Quality of Healthcare and Physicians

[jstar]

Our nephew, a student in Bandung, played a friendly game of basketball and made a wrong move.

Torn ligaments of course. To be safe he went to an orthopedist who claimed he needed surgery. And soon. It would cost 100 juta (approx. $6,500, €6.000), payable before the operation.

His father -luckily- decided to get a second opinion and took him to Singapore. And as somewhat expected; “operation? No way. Rest, ice, bandage, ….. and in two months you will be as good as new.”

Another member of the family-in-law, after not having the feeling the local doctor took his complaints serious, went to see a well known specialist in Jakarta. Even here there was unclarity about his condition. The bloed tests they performed did not give a definite answer but a certain treatment was proposed anyway.

So he decided to go to Singapore to see another specialist. After redoing all tests etc. the diagnosis was acute lymphoblastic leukemia (ALL). The current life expectancy for people in his position is 10 years. After a bone marrow test I attended the Zoom sessions (it was all in English of course and they requested my presence) and the Singaporean specialist really tore the findings of the Indonesian doctors apart. He found them almost laughable.

The initial treatment had to be swift; it was done in Singapore. Under the supervision of those specialists, later treatment was done here locally. The recurring blood test results are being sent to and interpreted by the medical staff in Singapore. It’s going quite well but they expect a relapse in a couple of years.

As you can imagine, these things do not really help to increase one’s confidence in the medical expertise here.

 

[snpark]

Are Singapore's doctors superior to Indonesia's? Comedian's tweet sparks debate | Coconuts

Earlier this week, President Joko Widodo lamented how the country loses out on IDR165 trillion in foreign exchange due to 2 million Indonesians getting medical care abroad annually. According to the president, of those 2 million, 1 million routinely go to Malaysia, 750 thousand go to Singapore...

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[ChrisTex]

I think some of it depends on where the doctor went to get his/her degree, training and license along with the hospital itself. This is also after one doctor nearly killed me in 2019 after an appendix operation.

In general, though, I do agree and I have heard in Singapore they have two different prices: one for Singaporians and those who aren't.

 

[Balifrog]

In general, though, I do agree and I have heard in Singapore they have two different prices: one for Singaporians and those who aren't.

Here (Bali) they have 3, locals, expat residents, tourist.

 

[dafluff]

While without a doubt there are excellent Indonesian doctors, the reality is that the quality varies widely. I heard and experienced far too many horror stories to think otherwise. For anything serious/that requires surgery, get a second opinion abroad if you can.

 

[pantaiema]

The quality of Indonesian physician’s, Doctor's varies widely.
Is Money, (corruption?) the root cause of the problem?

Nowadays by paying say IDR 100m+ any high school leaver, even the one who barely pass high school could enter state medical schools if their parent could effort to pay for the non subsidised tuition fees.
https://www.detik.com/edu/seleksi-m...an-jalur-mandiri-ui-unpad-ugm-undip-unair-uns

The state universities still have limited places for the state subsidised program but it is now overwhelmed by a non-subsidized route. The people managing the state universities certainly prefer the non-subsidised route as they have more freedom to use the money they received directly from the candidate’s parents with less accountability.

Entering the university the professors might be under pressure to pass them like this

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(In Indonesians, so use google translate to translate them)

In the past, it was only very smart, highly competitive, hard-working high school leavers could enter the state universities, especially the medical school. The tuition fees are the same with other subjects at the universities, as all of them were getting subsidy from the government. So they compete solely base on their own ability and merit.

The problem here you will never know who will examine you. You will never know how they get their degree what route they use if they later become physicians.

 

[jstar]

Our nephew, a student in Bandung

The ‘funny’ thing is that he’s studying medicine ….

 

[Samoerai]

The ‘funny’ thing is that he’s studying medicine ….

Learning by doing

 

[jstar]

Yes, but it makes you think what the guy learns in his studies if he does not challenge the whole operation necessity.

 

[serious_fun]

The problem here you will never know who will examine you. You will never know how they get their degree what route they use if they later become physicians.

Q; What do you call someone who finished at the bottom in medical school?

A: Doctor

(one of my childrens' fave jokes)

 

[Samoerai]

Q; What do you call someone who finished at the bottom in medical school?

A: Doctor

(one of my childrens' fave jokes)

I don't get it ...

 

[R Cameron]

I don't get it ...

The doctors that barely graduate and pass the exams are out in the world practicing medicine, and most people have no idea if their doctor was at the top of their class or the bottom. It's a kind of dark humor; the guy operating on you may have been deemed just barely good enough.

 

[Samoerai]

The doctors that barely graduate and pass the exams are out in the world practicing medicine, and most people have no idea if their doctor was at the top of their class or the bottom. It's a kind of dark humor; the guy operating on you may have been deemed just barely good enough.

I figured that much, but didn't see the joke in that. Thinking "What do you call someone finishing medical school at the top?" ... must be something I missed because English is not my first language.

 

[nd_eric_77]

Q; What do you call someone who finished at the bottom in medical school?

A: Doctor

(one of my childrens' fave jokes)

Same idea as, Q: What do you all the person who graduated in last place at West Point?
A: Officer

 

[Jaime C]

My MIL recently had cataract surgery for one eye. The hospital in Bandung that BPJS uses doesn’t own the machinery necessary, so has to get at least 10 patients at a time, before they rent the equipment.

She was pretty scared, as a neighbor in Bekasi had a horror story, and was blind after her surgery. I reassured her, that I had relatives who had it done very safely.

The main downside is they wanted them at the hospital at 6am. She didn’t have the procedure done until the afternoon. My wife was in waiting room the whole time, so not much fun.

Her one week checkup was fine. And she didn’t pay a dime for everything. She has the basic BJPS plan.

 

[pantaiema]

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Rektor Universitas Udayana Bali, Profesor I Nyoman Gde Antara, ditetapkan sebagai tersangka oleh Kejaksaan Tinggi Bali dalam kasus dugaan tindak pidana korupsi dana sumbangan pengembangan institusi (SPI) mahasiswa baru seleksi jalur mandiri tahun akademik 2018/2019 - 2022/2023.

www.bbc.com

The Chancellor of Bali's Udayana University in Bali has become a suspect in corruption in University Development Funds (SPI)
This is again why the quality of Physicians Doctor's in Indonesia varies widely. The embezzlement of the university development fund (SPI) that they collect directly from the students (e.g students parent's) that supposed to be used for university development.
The state universities such as Udayana and other state universities in Indonesia although naming the program as non-subsidised route, in fact they are fully subsidised by the government as their staffs: administrative staff, lecturers are civil servants who get fully paid directly from the government, not from the money collected directly by the Universities. Also all of their estates, building facilities are funded by the governments. They money they collect directly from the student are therefore open for misused as there will be less accountability. They tend to accept the students who could pay more even though they might not meet the admission criteria.

 

[centurion]

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The rector of Udayana University, I Nyoman Gde Antara, is caught in a corruption scandal centering on the misappropriation of funds from student enrollment between 2018 to 2022.

coconuts.co

Rektor Universitas Udayana Bali jadi tersangka korupsi dana sumbangan - BBC News Indonesia

Rektor Universitas Udayana Bali, Profesor I Nyoman Gde Antara, ditetapkan sebagai tersangka oleh Kejaksaan Tinggi Bali dalam kasus dugaan tindak pidana korupsi dana sumbangan pengembangan institusi (SPI) mahasiswa baru seleksi jalur mandiri tahun akademik 2018/2019 - 2022/2023.

www.bbc.com

The Chancellor of Bali's Udayana University in Bali has become a suspect in corruption in University Development Funds (SPI)
This is again why the quality of Physicians Doctor's in Indonesia varies widely. The embezzlement of the for university development fund (SPI) that they collect directly from the students (e.g students parent's).
The state university such as Udayana and other state universities in Indonesia although naming the program as non-subsidised route, in fact they are fully subsidised by the government as their staffs: administrative staff, lecturers are civil servants which get paid directly from the government. Also all of their estates, building facilities are funded from the governments. SO they money they collect directly from the student are open to be misused as there will be less accountability. They tend to accept the students who could pay more rather than even though they might not meet the admission criteria.

Is this guy also driving without a helmet?

 

[jstar]

The main downside is they wanted them at the hospital at 6am. She didn’t have the procedure done until the afternoon. My wife was in waiting room the whole time, so not much fun.

Try an endoscopy in a western country….

 

[pantaiema]

If you want to see one of many reasons why many Indonesian doctors diaspora, foreign doctors who are trained in well known hospital around the world do not want to return to work in Indonesia, why people prefer to be treated abroad, watch this video


Watch the minutes 01:32-02:15, A person who has shame should be embarrassed. I am really sorry to see this guy. He is just doing his job, defending IDI (Indonesian Doctor Association). Glad to see, now the Indonesian media could speak more openly to public.

This is also how IDI treat the junior doctors to get their licence


IDI (Indonesian Doctor Association) is allegedly one of the root cause of the problems. In Indonesia the licence to practice as medical practitioner or even to open a medical school were issued by IDI. Since recently, it is taken over by the department of health. I think one of the main reasons why IDI is making it difficult for foreign doctors to get licence is that their members can not compete to get wealthy patients in Indonesia. Keep in mind many wealthy patients will pay whatever it takes if it can cure their diseases.

Just look at the Indonesians doctors licenced by IDI, trying to find work in the world renown hospitals, only a few could make it. Others are ended up working as adult carers/nurses instead of working as doctors.

Also in Indonesia many of Indonesians doctors could study medicines at good state universities without passing the main entrance test. Even they fail the main entrance test they could still be trained as a doctor if they want to pay a few hundred millions rupiahs, using what is the so called a non subsidised route (jalur mandiri). The money, tuition fees collected from a non-subsidised route is managed by the university itself with less accountability to the public and government. Depending on their creativity, they could literally spend most of this money for comparative studies (euphemism for having nice holidays, foreign travels funded by public money).

Instead of addressing this low quality candidates they complicate or cause difficulties to get a licence to practice as doctor for foreign doctors, or Indonesian doctor diaspora.

 

[harryopal1]

Anyone had esperience with dialysis in Bali? Later may find that treatment necessary but returning to live in Australia now on the pension with impossibly high rentals and overall inflation makes it nigh impossible. Apprehensive about dialysis treatment here