Doctors' Unions within the Framework of Professional Protection and Public Interest

In Indonesian healthcare services, the burden on doctors is increasing faster than their protection. World Health Organization (WHO) data indicates that Indonesia’s doctor ratio is around 0.47 per 1,000 population, far below that of many other countries. The issue is not only the number but also the distribution. Disparities between regions remain evident and are acknowledged by the government as a primary challenge. Under these conditions, doctors work under high pressure. Handling dozens of patients per day, making quick decisions, and facing clinical risks that are never zero. However, the greatest pressure arises when medical practice intersects with the law. In recent years, medical disputes have increasingly entered the criminal realm directly. Real examples abound. In 2025, allegations of malpraxis at RS Metta Medika in Sibolga were immediately processed criminally, while authorities awaited recommendations from the professional disciplinary council. On a national scale, the government has also recorded dozens of medical dispute cases in recent years. This pattern places doctors in a vulnerable position. Not because they are immune from the law, but because the evaluation mechanisms are not yet proportional to the nature of medical practice. On the other hand, working conditions are also not uniform. Based on various field reports, the income of general practitioners in primary care in several regions ranges from Rp5-8 million per month, and under certain conditions can drop to around Rp3-4 million, especially when service fees are unstable. At the same time, the government must prepare significant incentives to attract doctors to certain areas. This indicates clear imbalances within the same system. The early career stage is not free from issues either. In 2023, participants in the Indonesian Doctor Internship Programme voiced delays and uncertainties in incentives. This issue is not merely about amounts, but certainty regarding the basic rights of medical personnel who have already provided services. The diversity of conditions between regions and cities, primary and referral services, as well as public and private sectors, is often referred to as professional fragmentation.