Doctors are also humans, who have hearts and feelings. So, they can also experience burnout. According to the Chairman of the Indonesian Junior Doctors Network (JDN), dr. Tommy Dharmawan, Sp.BTKV, PhD, this reality happens to doctors. Globally, his data shows that 5-10 percent of doctors experience burnout. For affected doctors, they are ready to help and advocate.

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According to medicalnewstoday.com, burnout is a type of stress that someone experiences in a job or role that makes them feel tired, overwhelmed, or helpless. This causes a person to lose interest in their role, feel unprepared for the job, and lose sight of purpose. In many cases, someone who is experiencing burnout may no longer want to do their job.

The past COVID-19 pandemic was one of the reasons for the high burnout rates experienced by doctors. “The global prevalence is around 5 to 10 percent. Many factors can cause doctors to experience burnout, such as low welfare, hard-working hours, and lack of support from family and the environment. We hope to be able to help doctors who are experiencing a situation like this," said Tommy Dharmawan, who was newly inaugurated as General Chairman of JDN Indonesia at the National Gathering which took place in Jakarta in July 2023.

Even though Tommy doesn't have the latest data on how many doctors in Indonesia experience burnout, a study conducted by the 2020 Study Program in Occupational Medicine, Faculty of Medicine, University of Indonesia (FKUI), illustrates a moderate prevalence rate of burnout among health workers during the COVID-19 pandemic. 19 reached 82 percent. Of the 1,414 respondents from various professions, 716 respondents were doctors, 390 respondents were midwives, and 151 respondents were nurses.

Not only regarding colleagues who are experiencing burnout, as the highest leader of JDN Indonesia, Tommy Dharmawan also coordinates with JDN International and the Indonesian Doctors Association (IDI) in carrying out activities. Including public health education, empowering doctors, and community lifestyle issues that affect health quality. "Before doctors move to help maintain public health, of course, they must be healthy physically and spiritually," he told Edy Suherli, Savic Rabos, Rifai, and Dandy Januar from VOI, who met him at the Dr. R. Soeharto (PB IDI), Menteng, Central Jakarta, recently. This is the excerpt.

You were elected as General Chairman of JDN Indonesia, what is the crucial program you want to realize during your tenure as General Chairman?

Broadly speaking, there are two things we will do, namely inside and outside. First, we want to empower young doctors, starting from activities that have not been accommodated so far, such as sports and the arts. Furthermore, we also have a movement to protect doctors in remote areas. Doctors who have just graduated pay around 2 million. That is very low, even below the UMR Jakarta which is now 4.9 million. There is also advocacy for friends who are still in advanced school at the specialist level, allegedly being bullied by their seniors. Is it true that what is circulating in the news, we will do advocacy regarding this matter.

For JDN Indonesia, what is the vision and mission of this organization in moving?

We cannot be separated from JDN International, because we are their representative for Indonesia. JDN is formed by the Medical Association in each country, or IDI if in Indonesia. Our vision and mission are not much different from JDN International. Our vision is to become a young generation of doctors who are productive, solid, and useful for the public. Our mission is to create solid, consolidated, and useful programs for the young generation of doctors.

JDN Indonesia as a forum for empowering young doctors to work together to create a healthier Indonesia through education, advocacy, and what collaborations are being and will be carried out?

Before making people healthy, the first thing to do is to make sure the doctors are healthy first. We want to protect the physical and mental health of these doctors. We hold sports and art competitions for doctors. In addition, we also improve the skills and competence of these doctors. After that, only these doctors can try to improve the health of society. The trick is to provide education to the community through various existing facilities and infrastructure. The government wants to make doctors as agents of change in society.

How to?

Doctors will provide education to the public, both directly and through their social media. We will also implement programs such as healthy schools or healthy pesantren in institutions such as schools and Islamic boarding schools. We also have a drug-free healthy generation program. This is done by JDN which already has representatives in 34 provinces throughout Indonesia. Our members now cover 40 percent of all doctors in Indonesia, which is around 100,000 doctors. This is a great potential that must be optimized. They are also active with their respective social media.

You emphasized that the doctor must be healthy first. Are there any indications that make the doctor unwell?

During yesterday's pandemic, many doctors experienced burnout. Doctors also have benchmarks for staying mentally healthy. Therefore, we learned that doctors must be physically, mentally, and spiritually healthy. We have a program to help doctors who are experiencing burnout find a way out. Young doctors must have good capacity and capability so they can help make the community healthy.

How many doctors have burnout?

We don't have specific data for Indonesia yet, but the global prevalence is around 5 to 10 percent. Many factors can cause doctors to experience burnout, such as low welfare, hard-working hours, and lack of support from family and the environment. We hope to help doctors who are in this situation.

JDN Indonesia is part of IDI. How is the synergy carried out with IDI and other medical professional organizations?

JDN International Coordinator, Dr. Uchechukwu Chukwunwike Arum, when attending the JDN Indonesia Silatnas some time ago, stated that JDN always relies on existing medical organizations, such as the IDI. Therefore, we follow the organizational rules and regulations set by IDI. We have plans to hold our own conference before 2025. We also collaborate with JDN International on their programs focused on youth empowerment, research, and more.

Talking about the current level of public health in Indonesia, is there an index that measures the level of public health? What is Indonesia's position among other countries?

There are many rankings that measure the public health index. One of them is the Global Health Security Index (GHSI). Currently, Indonesia is ranked fourth in ASEAN in terms of public health index. Thailand is ranked first, followed by Singapore and Malaysia. After that, Indonesia was in fourth position, followed by the Philippines and other countries. From this index, it can be concluded that efforts to improve public health are urgently needed.

What concrete steps should the government take to improve the public health index?

Even though the COVID-19 pandemic has subsided, the government needs to face three main burdens. The first is the COVID-19 pandemic, the second is the increasing incidence of communicable diseases (for example, TB), and the third is the increasing number of non-communicable diseases. The government must cooperate with JDN to conduct education, especially with the younger generation who are active on social media.

A culture of prevention is better than cure, is this ingrained in our society? If not, what can be done to make it a culture?

We still don't have a strong culture of prevention. For example, in the BPJS and health budget, there is still a high balance on the curative side. I've written in the media about the importance of prevention. So, when we promote prevention, the budget for curative treatment should be reduced. However, this requires a long time. Therefore, the government needs to support this effort.

Many diseases arise from a bad lifestyle such as cancer, diabetes, and heart disease. What are your suggestions for increasing public awareness of this?

There is a lot that results from an unhealthy lifestyle. In terms of smoking, there are many efforts that can be made, one of which is the government increasing cigarette excise. Likewise, with sweetened drinks, I agree with the government's plan to impose excise duty on sweetened drinks. While I was studying in Japan, I saw how the government was educating the public about the high sugar content in sweetened drinks, which is unhealthy. However, in Indonesia, there has been no such campaign. Finally, the burden of these three factors arises, including diabetes.

What are the concrete steps to encourage people to be more aware of a healthy lifestyle?

In addition, sports activities must be increased both individually and collectively, for example at work. In addition, a healthy lifestyle can be emphasized by giving sanctions to employees who are overweight. Lifestyle is closely related to non-communicable diseases.

Are all proposed objectives and activities covered by existing laws or regulations?

Not everything can be regulated in law. The government needs to discuss with professional organizations and related parties to realize efforts to improve public health. However, what is lacking is the required budget allocation. The government should pay more attention to this budget allocation. Although there are several countries that have insufficient budget allocations in this field but are still healthy, this needs to be seen in context.

Have attempts to propose changes to this matter been made?

The Ombudsman Health Act is indeed designed with a broad scope. Therefore, there will be derivative regulations that will be applied. We plan to draft these derivative regulations together, and although there are some colleagues who will be seeking a judicial review of this law, we are focusing more on developing the derivative regulations.

Tommy Dharmawan Is Lucky To Have A Mother Who Is As Strict As A Lion

All mothers want their children to be successful in their studies and careers. dr. Tommy Dharmawan, Sp.BTKV, PhD is very lucky to have a mother who is firm in educating and directing him. In Tommy's terms, his mother is like a lion or tiger mom, so firm. However, it is because of this firmness that has become the basis of his success in his career as a Cardiologist and Vascular Surgeon who is now trusted as General Chair of JDN (Junior Doctors Network) Indonesia, an organization of doctors under the age of 40.

Since childhood, Tommy admits, he had no aspirations to become a doctor at all. “It never crossed my mind to become a doctor. The problem is my parents are not doctors, and none of my immediate family members are doctors," he admits.

The desire and confidence to enter the Faculty of Medicine (FK) emerged when I was in high school. "When I was in high school, after my final exams, I only had the desire to try to enroll in medical school if I got good grades and met the requirements," continued the son of the couple Tien Yososuwito and Imam Wiryosumarto.

And after trying, Tommy was surprised. It turned out that he was accepted at the Faculty of Medicine, University of Indonesia (UI), which is targeted by many high school students who want to realize their dream of becoming a doctor. "Thank God, after taking the entrance test, I was accepted at FK UI," said Tommy, who completed his studies at FK UI in 2008.

Upon investigation, what Tommy was able to achieve turned out to be a big contribution from his mother who returned to God during the past COVID-19 pandemic. "My mother was very strict in educating me, when I was in elementary school my math score dropped, and she immediately gave me a punishment by pinching," he said, who completed Cardiovascular Thoracic Surgery Specialist at UI in 2015.

Not only waiting for the final result, but during the process the mother also supervised. "When it's time for tutoring, I haven't left yet, she will go around my housing complex. She will look for me. And when she found me, she also made sure that I went to English lessons. The problem is when I play, I sometimes forget the time, hehe,” he admits.

After growing up, he just understood why his mother was so strict. “My mother was really strict in educating me, so I could study hard. She wants the best results. In the end, I also enjoy it," said Tommy, who holds a PhD, Gunma University Graduate School of Medicine - Japan (2019), and a number of training and scholarships both from within and abroad.

“It feels so good now that I am a surgeon. There can't be any mistake. The discipline taught and applied by my mother is very beneficial,” he said while adding that his mother always emphasized when doing something it had to be right, precise, and diligent.

The only Doctor in the Family

The burden of completing education at FK UI was already felt when he was accepted into the yellow jacket student corps. The problem is that no one in his family has become a doctor. “I realize that the hope to become a doctor does not only come from within me, but my family, especially my mother and father and extended family expect me to complete my education. And I really take care of it, I don't want to disappoint them," said Tommy Dharmawan who is now working at the UI Hospital and several private hospitals in Jakarta.

According to Tommy, the biggest challenge in completing studies at FK is not being able to procrastinate on assignments. "So you can't delay and you have to be diligent, once you can overcome this, your path to becoming a doctor will be smoother," he said.

After completing his studies as a general practitioner, he was not satisfied. He went on to specialize in surgery. "I am interested because I prefer work by hand, surgery must be done by hand even though it is assisted with tools too. And next, the results of the actions that I and my team carried out can be immediately seen by the patients and their families," said the Deputy Secretary General of the Indonesian Cardiovascular and Thoracic Surgery Association 2021-2023.

Although now the progress of science and technology is so rapid, including in the field of medical surgery. There is artificial intelligence (AI) that allows the surgical process to be assisted and replaced by robots. But Tommy remains optimistic that robots cannot replace the human side of a doctor.

“In the world of medicine, robotic surgery already exists. Surely the work of a surgeon will be rivaled by the presence of such sophisticated science. But there are several operations that still have to use humans, they still need surgeons because robots can't do it," he admits.

Tommy has his own tricks so he can compete with robots. “The human side that cannot be lost and cannot be replaced by no matter how sophisticated the robots that are created. The approach and attitude of a doctor cannot be replaced by a robot. So how do you become a humanist doctor while still being aware of developments in medical science and technology," said the man who once served as Chair of the FK UI Student Senate 2004 - 2025.

Effective Research

As a doctor, Tommy is fairly diligent in doing research. He has conducted a number of research and published them in international journals. And that is a matter of pride for him. "One of the things that makes a researcher proud is when people read their research results and they will be even happier if they are cited by other researchers," he admits.

And as a doctor, ideally, continued Tommy, he should do research. Because every time he examines a patient, what he does is do research.

He advised doctors, especially those younger than him, to be more diligent. “Doctors must be more diligent in studying. Must be aware of the rapid development of technology, and learn about it. You have to be able to educate the public," suggested the winner of the Dean's Awards, Gunma University Japan (2019), and the Social Contribution Awards, Gunma University Japan (2019).

The challenges in the world of medicine today and in the future are enormous, but behind that there are also enormous opportunities and it would be a shame to waste them. "That's what doctors, especially young ones, have to achieve," emphasized Tommy Dharmawan who also won Best in Show Case Reports, Heart Rhythm Society, Boston USA, May 2018, and a number of other awards.

"The global prevalence of doctors' burnout is around 5 to 10 percent. Many factors can cause doctors to experience burnout, such as low welfare, heavy working hours, and lack of support from family and the environment. We hope to help doctors who are in a situation like this,"