DOI: https://doi.org/10.14710/dmj.v12i5.40503

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

*Tuntas Dhanardhono  -  Department of Forensic and Medicolegal, Faculty of Medicine, Universitas Diponegoro, Indonesia
Wian Pisia Anggreliana  -  Division of Forensic and Medicolegal, Sunan Kalijaga Hospital, Demak, Indonesia, Indonesia
Intarniati Nur Rohmah  -  Department of Forensic and Medicolegal, Faculty of Medicine, Universitas Diponegoro, Indonesia
Sigid Kirana Lintang Bhima  -  Department of Forensic and Medicolegal, Faculty of Medicine, Universitas Diponegoro, Indonesia

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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.

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Keywords: dilemma; ethical; professional; National Health Insurance System; Indonesia
Funding: Faculty of Medicine, Universitas Diponegoro under contract 68/UN7.5.4/HK/2019.

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