77 years of the State of Israel, we look at the path that public medicine has taken in Israel – led by family medicine in the community. Within the health system that has been taking shape over decades, there are those who choose to stay close – close to the patient and his family.
One of them is Dr. Yelena Kogan, married and a mother of two, a family physician and director of the Kiryat Eliezer Clinic in the Haifa and Western Galilee District in Klalit. She has been practicing medicine for 27 years, 16 of which in Klalit. For the past seven years, she has served as the director of the clinic, which provides primary care services to the community.
In a conversation with her, she lays out her medical 'credo', while presenting a firm and clear line: "Even as a young doctor, I chose to focus within the framework of my role as someone who deals with health and not disease. This is a fundamental difference in my opinion, and one that I try to instill in all my patients. For me, it means focusing first and foremost on preventive medicine. This is what also led me to broaden my horizons in my free time in everything related to a healthy lifestyle, through naturopathy, physical activity, personal training, and more. Everything comes together under one roof of health promotion and preventive medicine."
Dr. Kogan also refers to the changes that community medicine has undergone in the country: "It's hard for me to put my finger on one significant move, but in practice we feel the burden that is increasing year by year. At the same time, over the years we see the strengthening of the bond between the therapist and the patient. In community medicine, we accompany patients throughout the entire life cycle. The doctors and teams know the patient as a person, his family members, his immediate environment or his occupation. They see him in different situations, and thus can provide a complete opinion about him, and also motivate him to change if necessary, whether at the level of lifestyle or, God forbid, dealing with an illness. The role of community medicine is to be by the side of the patients at any given moment. This is what leads to a much deeper connection, along with a sense of trust on their part and an understanding that they can rely on us."
To illustrate the significance of the medical connection in the community, she shares an incident from the clinic: "A young patient recently came to me who said she was suffering from stomach pain. From an initial look at the medical file, I realized that for many years she had not seen a doctor or been under any kind of follow-up. The first conversation with her was on the phone, where she requested a referral for blood tests. In light of the situation, I suggested that it would be much more professional for me to come to the clinic, and after I examined her, sat down together and got to know her a little more deeply, I could write her a referral. And so it was. Luckily for her, she came to the clinic.
"The moment I put my hand on her stomach, I realized that this was a catastrophe. It turned out that for several months she had been walking around with a tumor that was causing the pain, which she had simply completely ignored. The big insight from this story is unfortunately something that we as doctors often experience with our patients. People try to take shortcuts or cut corners. It is important to understand that in medicine, as in many other things in life, it doesn't work that way. Some people think that with the digital revolution or the possibilities of remote medicine, it is also possible to manage a medical condition. With all the good intentions, it is our duty as human beings to take responsibility for our health."
On the question What is family medicine for you?, she answers with touching simplicity: "Family medicine is much more than medicine. It is personal accompaniment of the patient throughout the entire journey. We grow with the patients, grow old with them, and most of all, we are proud to be there for them in the important moments of life."
And if you ask about the satisfaction of the profession – the answer is clear: "Being a doctor is my calling in life. It's a huge satisfaction to know that I was able to help a person. As someone who comes from a family of doctors, the desire to help people probably passes from generation to generation. It's an urge that comes from within and something that motivates me every day. I was privileged to be engaged in a profession that literally helps people, whether they are in a precarious physical or mental state. Knowing that I was there for them – there is no greater satisfaction than that."
And finally – a look ahead: "Community medicine is here to stay and get stronger. My most important message is to patients: take responsibility for yourself. We will do everything we can to support you, but at the end of the day, the ball is in your hands."