Introduction to Indonesian Health System & Law: Pendidikan & Praktik Dokter di Indonesia

Harun Al Rasyid, dr. MPH

Learning objectives:At the end of this session, students should be able to:

1. Know characteristic of a professional doctor

2. Know roles of medical doctor in Indonesia

3. Give examples of primary, secondary and tertiary care facilities

4. Know a journey to be a doctor

5. Know national competence examination for medical students

6. Know Standar Kompetensi Dokter Indonesia

7. Know patients’ rights and responsibilities

8. Know doctors’ right and responsibilities

Who want to be a good doctor?

Good doctors make the care of theirpatients their first concern

A professional doctorGood Medical Practice 2013

Roles of a medical doctor in Indonesia

Individual health service

Public health service

UU No.36 th.2009 tentang kesehatan

Place of work

Primary Care

•Private Practice / clinic

•Puskesmas

Secondary Care

•General hospital

•Public/private

Tertiary Care

•Sub-specialistichospital

•Cancer hospital, psychiatric hospital

UU No.36 th.2009 tentang kesehatan

Medical License (Surat Ijin Praktek)

•Compulsory for all doctors

•Re-evaluate for every 5 years

A journey to be a doctor

Medical students

(11 semesters)

National medical competency examination

Registered doctor for Internship

Internship

(12 months)

Registered doctor (general physician)

What’s next?

General Physisician(dokter umum)

Dokter LayananPrimer

(Family Doctor)

Working with BPJS in

primary care

SpecialistWorking in

hospital/clinic

National Competence Examination for Medical Students(Ujian Kompetensi Mahasiswa Program Profesi Dokter)

• Compulsory for all medical students in Indonesia

• Exit exam

• Competency evaluation Standar KompetensiDokter Indonesia

Regulations:

UU RI No.29 th 2004 tentang Praktik Kedokteran

Peraturan KKI no. 1 /kki/per/ i /2010 tentang Registrasi dokter program internsip

Peraturan KKI no. 11 Tahun 2012 Standar Kompetensi Dokter Indonesia

Peraturan KKI no. 10 tahun 2012 tentang Standar pendidikan profesi dokter Indonesia

SE Dirjen Dikti No. No.88/E/DT/2013 tentang Uji Kompetensi sebagai Exit Exam

UU RI No.20 tahun 2013 tentang Pendidikan kedokteran

Standar Kompetensi DokterIndonesia (2012)

• Basic competency (standard) of medical doctor in Indonesia

• Medical education curriculum must refer to SKDI

• National competence examination of medical students uses SKDI as a reference

Standar Kompetensi DokterIndonesia (2012)

Standar Kompetensi DokterIndonesia (2012)

Standar Kompetensi DokterIndonesia (2012)

• Able to identify and explainLevel 1

• Able to diagnose and referLevel 2

• Able to diagnose, do initial treatment and refer Level 3

• Able to diagnose and make a complete careLevel 4

Standar Kompetensi DokterIndonesia (2012)

• There are approximately 144 diseases that can be categorized as Level 4

• Most questions in national exam are level 4 diseases (CBT and OSCE)

Health is one of human rights

• Everyone has right to have access to health care, which is safe, standardized quality, and affordable

• Everyone has right to have a healthy environment

• Everyone has right to have a proper information and education about health

UU No.36 th.2009 tentang kesehatan

• Everyone has right to know information about his/her health condition including any examination and treatment that they already have or they are going to have

UU No.36 th.2009 tentang kesehatan

Universal Health Coverage

• To ensure equity in accessing health care for every Indonesian, government has implemented Jaminan Kesehatan Nasional (JKN)

• JKN is held by Badan Penyelenggara JaminanSosial Kesehatan (BPJS Kesehatan)

• BPJS kesehatan starts 1 January 2014

• It has been expected by 2019 all Indonesians has join BPJS Kesehatan

UU RI No.24 th.2011 tentang Badan Penyelenggara Jaminan Sosial

Patient’s rights

• get a complete description of the medical treatment referred to in Article 45 paragraph (3)

• ask the opinion of another physician

• get the medical care according to need

• refuse medical treatment; and

• get the contents of the medical record.

UU RI No.29 th 2004 tentang Praktik Kedokteran

Patient’s responsibility• Provide complete and honest information about their

health problems;

• Adhere to doctor’s advice and instructions;

• Comply with regulatory requirements in health care facilities; and

• Providing fee for service received.

UU RI No.29 th 2004 tentang Praktik Kedokteran

Doctor’s Rights• obtain legal protection throughout the task in accordance with professional standards and standard operating procedures;

• provide medical care according to professional standards and standard operating procedures;

• obtain a complete and honest information from the patient or his family; and

• receive payment for services.

UU RI No.29 th 2004 tentang Praktik Kedokteran

Doctor’s Responsibility• provide medical services in accordance with professional

standards and standard operating procedures as well as the medical needs of patients;

• refer the patient to another physician or dentist who has the skills or abilities better, if not able to perform an examination or treatment;

UU RI No.29 th 2004 tentang Praktik Kedokteran

Doctor’s Responsibility• conceal everything he knows about the patient even after

the patient has died;

• perform emergency care on the basis of humanity, except when he was sure no one else is in charge and able to do so; and

• increase knowledge and keep abreast of medical or dental science.

UU RI No.29 th 2004 tentang Praktik Kedokteran

What happen if a doctor did violations?

• Investigation by Majelis Kehormatan DisiplinKedokteran Indonesia

• Disciplinary action may include: written warning;

revocation recommendation letter of registration or

practice license; and / or

obligation to participate in education or training in

medical education institution