JAKARTA – Doctor Terawan Agus Putranto, former Minister of Health of the Republic of Indonesia, has been dismissed from the membership of the Indonesian Doctors Association (IDI). This decision was stipulated at the 31st IDI congress in Banda Aceh, March 25, 2022. As a member of the IDI, Terawan was judged to have committed a serious ethical violation.
"The dismissal was carried out by PB IDI no later than 28 working days," said an excerpt from the video of the trial's decision which was shared by UI Epidemiologist Pandu Riono via his Twitter account @drpriono. Pandu allowed his tweet to be quoted.
Terawan's name immediately became a conversation after being fired by the Medical Code of Ethics Council (MKEK), the main board of IDI. The consequence is that Terawan is in danger of not being able to apply for a practice permit anymore.
This is not the first time there has been news of Terawan's dismissal from the IDI membership. In 2018, dismissals were also carried out on the grounds of serious ethical misconduct, or serious ethical violations. The decision to dismiss Terawan from IDI membership in 2018 was stated by the Chair of the IDI MKEK, doctor Djoko Widyarto JS.
"For Terawan's colleagues, there is a special note that the decision has been in place since 2018 and has not been implemented. With special considerations, which was enforced in October 2018 there was a letter from PB IDI stating that the sanctions had come into effect," Djoko said during a press conference, Thursday, March 31.
The serious ethical violation in question is related to the treatment of chronic ischemic stroke through the Diagnostic Digital Subtraction Angiography (DSA) conducted by Terawan since July 2014. Even though this method has not yet obtained scientific medical evidence. As a diagnostic procedure, the cost of the procedure is also called fantastic.
Doctor Terawan did this not in the research phase, but in the implementation phase in the community. This violates medical and pharmaceutical ethics, because the medical action has not been published scientifically.
The MKEK also stated that Terawan had seriously violated ethics and imposed a sanction in the form of temporary dismissal as an IDI member for 12 months, from February 26, 2018 to February 25, 2019. The Assembly also recommended the revocation of his practice permit.
According to the prevailing mechanism, Terawan at that time had the opportunity to defend himself before being definitively fired. But Terawan did not take the opportunity to defend himself.
Responding to his dismissal from IDI membership, Terawan was resigned. The doctor who is a soldier is adamant that his practice is based on the humanity he said when he was sworn in as a doctor.
"Let my brothers and sisters decide whether I can stay at home or be kicked out on the street. I have been sworn to always dedicate my life to humanity, prioritizing the health of patients, and the interests of society. like siblings, so I look after all my brothers there," Terawan said in a statement released by his communication team, Andi, Tuesday, March 29.
Who is Terawan?Terawan Agus Putranto was born on August 5, 1964 in Yogyakarta. His education from elementary to university was taken in Yogyakarta. He took his undergraduate education at the Faculty of Medicine, Gadjah Mada University and graduated in 1990.
After completing this education, Terawan continued his education in the military field by entering Sepawamil 1990. Now this education is known as the Indonesian National Armed Forces Career Officer's School.
Terawan started his career as a military doctor in the Indonesian Army in 1990. His first assignment was as a doctor at the Mataram Army Hospital, Lombok for eight years, 1990-1998.
In 2009, Terawan was listed as a member of the Presidential Doctors Team. In addition, he is an expert doctor at the Gatot Soebroto Army Hospital. He then served as head of the hospital in 2015.
The Most ControversialTerawan always invites controversy. It is not only related to the method of treatment he uses, but also the policies he issued while serving as Minister of Health for 2019-2020.
The commercial practice of intra-arterial heparin flushing (IAHF) for stroke patients, or who has the general term “brainwashing” is the treatment method that has received the most attention from IDI. Although it has helped a lot of patients, IDI does not budge that this method has not been clinically tested and has passed the publication stage in medical scientific journals.
While serving as Minister of Health, Terawan issued a Minister of Health Regulation (Permenkes) which stipulates that radiology services will only be carried out by radiology specialists. With Permenkes No. 24/2020, radiology services can no longer be performed by non-radiology doctors.
Dozens of doctors' organizations objected to the Minister of Health Regulation No. 24 of 2020. They considered that the regulation would interfere with public health services.
Terawan's ensuing controversy saw him fired from the seat of Minister of Health. Jokowi rebuked the Ministry of Health for being slow in budget absorption. Finance Minister Sri Mulyani also said that the verification process carried out by the Ministry of Health was the reason for the delay in disbursing incentives for health workers.
Then the Secretary General of the Indonesian Forum for Budget Transparency said that Terawan stuttered and was less responsive when dealing with the COVID-19 pandemic.
The Nusantara vaccine has also made Terawan a hot topic of discussion because he is the initiator of the vaccine created to fight COVID-19.
Spokesman for PB IDI, Dr. Beni Satria, at an online IDI press conference, stated that the issue of Terawan's termination of membership was a long case that had been rolling since 2013. Terawan's dismissal was said to be unrelated to the Nusantara vaccine polemic.
"Relation to the Nusantara Vaccine is the authority of the government agency in this case BPOM. This decision has nothing to do with the Nusantara vaccine," said Beni on March 31.
Inviting AttentionThe internal conflicts of this professional organization received wide attention, ranging from support to opposition from many groups. Doctor Andi Khomeini, a health practitioner who is also a social media activist, assessed that mediation was needed to mediate this protracted feud and regretted that the news was getting wider.
"The different paths between Doctor Terawan and the assembly in the Indonesian Doctors Association were led to the cebong-kadrun conflict. Even though the solution is easy. Do an audit and mediation," Andi said in his tweet.
"And because it has become a public discussion, in my humble opinion, the audit and mediation are open. To be clear," he said again on his Twitter account @dr_koko28.
Terawan's replacement Health Minister, Budi Gunadi Sadikin, in a virtual press conference, Monday, March 28, said that he as the government's representative observed the conflict between Terawan and IDI.
“We observe the dynamics surrounding the debate or conflict between the Indonesian Doctors Association and Dr. Terawan. We understand that each professional organization has its own by-laws and has its own members which they need to regulate," Budi said in a virtual press conference related to the dynamics of the medical profession.
"This is just a misunderstanding that can actually be worked out together," said Deputy Chairman of Commission IX DPR, Emanuel Melkiades Laka Lena about the crisis between IDI and Terawan.
According to Emanuel, the House of Representatives Commission IX will invite both parties to jointly seek a solution to this problem, while still prioritizing the honor and nobility of the profession.
"With communication, I believe this problem can be resolved," he said.
According to him, both parties must suppress all egos and continue to focus on the interests of the community at large, not personal or group interests
The Ministry of Health and the DPR are committed to mediating the crisis that occurred between IDI and Terawan Agus Putranto. This meeting is important to create more conducive conditions, as well as to advance medical science in Indonesia.
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