United Hatzalah became only the second organization in Israel to receive permission from Israel’s Health Ministry to operate a mobile intensive care ambulance (MICU) without the oversight of a physician on board. According to Health Ministry regulations, all MICU ambulances are required to be staffed by both a physician and a paramedic. In 2015, the Ministry decided to remove the requirement of having a physician on board for Magen David Adom, trusting their paramedics to manage the emergencies that the ambulances respond to.

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United Hatzalah MICU ambulance in Jerusalem

Thus far, United Hatzalah has been operating its MICU ambulances with a physician and a paramedic. Following the new permit, United Hatzalah will now be able to dispatch MICU ambulances without a physician on board, thus enabling the organization to have more of these ambulances on the road and provide more services to the public in a far easier and less costly manner. These services, in addition to responding to medical emergencies, including providing medical coverage for large events where MICU ambulances are required.        


Until just a few years ago, physicians were required to perform certain tasks onboard all MICU ambulances, such as pronouncing death in the field, administering life-saving medications during CPR, and others. In 2015, MDA was given an exemption. However, that rule still applied to all other ambulance organizations across the country including United Hatzalah. This regulation raises the overall operating cost of running a MICU ambulance as the salaries of licensed physicians are costly. This allowance had given MDA an advantage when offering services of these ambulances, such as providing medical coverage for events, as it was able to charge less due to not having to cover the fee of having a physician on board. Thanks to the permission now granted, United Hatzalah is also exempt from the rule and is trusted to have its paramedics perform all tasks on its MICU ambulances.


President and Founder of United Hatzalah Eli Beer praised the decision to bequeath United Hatzalah with the new permit. “This was the culmination of a process that began years ago when we first began to operate mobile intensive care ambulances and requested the ability to do so without having a physician on board. I want to thank Yair Hevroni, the Director of the field of advanced emergency medical services (EMS) in the Health Ministry for his help in acquiring this permit which will allow for fair competition in the field of EMS and allow us to operate many more teams on additional mobile intensive care ambulances. This will in turn save many lives. I also want to thank our volunteers who are providing all of their services free of charge and to the rest of the leadership of United Hatzalah who are working tirelessly every day to make our organization bigger and better. Through their hard work, we are increasing our level of care and dedication while lowering our response times every day in order to better serve the people of Israel.


Vice President of Operations for United Hatzalah Dov Maisel added, “The ability for our organization to operate MICU ambulances without a physician on board is a significant force multiplier for United Hatzalah’s ability to provide services for the general public. These services will be provided by paramedics who are highly trained and have met all of the requirements set forth by Israel’s Health Ministry and the American Heart Association. Our ambulances and staff stand at the cutting edge of EMS in Israel, both in their technological and medical capabilities. Our physicians will not be removed from the picture entirely, as they will still be overseeing the operations and procedures done inside our growing fleet of MICU ambulances from our Dispatch and Command center, and will be able to advise the paramedics in the field when necessary. Thus, the quality of service will not be diminished by transferring the leadership inside the ambulance to the hands of the paramedics, and this permission will allow us to have more MICUs operating in the field at any given time, providing a faster and higher level of EMS response.”   


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