Local patients seek 'personal touch' abroad

JAKARTA (JP): Indonesia's lack of sufficient medical facilities and the absence of an overall personal touch in health care may be among reasons thousands head to Singapore every year.

Through necessity, the government has focused on meeting basic medical provisions due to the nation's huge population and geographic scope.

Like most of the developing world, Indonesia is an agricultural society still beset by "traditional" health problems, according to Dr. Karjadi Wiroatmodjo of the Dr. Soetomo Teaching Hospital in Surabaya, East Java.

Health development programs since the late 1960s have concentrated on maternal and child health care, family planning, nutrition, immunization environmental sanitation.

But disease patterns are changing as a result of economic development.

Karjadi noted that from 1985 to 1990, the number of orthopedic surgeries at Dr. Soetomo soared by 253 percent.

Before 1990, the private sector was barred from investing in hospitals.

Private sector participation since then has helped improve the quality of health care in the country.

There are now 515 private institutions among 1,039 hospitals nationwide.

But with only about 17,000 doctors, 14 percent of whom work in private hospitals, the ratio of physicians to the current population of 200 million is staggeringly low.

To fight heart disease, the leading cause of death, the country can only plan setting up cardiac clinics across the country, with the National Cardiac Center at Harapan Kita Hospital serving as a referral center.

This is the most viable option as it is too costly to establish more hospitals and pharmaceutical production facilities.

In the greater Jakarta area alone, analysts project the need for 5,000 more hospital beds by the turn of the century.

The harsh reality is there may not be enough for everyone, including those seeking better quality medical services.

The Ministry of Health's Director General of Medical Care, Soejoga, notes that improved education and income levels have increased people's expectations.

They now want specialists in addition to standard general practitioners, he said.

Soejoga maintained that motivation for people seeking medical care abroad was not just a question of quality.

"In my opinion, our medical facilities and quality of our doctors aren't much different from other countries," he argued.

He attributed the penchant for foreign treatment to the lack of a personal touch among some local medical personnel.

Some doctors were unable to maintain close relationships with patients, he said, but abroad "the patient is considered king".

But doctors in Singapore spoke highly of their counterparts in Indonesia.

Cardiothoracic and vascular surgeon Dr. Lee Chuen Neng said infirmaries like Harapan Kita had adequate facilities, but the limited number of surgeries they could perform often led patients to travel abroad.

Neurosurgeon Dr. Balaji Sadasivan made a similar observation, adding that while hospitals like Gleneagles in Singapore had an edge in various medical facilities, its counterpart, the Siloam Gleneagles in Hospital in Jakarta, was being assisted to catch up in several areas.

Balaji said a doctor's manner with patients should be thorough and open to discussing all their concerns, particularly for foreign ones who had traveled great distances.

Indonesian patients are "too appreciative", he said.

"You quickly bond with them and when they come back they never forget to bring something personal for me, usually a cake. As a result of treating so many Indonesian patients, I've probably tasted cakes from every Indonesian region."

The holistic approach of providing all aspects of patient needs is something which Indonesia could learn to adopt.

"Patients are apprehensive when they go abroad...We try and make sure that they feel at home," said Tan-Hoong Chu Eng, head of Physician Relations of Parkway Group Healthcare.

Parkway has developed a one-stop Medical Referral Center (MRC) for patients in Singapore and abroad seeking medical assistance or information.

"The MRC helps to arrange for the appropriate specialist consultation, medical evacuation and even makes arrangements for accommodation for the accompanying relative," she said, referring to the (62) 755-2000 hot line serving both English and Indonesian speakers.

Since its establishment last year, the MRC has received 400 calls monthly, more than half from Indonesia, she said. (09/mds)