Mon, 22 May 2000

Standard income for medical specialists needed: Experts

JAKARTA (JP): A standard for the minimum wage for medical specialists is needed to encourage them to work in areas which offer fewer benefits, experts said here on Saturday.

Gadjah Mada University's health services management center's director, Laksono Trisnantoro, said that the standard would make hospitals and local governments prepare a "decent" incentive if they were willing to employ specialists.

"An obstetrician-gynecologist who is a civil servant in Abepura Papua State Hospital in Irian Jaya only receives a monthly salary of Rp 1 million from the provincial government," Laksono told a one-day seminar seeking a standard income for specialists.

He added that the amount was far from decent given the profession's level of responsibility.

"It is unlikely for the doctor to earn more money from opening a private practice because people (in Irian) are poor," Laksono said.

In East Kalimantan, Laksono said, medical specialists could receive Rp 15 million a month from opening private clinics because people could pay more there. In Jakarta, specialists can earn even more, he said.

Laksono said that while many areas in Indonesia need medical specialists, 23.63 percent of all doctors are working in Jakarta.

"In Aceh, there is one anesthetist to four million people, while there are a lot of trauma cases there," Laksono said.

However, the seminar failed to propose a standard for a specialist's minimum wage. There were proposals to set a standard for specialists' fees. But other participants said this was impossible because services among specialists were perceived to be of different quality.

The Ministry of Health's employment bureau head, Koeswartini M. Suhel, warned the seminar that many regional governments would not able to afford to employ a specialist if the minimum wage was set too high.

Chairwoman of the Indonesian Consumers Foundation's plenary board, Zumrotin K. Susilo, said setting a service standard was more important than determining income standards for specialists, moreover if a desire for "a luxurious life" was taken into account.

Zumrotin said that "the excuse" of insufficient specialists is often used to neglect patients and hand over the role to general practitioners who have no special expertise. But consumers often still had to pay the specialists' fee, she said.

Health experts have noted the frequent incidents of patients made to pay high costs for unnecessary medical procedures.

Laksono said setting a standard for specialists would help prevent them operating in too many places. The Indonesian Medical Association allows specialists to practice in up to seven places.

"This is impossible," Laksono said. "Jakarta is congested." The regulation might extend to surgeons "operating via the phone", he said.

Laksono's paper also touched on discrepancies between private and government facilities.

A 1998 thesis by Ketut Sandjana on the monthly income of specialists in Denpasar, Bali, shows that a specialist in private practice earned 10 times more than one in the Sanglah government hospital. (08)