Ethical and Professional Dilemmas encountered by Doctors in the National Health Insurance System

Abstract

Background: The implementation of the National Health Insurance System in Indonesia has not only increased access to medical services but also raised various dilemmas among doctors. Objective: This study aims to analyse various ethical and professional dilemmas among physicians in the National Health Insurance System (NHIS).Methods: This is a cross-sectional descriptive study with a purposive sampling method. A questionnaire was distributed online between June to December 2019 to physicians practicing in Indonesia.Results: Of the 87 doctors who participated in this study, 60.92% were general practitioners and 39.08% were specialists. The inability to maintain professional independence (63.41%) is the most common ethical dilemma faced by doctors with 65.38% of them experienced in advanced level health facilities. Meanwhile, the limitation of adequate medical care in an emergency (25.45%) is the most dilemmatic situation experienced in terms of professionalism with 85.71% occurring in advanced level health facilities.Conclusion: Physicians in Indonesia were deal with various dilemmas while practicing in the NHIS. The high rate of dissatisfaction and the various ethical problems and professional disciplines require a review of the health system to improve the quality of services and maintain the professionalism of doctors.

Kekerasan dalam Pacaran yang Dialami oleh Perempuan : Sebuah Kajian Literatur

“…Hal tersebut serupa dengan temuan hasil analisis yang menemukan beragam perilaku kekerasan ekonomi diberikan oleh pelaku kepada perempuan korban kekerasan dalam pacaran, yakni pemanfaatan hak milik dengan menggunakan barang milik korban, permintaan material terkait biaya kehidupan sehari-hari, mengambil uang secara paksa, dan memanfaatkan untuk mendapat barang-barang mewah (Khaninah & Widjanarko, 2016;Sholikhah & Masykur, 2020;Mesra et al, 2014;Huzaimah, 2019;Astutik & Syafiq, 2019;Haes, 2017). Temuan ini sejalan dengan penelitian oleh (Wulandaru et al 2019) yang pada penelitiannya terdapat 13% kasus kekerasan ekonomi dengan perilaku kekerasan berupa peminjaman barang yang tidak dikembalikan serta pemaksaan untuk membayar segala keperluan.…”