Paying for Medical Services
Question: Is it permitted for a physician or a nurse to accept remuneration for medical services rendered on Shabbos or Yom Tov?
Discussion: Generally speaking, one is not allowed to receive payment for work performed specifically on Shabbos, even if no melachos were violated in the performance of the work. Thus, it is forbidden to pay a babysitter or a waiter who is hired for Shabbos only, since they are receiving remuneration for work performed on Shabbos. This prohibition, known as sechar Shabbos, is part of the general rabbinic prohibition to conduct business transactions on Shabbos.68
Many poskim maintain, however, that a health-care provider is different from a babysitter or a waiter and is permitted to receive compensation for medical services that he performs on Shabbos. Two basic reasons are posited for this distinction:
- Some poskim hold that the prohibition of sechar Shabbos is lifted when a mitzvah is performed. Since it is certainly a mitzvah to heal the sick, the prohibition of sechar Shabbos does not apply.
- Some poskim suggest that the reason we permit Shabbos pay for a health-care provider is so that he will not hesitate to see patients on future Shabbosos; otherwise, lives could possibly be put in danger.69
While one may rely on this ruling,70 it is not accepted by all poskim.71 Moreover, the poskim agree that money earned from Shabbos services, even when performed for the sake of a mitzvah, does not bring one a siman berachah, a “sign of blessing.”72 Thus, the recommended method (according to all views) for a health-care provider to collect Shabbos pay, is to schedule a follow-up visit after Shabbos, and then bill the patient in one lump sum. This is based on the ruling of Shulchan Aruch73 that it is permitted to accept Shabbos payment when it is included in the payment for a service rendered on a weekday (a process known as havla’ah – literally, “absorbing”).
68. O.C. 306:4 and Mishnah Berurah note 16.
69. Minchas Shabbos 90:19.
70. See Kovetz Teshuvos (Eliyashiv) 1:29.
71. See Aruch ha-Shulchan 306:11-12, who rejects the view that sechar Shabbos is permitted for the sake of a mitzvah. See also Teshuvos Chasam Sofer, C.M. 194, who rules that money earned from healing a non-Jew on Shabbos must be donated to charity.
72. O.C. 585:5; Mishnah Berurah 306:23. See Har Tzvi, O.C. 204 who applies this principle regarding medical services as well.
73. O.C. 306:4. See Tzitz Eliezer 8:15-13.