Switching Doctors

HMOs tend to restrict or prevent the transition of their clients from one doctor to another within the same field of expertise during a certain quarter. Therefore, if you visit a doctor in a certain field of expertise, you will have to continue to visit them during the quarter to maintain the principle of continuity of care that has been proven in studies to ensure good and high-quality care in the event of an illness or a medical condition requiring treatment.

A visit to an additional professional doctor to obtain a second opinion is possible as part of the existing medical counselling of the supplemental health insurance plans (Shaban) of the HMOs.

Every HMO establishes agreements with multiple service providers and provides its clients with the option to select from them based on the insurance plan they hold (basic or extended layer).

According to the law, you can switch from doctor to doctor every quarter without a special permit. However, what happens if the doctor is absent? ,or if you require urgent medical treatment and the doctor is unavailable? or if you require treatment in a medical area where the practicing doctors are far from their clinic, such as when you are on vacation, HMOs permit their clients to contact them and request a permit for switching to another doctor within the same quarter.

It is important to point out that each HMO has its own rules and regulations for switching doctors, which it is obliged to advertise openly, for example, on the internet website of the HMO, as well as its list of services and the doctors and clinics it offers its clients. It is advisable to check these details and the terms and conditions and act accordingly.

If you have reservations, you can always try and appeal to the HMO, and submit a new request outlining the specific details of your case that require switching doctors within the same quarter.

Payment in the event of switching doctors

The fee schedule plan, which is determined by the Ministry of Health and updated annually, is featured in the payments update circular for medical and drug services (HE). The plan allows the HMO to charge a fee once during one quarter for a visit to a doctor of the same medical field, even if you switch doctors during the same quarter. In other words, in the event that the switch has been approved, you would only need to make a single payment per quarter for every visit to a doctor within the same medical field.

The importance of upholding the principle of continuity of care

When a patient switches doctors or a treatment framework, upholding the principle of continuity of care is of great importance. It enables healthcare providers to access and review the patient’s complete medical documentation, including medical history, past doctors visited, medical diagnoses received, drugs administered, etc. The medical history record holds significant value as it provides a comprehensive overview of the patient's condition through a collection of documents. This enables appropriate and high-quality treatment, thereby contributing to improved health outcomes.

Therefore, it is vital to ensure the sharing of treatment information among the different doctors involved in your care.

The continuity of care is important for both patients and healthcare caregivers, and it is particularly vital for patients who require frequent healthcare services, such as older adults who are sick and suffer from complex medical conditions or chronic diseases.

The family doctor: overseeing the patient's comprehensive healthcare

The family doctor is the primary therapeutic factor who coordinates, mediates, and obtains information regarding additional therapies that the patient may require and therefore has a significant role in ensuring the continuation of healthcare over time.

Studies show that establishing an effective continuity of care process necessitates minimizing the number of doctors and healthcare providers involved. Consequently, it is important for the patient to have consistent doctors and healthcare providers, and the healthcare system should be adaptable and responsive to the patient's evolving needs and circumstances. Moreover, there is a need for transparency and easy access to patient information across all healthcare information systems, accompanied by effective communication among healthcare providers spanning various healthcare institutions, hospitals, HMOs, and medical professionals.

The doctor who treats the insured individual oversees their medical file; therefore, it is extremely important to receive consistent treatment from the same doctor.

Doctors’ certifications

The Ministry of Health handles the certification of certain healthcare providers who practice medicine and healthcare and are recognized by law.

Before choosing a certain doctor or healthcare provider, it is important to ensure that they are duly certified by the Ministry of Health, which license specifically they hold, when they were certified, what their field of expertise is, etc. This information is located in the licensing databases of the Ministry of Health, and it is recommended to review it. To locate the required information, you can log in to the online database. In the database, you can search for licensed healthcare providers according to their name, license number, or field of expertise.

The online data retains its validity until the date of the update, and it is under the responsibility of the Licensed Medical Professions Unit in the Ministry of Health. However, it should be noted that this information is not considered an official document.

Doctors who are forbidden to practice

Some healthcare providers whose licenses have been revoked fail to comply with the Ministry of Health's request to return their license. In some cases, they continue practicing while misleadingly presenting a license or certificate that appears to be valid. Therefore, it is essential to check before going to a doctor or healthcare provider that their license is valid, in addition to presenting an original license or certificate.

The health minister is entitled to revoke the license of certified healthcare providers for several reasons:

• Due to medical malpractice
• The healthcare provider suffers from a physical or mental illness that can pose a potential risk to the patients under their care
• The healthcare provider has been convicted of a felony, which can have implications for their ability to continue practicing medicine.

Access the webpage (Hebrew) that compiles the decisions made by the Disciplinary Rulings Committee of the Ministry of Health. This platform provides information regarding doctors who have had their licenses revoked, suspended, or have faced practice restrictions.