Disclaimer: This article is an editorial that highlights the problems in Indonesia today

PIKIRAN RAKYAT - The programme to bring in foreign doctors to address the shortage of doctors in Indonesia has been widely discussed again recently, especially after the removal of the Dean of the Faculty of Medicine at Airlangga University, Budi Santoso (which has since ended peacefully). Before implementation, the government is urged to create appropriate and adequate domestic mapping and regulations.

Head of the Medical and Health Cluster of the Indonesian International Scientists Association, Dr. Iqbal Mochtar, stated that the procurement of foreign doctors in the world is not something new. The presence of foreign doctors for the transfer of knowledge or technology is a common occurrence.

Various countries have implemented the program, including the United States, England, Canada, Australia, etc. But there are also countries that refuse to use foreign doctors to practice, such as Japan, South Korea, China, and India.

Meanwhile, Iqbal believes that there are still many obstacles and solutions that must be clarified or sought first before implementing the foreign doctor procurement policy in Indonesia. One of them is regarding the unclear basis and objectives.

“It has been said that Indonesia lacks the number of doctors when compared to the population ratio. But, what are the criteria for the shortage of doctors? Which areas are in need? What kind of doctors are needed? How many? If there are specialist doctors, what specializations are needed? Before running the program, adequate mapping needs to be done,” said Iqbal in the Indonesian Doctors Association (IDI) Media Briefing which was held virtually with the theme “How Should the Regulations for Foreign Doctors Practicing in Indonesia Be?”, on Tuesday, July 9, 2024.

It was substantially stated that the procurement of foreign doctors is needed to overcome the shortage of doctors in Indonesia. If so, Iqbal continued, then thousands of foreign doctors are needed.

"When they are brought in, who will pay them? Are they ready to pay a large salary? If you add it up, won't it affect the cost of treatment?" said Iqbal.

It is well known that doctors working abroad or expatriates in other fields usually receive a higher salary than in their home country. For example, cardiologists in the United States receive a take-home pay of Rp 400-600 million per month, in addition to other benefits.

Thus, what is feared here is that foreign doctors who were transferred to Indonesia are not highly qualified. "Then the question is where will they be placed, can they speak Indonesian and pass the competency test by the collegium?" he said.

Another question is whether foreign doctors can also serve the general public through the BPJS or a group of upper-class people. If they only serve the upper-class, Iqbal believes that the procurement is not in line with the original purpose.

"I believe there are no doctors who are against foreign doctors in Indonesia, we just want to remind the government to be careful in implementing the program for the various reasons mentioned above," said Iqbal. Chairman of the IDI Executive Board, Dr. dr. Moh. Adib Khumaidi, said that Indonesia has been directly involved in the MEA multilateral cooperation for several years, so that in its regulations, Indonesia (like other countries) is already open to foreign doctors.

However, every country has national regulations that must be respected to protect its citizens. "So can it be included if there is a domestic regulation, yes it can, but can it answer the problem of the need for doctors in places where there is a shortage? There has been no answer so far," Adib said. Adib said questions about sourcing or preparing foreign doctors could not be answered immediately.

This is because the problems faced are quite complex, as it concerns the health system and the management of medical personnel that need to be fixed together. In particular, in regulating the requirements for foreign doctors, such as competency testing or assessment, ethical or disciplinary issues in their country, and the length of time they can work in Indonesia.

However, Adib considers that the entry of foreign doctors into Indonesia is an inevitability that cannot be avoided in relation to the current development. In principle, doctors have nothing against this policy, as they are prepared to compete with foreign doctors. Efforts to internationalise and cooperate with foreign medical personnel have also been under way for a long time.

“So, this is not a matter of agreeing or disagreeing, but there must be a stronger study regarding the management of medical personnel in Indonesia, because there are still many problems that the state is responsible for," he said.

Adib added that the health system cannot be separated from four things, namely the financing system, infrastructure, medical devices, and human resources. So, health disparities cannot only be solved partially.***(Politeknik Negeri Bandung/Yeurley Arba Nabila)