Next year, a few weeks from now, Indonesia will face the realization of Asian Economic Community (AEC) policy. More and more professionals, including foreign doctors, will come to Indonesia and have practices here. The AEC will remove substantially all boundaries on trade so that ASEAN will become a region with liberated movement of services, investment and skilled labor, including in the healthcare sector.
Before the AEC policy many Indonesians went to other countries to seek better healthcare services. According to the Health Ministry, in 2014 more than 600,000 Indonesians went abroad to seek medical assistance, especially to Singapore and Malaysia. Indonesian patients have contributed more than US$600 million to those countries every year since 2003. Next year, many foreign physicians are expected to open practices in Indonesia.
Many physicians here are still skeptical and defensive toward this policy. The pessimists state they will lose their patients, assuming Indonesians trust foreign doctors more. This would be because other countries’ medical professionals provide better quality aid, hospitality and professionalism than that perceived in Indonesian medical services.
Moreover, Indonesian doctors still think that their position is higher than that of their patients, so they do not care about their patients’ needs or privacy; this problem affects communications between doctors and their patients. Healthcare specialists are like any other professionals; this job needs the trust of its clients. Indonesian doctors should change their attitudes so clients will trust them.
Lack of time to communicate with the patient and practicing in many places are two reasons why hospitality and professionalism of Indonesian doctors has decreased. Many of our physicians practice late into the night with many patients and at several places. To prevent Indonesian doctors from practicing in multiple places, government and the private sector should raise their pay.
Optimists say, to the contrary, that Indonesian customers are still quite confident in the reputations of Indonesian doctors. Despite some reports about malpractice, Indonesian doctors have the advantage of knowing the local language and are very familiar with tropical diseases that affect most Indonesians.
To practice here legally foreign physicians still need to pass examinations held by the Indonesian Medical Council, including one on the Indonesian language.
The main reason why the test for foreign physicians is quite difficult is ultimately to protect Indonesian customers. How can a doctor treat the patient if the doctor does not understand the patient’s language? If we correctly interview a patient about the symptoms and history of an illness this would contribute to around 80 percent of an accurate diagnosis.
The last reason is related to the implementation of the universal health coverage, , which many aspire to. If it still involves cooperates with only Indonesian doctors, many Indonesians will still choose Indonesian physicians.
Local physicians would only have themselves to blame if customers shift to foreign physicians.
Cooperation with ASEAN countries is a must in the AEC era. With cooperation, Indonesia can organize the facilitation of medical professionals’ mobility within ASEAN, enhance exchange of information and expertise on standards and qualifications, promote adoption of best practices for professional medical services and provide opportunities for building capacity and training medical practitioners.
In 2008 Indonesia implemented a new medical practice law. Our country already has a council known as the Indonesian Medical Council that regulates, monitors and maintains the quality of physicians. In the AEC era, the task will be also to monitor foreign physicians.
From experiences in Europe, a national medical council must work hard. In the European Union, for instance, a physician punished and fired from his profession in one country could still practice in another country. Now Europe wants to install a Europe-wide alert mechanism to prevent such occurrences.
The Indonesian Medical Council should have cooperation with all schools of medicine in Indonesia and impose on them worldwide standards of medical education. Lack of communication and empathy are among the complaints of many patients in Indonesia. So, those skills should be enhanced in the Indonesian medical school curriculum.
Last week in a discussion at the Faculty of Medicine at the University of Indonesia, Akmal Taher, the directorate general at the Health Ministry, stated Indonesia is not worried about the AEC policy to liberalize the movement of foreign doctors to our country.
He said the goal of this policy is to make Indonesians get the best medical service available. Thus, local physicians would only have themselves to blame if customers shift to foreign physicians. They should be angry at themselves over why their level of competency and skills lag behind foreign doctors.
The AEC is a reality and foreign doctors will work in Indonesia soon. So it is high time for Indonesian doctors to change their attitudes and improve their competence to make more people trust their quality service. This is a challenge that must be answered to prevent the dignity of Indonesian doctors from shattering into pieces.