Bad doctors 'force many to seek treatment abroad'

Sari P. Setiogi, The Jakarta Post, Jakarta

Poor facilities and badly trained doctors have prompted many Indonesians who can afford it to seek treatment abroad, Minister of Health Achmad Sujudi said on Wednesday.

He said wealthy Indonesians had spent some US$600 million last year on their medical treatment in overseas hospitals.

Speaking at a two-day seminar on the improvement of hospital quality in Jakarta, Sujudi said hospitals often offered inadequate treatment that meant patients often had to fork out more money for costly medication or pain relief.

Because of this, and the increasing allegations of malpractice in the press, many Indonesians had little faith in local hospitals, he said.

Citing the results of a survey, Sujudi said Caesarean section deliveries in many hospitals had increased sharply in Indonesia. "Is that true that most women here have hip problems that force them to get Caesareans?" he said.

A Caesarean delivery is normally only made when circumstances surrounding a birth could put the health of the mother or the child in danger.

However, many Indonesian women were now choosing Caesareans for cosmetic reasons, to avoid labor pains, or even to give birth on a certain day for luck.

"People here still pay their medical costs based on one-fee- for-one-service system, which prompts hospitals to offer many cost-effective services in a bid to get more fees from patients," Sujudi said.

He said all professionals in hospitals should be full-time. "A doctor should only practice in a maximum of three different hospitals."

However, many, if not most, Indonesian doctors worked for a series of different hospitals, leaving them with little time to communicate with their patients.

"If we look (at hospitals) abroad, we find they are now more patient-oriented, while most of our hospitals are still doctor- oriented. Nurses here only serve doctors, not patients. This is wrong," Sujudi said.

"Patients like to have good service. Being ill does not mean they should be treated authoritatively. We should learn to treat our patients more democratically," he said.

Medical services director-general at the Ministry of Health Sri Astuti Suparmanto said doctors here often prescribed too many medicines.

"In cases of flu, some doctors often prescribe more than one medicine, when one might be enough," she told the seminar.

Reports of poor medical treatment at Indonesian hospitals were confirmed by the head of a marketing department at a prominent hospital in Jakarta.

She told The Jakarta Post that although she was working for a hospital, she never underwent any medical treatment at home.

"I know doctors and their abilities, and I know the service offered by hospitals here. For the sake my own health, I don't think I would be willing to be treated here," she said.

"We should expect better service from both hospitals and doctors. To speed up improvements perhaps it would be better for hospitals here to combine in franchises with hospitals abroad," she said.

She quoted marketing expert, Hermawan Kartajaya, who once said, "If we cannot compete with our enemies, we should make friends with them."

There are about 1,000 private and 600 state hospitals in Indonesia.