Quality of Healthcare and Physicians

Yeah, doctors here are hit and miss (often miss).

Some anecdotes, off the top of my head:

1. That time I had the audacity to be admitted in ER with horrible kidney stone pain. I waited 3 hours in agony, puking everywhere due to pain, for the specialist to come back from sholat jumat

2. The time I went to see a surgeon due to very slight but odd pain near my nether region after deadlifting and feeling a little "pop". Without examining me, checking temp or anything else, he concluded I had appendicitis and should be operated on immediately. Obviously, I walked off and went to RSPI where I was quickly and accurately examined for a hernia inguinal.

3. The time I messed up my knee (I think I shared about this), basically bend it the wrong way in a motorbike accident. Knee was like a watermelon and the surgeon wanted to operate immediately, which is not recommended at all. In the end, I waited 3 weeks with some physiotherapy for my knee to swell down and do a confirmation diagnosis through knee manipulation that my ACL was truly gone.
 
Yeah, doctors here are hit and miss (often miss).

Some anecdotes, off the top of my head:

1. That time I had the audacity to be admitted in ER with horrible kidney stone pain. I waited 3 hours in agony, puking everywhere due to pain, for the specialist to come back from sholat jumat

2. The time I went to see a surgeon due to very slight but odd pain near my nether region after deadlifting and feeling a little "pop". Without examining me, checking temp or anything else, he concluded I had appendicitis and should be operated on immediately. Obviously, I walked off and went to RSPI where I was quickly and accurately examined for a hernia inguinal.

3. The time I messed up my knee (I think I shared about this), basically bend it the wrong way in a motorbike accident. Knee was like a watermelon and the surgeon wanted to operate immediately, which is not recommended at all. In the end, I waited 3 weeks with some physiotherapy for my knee to swell down and do a confirmation diagnosis through knee manipulation that my ACL was truly gone.
Ouchies El_G.

I have a couple too-
The doctor I went due to an ear infection (it was oozing gunk) purely to get a certain medication.
This is in some strange little 'clinic' near my house - it is literally a house living room. She was the only person there. I said "Are you the doctor?" She flounced "I am , do you need me in a white jacket?" Before I could reply, she went off & came back again with some random beige jacket on.
I told her I had an ear infection. She insisted on looking in my ear and promptly pronounced that I had an ear infection.
After looking in my ear, she just put her equipment back on the tray- without cleaning procedures. She prescribed me a medication that has been banned in most countries.

Then there is the ENT specialist I went to see due to a strange lump on my neck. He didn't even look at it before he announced - "it isn't cancer- you are too pretty to get cancer- pretty women do not get cancer."
He decided that a lump on my neck was a GERD symptom.
(There seems to be a theme re Docs and GERD diagnoses).
Needless to say, I walked out & threw his prescription for PPI & pain meds in the trash.
 
Yeah, doctors here are hit and miss (often miss).

Some anecdotes, off the top of my head:

1. That time I had the audacity to be admitted in ER with horrible kidney stone pain. I waited 3 hours in agony, puking everywhere due to pain, for the specialist to come back from sholat jumat

2. The time I went to see a surgeon due to very slight but odd pain near my nether region after deadlifting and feeling a little "pop". Without examining me, checking temp or anything else, he concluded I had appendicitis and should be operated on immediately. Obviously, I walked off and went to RSPI where I was quickly and accurately examined for a hernia inguinal.

3. The time I messed up my knee (I think I shared about this), basically bend it the wrong way in a motorbike accident. Knee was like a watermelon and the surgeon wanted to operate immediately, which is not recommended at all. In the end, I waited 3 weeks with some physiotherapy for my knee to swell down and do a confirmation diagnosis through knee manipulation that my ACL was truly gone.
Anecdotes plenty ...
But one incident at the hospital made my really angry ...
After examination ... by a doctor\specialist (who cannot speak English) ... I had to wait in the lobby of the hospital for more than a hour ... just to receive the bill and to pay. Huh? And I am a so-called 'pribadi', meaning I pay the hospital treatments by cash.

I was expecting some kind of diagnosis and medicine.
 
I have a tumor that grew from a salivary gland. It is from something missed over 30 years ago from a tumor surgery in the same place. My wife suggested I have it looked at and removed again here. In the US it took over 6 hours of surgery. Special monitors hooked to facial nerves to avoid cutting any when they were scrapped. Told my wife chances of me living longer with it were much better than if I had surgery where a local surgeon worked long on the side of my head and neck. So far that has been the case.

At my age, soon to be 73, I have to weigh life expectancy against suggestions concerning my well being. I challenge any and all medical advice. I look up all medications prescribed, especially for contradictions with meds already being taken. Even with a list of current meds right in front of the doctor which I provide every visit, they still give things that should not be given with what I already take. When I mention it they just say it will be OK because others have taken it.

I have a standing order of no life support if something doesn't have a quick fix. I see no reason to keep a hospital supplied with the cash my wife would need going into the future.
 
But on a positive note:

It is extremely easy to self medicate with drugs being sold without any prescription And thus no doctor visit necessary.
Antibiotics? Blood thinners? Alpha blockers? No problem. :whoo:
 
Anecdotes plenty ...
But one incident at the hospital made my really angry ...
After examination ... by a doctor\specialist (who cannot speak English) ... I had to wait in the lobby of the hospital for more than a hour ... just to receive the bill and to pay. Huh? And I am a so-called 'pribadi', meaning I pay the hospital treatments by cash.
This is the normal procedure here though. Unlike in many western countries the wards and administrative persons there don’t have payment terminals. So you practically always need to go to the (central) cashier. And then to the apotek to wait an hour for your medication.
 
For all the genuine criticisms of the Indonesian health system it is ironic and appalling that in Australia at least there is something of a hospital crisis so that even being taken by ambulance to emergency there is a practice called ramping where patients lie in wait and now not infrequently die in wait for hours as there is not enough capacity to handle the cases. If we go to a local emergency section here in Jimbaran you are seen in minutes.
1717034614901.png
 
I'm not sure if I'm lucky, so far we have very positive experiences in Indonesia . I recall some of our major medical treatment with good result or at least no complain.
1. 1985, successful RK surgery (old version of lasik) in Airforce hospital jakarta, I was the 3rd patient, the previous two are pilots.
2. 1992, hospitalized at Bethesda Yogya Hospital due to hepatitis A.
3. wife - MMC Jakarta for typhus.
4. my two children were born at Hermina Hospital; normal and C.
5. late mum had cataract surgery at JEC
6. my younger daughter had Lasik at JEC
7. my wife had retinal detachment surgery at JEC
8. recently I had ERCP at Eka hospital and then Laparoscopic cholecystectomy at RS Pondok Indah.
but our experience outside indonesia (Brunei, Singapore, Turkey, NL, UK, US, Egypt, KZ, Nigeria) were not all perfect.
I had complication ERCP surgery and laparoscopy scam in Egypt. Wife was not very happy with service of a well known hospital in london, and my daughter complain about her knee surgery in US.

this lady had collarbone surgery and left the hospital with puncture lung.
 
Eye surgery and LASIK is probably one of the more advanced (and better) developed areas in the medical world in RI.

For dengue, Lyme, malaria and rabies you‘re also probably better off here than in a western country.

Did you really mean typhus or was typhoid?
 
Eye surgery and LASIK is probably one of the more advanced (and better) developed areas in the medical world in RI.

For dengue, Lyme, malaria and rabies you‘re also probably better off here than in a western country.

Did you really mean typhus or was typhoid?
sorry, typhoid
 
Study at favourable medical school in Indonesia
Money Route : Up to Rp 161.670.000 (one off payment) + Rp 20.0000.000 per semester
Regular Route (based on talent) : From Rp 0 + Rp 500.000 per semester.
Screenshot 2024-07-16 153031.jpg

So, the news that a person will need to have a few hundred million rupiah to study medicine at a good university in Indonesia is referring to the "money route" rather than the "talent route".

There are two major funding models for higher education in the world: the European System (state-funded, no additional money collected from the student's parent) and the Anglo-American model (Mainly survive from Tuition fees, private donation on competitive basis) but all of the cost, academic staffs, admin staffs, new buildings are all paid by the universities.

State universities in Indonesia are using a mix of these two systems, another example of cherry-picking when there is public money that could be easily collected with less accountability. There are now around fifty percent of students at the state universities in Indonesia accepted via 'money route'

In Indonesia, professors, lecturers, and administrative staff at state universities are civil servants, meaning their salaries are paid by the state, not by the university. Additionally, the costs for buildings and land acquisition are covered by the state. This raises the question: where does the majority of the money collected directly from students go?

For comparison, several private universities in Indonesia also have medical schools and own their own teaching hospitals. They manage to sustain themselves with minimal government support by charging less than state universities 'money route'. Despite this, they still need to cover the salaries of their teaching staff, professors, lecturers, and administrative personnel. They produce doctor's comparable to those produced by state universties.

In other countries, when funds are collected directly from the public for local income instead of through national revenue and customs, there is typically a requirement for some level of transparency. This usually involves producing annual report, statistics to the stakeholders detailing the amount of money collected, its allocation, and the percentages used for various purposes such as building new facilities, training lecturers, and advancing education. However, in Indonesia, I have not observed any such statistics being produced.
 
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Study at favourable medical school in Indonesia.....
Money Route : Up to Rp 161.670.000 (one off payment) + Rp 20.0000.000 per semester
....... Additionally, the costs for buildings and land acquisition are covered by the state. This raises the question: where does the majority of the money collected directly from students go?
That's like expecting a magician to reveal how he does his tricks.
1721181282140.png
 
Of course the income of a tax does not have to be used or spent in the same field. Don’t think for one second the road and car tax is used to improve the state of the asphalt. Practically nowhere btw.
 
Study at favourable medical school in Indonesia
Money Route : Up to Rp 161.670.000 (one off payment) + Rp 20.0000.000 per semester
Regular Route (based on talent) : From Rp 0 + Rp 500.000 per semester.
View attachment 4180
So, the news that a person will need to have a few hundred million rupiah to study medicine at a good university in Indonesia is referring to the "money route" rather than the "talent route".

There are two major funding models for higher education in the world: the European System (state-funded, no additional money collected from the student's parent) and the Anglo-American model (Mainly survive from Tuition fees, private donation on competitive basis) but all of the cost, academic staffs, admin staffs, new buildings are all paid by the universities.

State universities in Indonesia are using a mix of these two systems, another example of cherry-picking when there is public money that could be easily collected with less accountability. There are now around fifty percent of students at the state universities in Indonesia accepted via 'money route'

In Indonesia, professors, lecturers, and administrative staff at state universities are civil servants, meaning their salaries are paid by the state, not by the university. Additionally, the costs for buildings and land acquisition are covered by the state. This raises the question: where does the majority of the money collected directly from students go?

For comparison, several private universities in Indonesia also have medical schools and own their own teaching hospitals. They manage to sustain themselves with minimal government support by charging less than state universities 'money route'. Despite this, they still need to cover the salaries of their teaching staff, professors, lecturers, and administrative personnel. They produce doctor's comparable to those produced by state universties.

In other countries, when funds are collected directly from the public for local income instead of through national revenue and customs, there is typically a requirement for some level of transparency. This usually involves producing annual report, statistics to the stakeholders detailing the amount of money collected, its allocation, and the percentages used for various purposes such as building new facilities, training lecturers, and advancing education. However, in Indonesia, I have not observed any such statistics being produced.
It seems, there are a lot of so called Doctors here, that from what I've seen, don't seem qualified, to be practicing medicine! They bought their degree, and didn't earn it, which is scary to me!
 
Is that so different from the west? Did you see the recent scandal in the renowned hospital in Belgian where they fired more than 10 radiologists on the spot? Incompetence, malpractice and incorrect advice.
 

A translation of a piece of the article:

Don't feel like writing a thesis? In Indonesia then you rent a joki
In Indonesia, there is plenty of fraud at universities. Status is more important than knowledge. Ghostwriters write theses and dissertations. „Nobody here reads a book.”

An Australian English teacher received about 5,000 to 10,000 US dollars when he delivered a ready-made thesis. For years he earned a large sum of money from wealthy children, civil servants and politicians who do want the social benefits that an academic title in Indonesia brings, but are not able or willing to do the work for it.

The Australian, who does not want his name in the newspaper, talks about his experiences as a joki in a coffee shop in Jakarta, as the Indonesian term for academic ghostwriters goes. „The amount of payment depends on the amount of work. Sometimes the research material has already been collected.” In other cases, there is only an idea, he explains. „And sometimes the person has already made a plan and he or she got stuck.”

Such fraud is punishable in Indonesia, but still widespread. In July, Tempo Magazine described how a network of eleven professors at the Lambung Mangkurat University in South Kalimantan published fake articles in dubious scientific journals. They did so to meet the requirements of their appointments.

Government officials were also involved in the fraud, including bribery. A true 'professor's mafia', writes the magazine. The revelation followed the suspension of dean Kumba Digdowiseiso of the Technical Institute PLN in Jakarta, after scientist Ilias Alami, affiliated with the University of Cambridge, suddenly saw his own articles appear under the name Digdowiseiso. The dean is said to have written no less than 160 scientific publications in 2024 alone. That work has now come in a different light.

Alarming observation
It is not only professors and civil servants who are guilty of publication fraud. The Jakarta Post newspaper recently came up with the alarming observation that it is fully accepted for many students to use a ghostwriter for a thesis. "As long as you understand the matter, hiring a joki is okay," a student explains to the newspaper. On special websites, jokis offer their services for rates between 30 and 130 dollars per hour – an article, thesis or thesis can be ordered in no time. Looking at the supply, it is a large industry.

Research figures support this impression. Indonesia is number two in the world in the field of academic deception, after Kazakhstan, according to two Prague researchers in the journal Quantitative Science Studies in 2022. It concerns three types of fraud: dubious publications in fake magazines (no quality requirements as long as you pay); plagiarism and hiring a joki, a ghostwriter.

The fraud culture is a legacy of the autocratic Suharto period, says the Australian. Under his reign, Soeharto ruled from 1967 to 1998, there was plenty of corruption, nepotism and self-enrichment. „Everyone with power bought his or her academic title from a 'title mill', a fraudulent academic institute. It wasn't even illegal.” He himself first came into contact with the fraud in 1996, two years before the fall of Suharto. "I worked in the Sudirman building, here in the heart of Jakarta," he continues. "Every now and then two foreigners came by. I knew who they were. Expired alcoholics, pricked in a business suit, so that they looked acceptable. They sold academic titles to people from business and politics. For five thousand US dollars each, if I remember correctly.”

Many Indonesians attach a title to their name, says Tristam Moeliono (58), research leader in legal philosophy at the Faculty of Law of the Catholic Parahyangan University of Bandung. „I think it's still a remnant of feudal culture.” Students and their parents are also mainly concerned with the title. They hope to climb the social ladder faster. „Students get angry when I ask difficult questions in exams. Don’t you want us to succeed, they say.”

Knowledge gathering is subordinate to many students, says Moeliono, who received his doctorate from Leiden University in 2011. „In Leiden, study life is concentrated around the library. No one here reads a book.” Partly because few students speak English, he says. Most students get to know each other through lectures and limit themselves to the teaching materials provided to them. „They do not venture into international literature.”
 

A translation of a piece of the article:

Don't feel like writing a thesis? In Indonesia then you rent a joki
In Indonesia, there is plenty of fraud at universities. Status is more important than knowledge. Ghostwriters write theses and dissertations. „Nobody here reads a book.”

An Australian English teacher received about 5,000 to 10,000 US dollars when he delivered a ready-made thesis. For years he earned a large sum of money from wealthy children, civil servants and politicians who do want the social benefits that an academic title in Indonesia brings, but are not able or willing to do the work for it.

The Australian, who does not want his name in the newspaper, talks about his experiences as a joki in a coffee shop in Jakarta, as the Indonesian term for academic ghostwriters goes. „The amount of payment depends on the amount of work. Sometimes the research material has already been collected.” In other cases, there is only an idea, he explains. „And sometimes the person has already made a plan and he or she got stuck.”

Such fraud is punishable in Indonesia, but still widespread. In July, Tempo Magazine described how a network of eleven professors at the Lambung Mangkurat University in South Kalimantan published fake articles in dubious scientific journals. They did so to meet the requirements of their appointments.

Government officials were also involved in the fraud, including bribery. A true 'professor's mafia', writes the magazine. The revelation followed the suspension of dean Kumba Digdowiseiso of the Technical Institute PLN in Jakarta, after scientist Ilias Alami, affiliated with the University of Cambridge, suddenly saw his own articles appear under the name Digdowiseiso. The dean is said to have written no less than 160 scientific publications in 2024 alone. That work has now come in a different light.

Alarming observation
It is not only professors and civil servants who are guilty of publication fraud. The Jakarta Post newspaper recently came up with the alarming observation that it is fully accepted for many students to use a ghostwriter for a thesis. "As long as you understand the matter, hiring a joki is okay," a student explains to the newspaper. On special websites, jokis offer their services for rates between 30 and 130 dollars per hour – an article, thesis or thesis can be ordered in no time. Looking at the supply, it is a large industry.

Research figures support this impression. Indonesia is number two in the world in the field of academic deception, after Kazakhstan, according to two Prague researchers in the journal Quantitative Science Studies in 2022. It concerns three types of fraud: dubious publications in fake magazines (no quality requirements as long as you pay); plagiarism and hiring a joki, a ghostwriter.

The fraud culture is a legacy of the autocratic Suharto period, says the Australian. Under his reign, Soeharto ruled from 1967 to 1998, there was plenty of corruption, nepotism and self-enrichment. „Everyone with power bought his or her academic title from a 'title mill', a fraudulent academic institute. It wasn't even illegal.” He himself first came into contact with the fraud in 1996, two years before the fall of Suharto. "I worked in the Sudirman building, here in the heart of Jakarta," he continues. "Every now and then two foreigners came by. I knew who they were. Expired alcoholics, pricked in a business suit, so that they looked acceptable. They sold academic titles to people from business and politics. For five thousand US dollars each, if I remember correctly.”

Many Indonesians attach a title to their name, says Tristam Moeliono (58), research leader in legal philosophy at the Faculty of Law of the Catholic Parahyangan University of Bandung. „I think it's still a remnant of feudal culture.” Students and their parents are also mainly concerned with the title. They hope to climb the social ladder faster. „Students get angry when I ask difficult questions in exams. Don’t you want us to succeed, they say.”

Knowledge gathering is subordinate to many students, says Moeliono, who received his doctorate from Leiden University in 2011. „In Leiden, study life is concentrated around the library. No one here reads a book.” Partly because few students speak English, he says. Most students get to know each other through lectures and limit themselves to the teaching materials provided to them. „They do not venture into international literature.”
Wow, I could be a joki too ... earn some extra cash.
 
After some of my experiences here with Doctors here, not knowing what to do, and prescribing the wrong medications, I believe they bought their degrees.
 
I bet chatgpt has decimated the industry though
True, that’s probably the new solution. The western universities seem not to have solutions in place to fight this as they had for detecting the copy and steal online approach.
 

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