or a refugee from Ukraine.”

While the conversion of her degree involved bureaucratic hurdles, early registration facilitated the process. She acknowledges the support of her colleagues, Dr. Colin Dick and Dr. Arnon Shachar, in easing her registration with Maccabi. “The hard part is being accepted by the Kupa, and to have colleagues to help and support you while you adjust is unparalleled. There was a lot of bureaucracy, many forms to fill out and interviews and I would never have managed to register with Maccabi without their help.”

Learning the ropes in a new healthcare system and mastering a different computer system presented challenges, especially in another language, but with time and an improvement in her Hebrew, the process became more familiar. And Hebrew is all-important, she stresses. The biggest challenge for Joanne has been communication, yet thankfully her Hebrew has improved tremendously which has made the daily job easier too. “I know there were many misinterpretations in the beginning and it was a very humbling experience.”

“It’s taken me almost two years to finally feel comfortable and familiar with the patients, language, computer system and new names of medicines. There were days I would come home and cry in frustration when I had struggled to communicate with a patient or a patient had been impatient with me. Professionally it is very humbling to be learning things from the beginning again and proving yourself to patients that don’t know you.”

Feeling “fortunate” with the relative “ease” of her transition, Joanne notes the presence of Telfed in the background. “Telfed remains ready to assist with any questions or problems, providing an additional layer of support that is there if and when it is needed.”

And one never knows when additional support will be needed. Joanne acknowledges the emotional challenges of Aliyah, which for her included personal loss as well as the anxieties of a country at war.

The challenges she faced are now part of a daily rhythm, and so are the rewards of serving a diverse community and contributing to the health and well-being of her patients in all their diversity.