For over 50 years, physician associates (PAs) have been a pillar of American healthcare, increasing patient access, improving outcomes, and filling critical gaps. Yet, despite their success, Israel has yet to integrate PAs into its medical system—until now.

Sixteen years ago, when I was living in Israel, I emailed Nefesh B’Nefesh with one simple question: Can PAs practice in Israel? The answer was an unequivocal “no.” That moment stuck with me. Years later, it was Nefesh B’Nefesh itself—recognizing the growing need—that helped lead the effort to change this reality, working hand in hand with Israeli healthcare leaders to bring PAs into the system. Now, as Israel finally takes steps toward integration, it’s a full-circle moment with the potential to revolutionize healthcare.

A Turning Point for Israel’s Healthcare System

Last week, 20 top Israeli doctors from hospitals across Israel, along with Dr. Sefi Mendelovich, deputy director general of the Health Ministry, and representatives from Nefesh B’Nefesh, visited Lenox Hill Hospital in Manhattan. Five years earlier, an initial delegation from Nefesh B’Nefesh and the Health Ministry explored the role of PAs in the U.S., laying the groundwork for their integration into Israel’s healthcare system. At Lenox Hill, the delegation saw firsthand how 180 PAs are utilized across various departments, gaining critical insight into their impact on patient care and hospital efficiency. The visit reinforced the potential for PAs to help address Israel’s growing healthcare challenges.

When an Israeli OB/GYN asked whether PAs can see prenatal checkup visits, he was stunned by the response: “Our PAs perform the full exams, ultrasounds, and manage patients from start to finish.”

This realization was just the beginning of a mindset shift that would continue throughout their visit.

How PAs Are Transforming Hospital Care

In the OB/GYN department, the delegation met Shira Grazi, the supervising PA, who explained that she and her team independently manage prenatal checkups, ultrasound monitoring, patient triage, and patients in labor. They also first assist in C-sections and OB/GYN surgeries, playing a critical role in ensuring smooth procedures and optimal patient outcomes. Standing by her side, her supervising physician affirmed her trust in her clinical judgment, saying, “I trust Shira as I trust myself, and I know that if she ever needs me, she will call.”

In the emergency department, they saw how PAs triage, diagnose, treat, run codes, perform procedures, reductions and discharge patients. Supervising PA Andrew Fabel explained how collaboration and trust between doctors and PAs make the system run smoothly.

The delegation also learned that PAs can advance into higher-level roles, such as department supervisors or hospital administrators, proving that they are long-term assets—not just entry-level providers.

Missed Opportunities In Times of Crisis

Michele Freund, an OB/GYN PA on the panel, was in Israel on Oct. 7, 2023 when the war broke out. Wanting to help, she immediately tried to volunteer at a hospital, offering her medical expertise. While she was accepted as a volunteer in the neurosurgery department at Ichilov Hospital, she was only able to help clinically with limitations—simply because the PA role was not well understood.

“Had PAs already been integrated, this would have been the best time to utilize them because some doctors had to leave for miluim,” Freund said. “I definitely helped, but I could have helped more. Had I had full capabilities and the hospital system understood my role, I could have made an even bigger impact.”

Her experience highlights the urgent need to integrate PAs into Israel’s healthcare system—not just for daily patient care, but also in times of crisis, when every available medical professional is needed.

Expanding Access Beyond Hospital Walls

At Refuah Health Center in Rockland County, the delegation saw how PAs and nurse practitioners are essential to outpatient care, managing exams, diagnoses, treatments and specialties. Chanie Sternberg, President and CEO, highlighted their role in improving access across all departments. NP Leora Perl shared the history and certification of midlevel providers, while the delegation observed how telemedicine expands patient care. PAs also conduct psychiatric and mental health visits via telemedicine, helping to support patients who may not otherwise have access to in-person care.

This hands-on experience allowed the delegation to engage directly with the medical staff, ask questions, and see the impact of mid-level providers on patient access and healthcare efficiency.

A Healthcare System on The Brink of Change

By the end of their visit, Israeli healthcare leaders were deeply impressed by the capabilities of PAs and the trust their supervising physicians place in them. They left with a newfound understanding of how integrating PAs could bridge gaps in healthcare, expand patient access, and enhance the overall quality of care.

The introduction of PAs in Israel is more than just a policy shift—it’s a transformative step toward a more efficient, accessible and patient-centered healthcare system. This change will not only benefit hospitals and patients, but will also open doors for American-trained PAs who have long dreamed of practicing in Israel.

In every medical discipline, PAs are indispensable to the success of the American healthcare system. Now, Israel has the opportunity to fully embrace the advancements that have transformed U.S. healthcare over the past half-century. This isn’t just about introducing a new professional role—it’s about strengthening Israeli healthcare for generations to come.

Aliza Black, MMS, PA-C, is the founder of SwiftHealth, an integrative wellness company that provides comprehensive care for the entire family. SwiftHealth blends conventional and holistic medicine, offering customized IV infusions, in-home diagnostics and treatments, at-home blood testing, virtual telehealth consultations, and medical weight-loss programs.