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Freedom of association and assembly is guaranteed by the Indonesian constitution. Because of that said the General Secretary (Sekum) of the Indonesian Doctors Association (PDSI); dr. Erfen Gustiawan Suwangto, Sp.KKLP, SH, MH (Kes), everyone has the right to gather and join any organization that he believes can realize his struggle and protect him when problems arise. According to him, the current medical organization must be reformed so that it is not outdated.

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For more than 70 years since IDI (Indonesian Doctors Association) was founded on October 24, 1950, not a single medical organization has emerged outside of IDI. The birth of PDSI became the first medical organization that could appear without a recommendation letter from IDI. In dr. Erfen Gustiawan Suwangto, Sp.KKLP, SH, MH (Kes) what happened to his organization, such as breaking a deadlock or breaking an egg. There is nothing wrong with them asserting that there is a need for reform in medical organizations.

“So far, there are many doctor associations, but all of them are under the auspices of IDI. After 70 years new PDSI emerged and not under IDI. This is the first time and the eggs are broken. In the past, the Minister of Law and Human Rights would not have given permission for a doctor's organization if there was no letter from IDI," he said.

Although proclaiming itself as a place and place for doctors to gather, the emergence of PDSI, said Erfen, is not to compete with IDI's hegemony so far. This is because they also do not want IDI's authority, which has been considered too large so far. They just want to position the medical organization like in foreign countries, such as the United States. Medical organizations are not singular and doctors are free to join organizations as they see fit.

He denied the presence of PDSI because they were among the ranks of the hurt because of Doctor Terawan Agus Putranto, a former Minister of Health who was permanently dismissed from IDI membership recently. He said it was just a moment. Efforts to fight the dominance of IDI have been carried out since 2017. “So long before there was chaos regarding Doctor Terawan. We ask the Constitutional Court so that the Medical Colligium, which is a specialist association, is independent from IDI," he said.

As a new medical organization, the targets set by PDSI are not many, one of which was revealed by the man who graduated from the Primary Service Medical Specialist Education Program at the University of Padjadjaran, was their plan to propose amendments to Law No. 29 of 2004 on Medical Practice. How the emergence of PDSI began and the steps to be taken now and in the future, here are excerpts of his interview with Iqbal Irsyad, Edy Suherli, and Rifai from VOI who met him at his practice in Tambora, West Jakarta, recently.

Dalamistilah  dr. Erfen Gustiawan Suwangto, Sp.KKLP, SH, MH (Kes) kelahiran PDSI seperti pemecah kebuntuan. (Foto: Rifai, DI: Raga /VOI)
In dr. Erfen Gustiawan Suwangto, Sp.KKLP, SH, MH (Kes) the birth of PDSI is like breaking the deadlock. (Photo: Rifai, DI: Raga /VOI)

The Association of Indonesian Doctors (PDSI) recently declared, what is the basis for the birth of this PDSI?

The basis for the establishment of PDIS is that freedom of association is guaranteed in Article 28 of the 1945 Constitution. From there, the Ministry of Law and Human Rights of the Republic of Indonesia issued a decree for us (PDSI). So the basis for the birth of PDSI is the 45 Constitution and the Decree of the Ministry of Law and Human Rights. With an association legal entity, the status of PDSI is the same as that of IDI which is also registered as a mass organization. So when juxtaposed PDSI is equivalent to IDI.

What is the vision and mission of the establishment of PDSI?

Our vision is to pioneer medical reform in Indonesia. Meanwhile, the first mission is to protect the Indonesian people as well as our members, doctors. The second improves the welfare of our people and members. And the third is to bring Indonesia to the world. We are not only players at the local and national level, but we also want to work together and then develop ourselves in the global realm.

Who are the founders of this PDSI?

There are 10 founders including myself. First, of course, the General Chairperson of PDSI, Brigadier General TNI (Ret.) Dr. Jajang Edi Priyatno Sp.B., MARS. Then those who sit as Deputy Chair: Prof. dr. Deby Susanti Pada Vinski, M. Sc, Ph.D. While sitting as my own Secretary: dr. Erfan Gustiawan, Sp. KKLP, SH, MH (Kes). There is also a Deputy Secretary: Dr. dr. H. Dahlan Gunawan M. Kes, MH, MARS. As General Treasurer: dr. Firman Parulian Sitanggang, Sp.Rad (K) RI, M.Kes. Then Deputy Treasurer: dr. M. Arief El Habibie, MSM. For the Board of Trustees: Dr. dr. Siswanto Pafield, SH, MM. While the Supervisory Board: Dr. dr Hendrik Sulo, M.Kes, Sp.Rad., and dr. Timbul Tampubolon, SH, MKK.

Since when was this PDSI prepared, after Doctor Terawan was permanently dismissed by IDI?

The establishment of PDSI has been prepared for quite a long time, so the dismissal of Doctor Terawan from IDI is just a momentum. How many times have I been to the Constitutional Court (MK) to question the IDI issue since 2017. So long before there was a chaos regarding Doctor Terawan. We ask the Constitutional Court that the Medical Colligium, which is a specialist association, is independent from IDI. So we have never actually sued IDI's singularity (as a medical professional organization). So that the Constitutional Court's decision regarding the singularity of IDI has never existed. This is different from the news circulating, if the Supreme Court's decision confirms that IDI is the sole forum for medical professional organizations. Please re-read the Court's decision on this matter.

At that time, the Constitutional Court rejected our application not because it did not agree with us. However, the Constitutional Court said this could be resolved internally without having to change the law. With AD-ART, the Medical Specialist Colligium can be independent even under the IDI umbrella. One of our claims was granted by the Constitutional Court, namely that IDI administrators and administrators of medical professional organizations may not hold concurrent positions at the Indonesian Medical Council.

Finally, after the decision, Professor Ilham Oetama Marsis was dismissed from the Indonesian Council by the President. Because actually abroad there has never been anything like this. The Medical Council is under the state, appointed by the president. So there are no representatives from professional organizations. Because he is a regulator, the regulated period can enter as a regulator as well. There is a conflict of interest there. The Constitutional Court is also anti-monopolistic just like PDSI. It turned out that the dismissal was opposed by IDI despite losing many times to the level of the Supreme Court.

Kepada para dokter,  dr. Erfen Gustiawan Suwangto, Sp.KKLP, SH, MH (Kes) untuk tidak takut mengemukakan pendapat. (Foto: Rifai, DI: Raga /VOI)
To the doctors, dr. Erfen Gustiawan Suwangto, Sp.KKLP, SH, MH (Kes) not to be afraid to express opinions. (Photo: Rifai, DI: Raga /VOI)

Did those who joined PDSI used to be IDI members?

Oh sure, even I myself am not only a member but an administrator. I was a member of the Medical College, the Jakarta Regional Ethics Council. So I also handled the file, Doctor Terawan. So don't think that we at PDSI are people who are hurt, relations with other IDI members are still normal friends. In foreign countries there is no requirement for a doctor to join a medical organization.

In the American Medical Association, America's IDI, only 20 percent of doctors join. And their authority is not as big as that of IDI. So they're just like a doctor's union. The focus is on creating legal aid institutions, scholarship institutions, cooperatives and others, unlike IDI which is authorized by the state. Because PDSI is different from IDI and PDSI also does not position itself as a rival to IDI. Because we don't want to have the authority of IDI.

So we want it to be like abroad, that the professional association is not an association that seems to act as a “state”. Taking care of licensing issues, practice recommendations, to the issue of whether or not certain methods are allowed. So we are no match for IDI because the authorities are different. We position ourselves as a pioneer of medical reform in Indonesia.

The IDI said they were a professional organization while PDSI was an Ormas, what is your opinion?

Don't get me wrong, IDI is also an Ormas, when we filed a lawsuit against the Constitutional Court, IDI was a related party. We question the legal standing of IDI. However, the IDI emphasized that they are a professional organization, but this matter was reprimanded. Well, because of that in 2020, IDI is back again to register itself as a mass organization.

Indonesia does not yet have a Law on Professional Organizations, so no one is recognized as a professional organization. All are included in the category of Ormas/Associations. Since re-registering with the Ministry of Law and Human Rights, the name of their organization is no longer IDI (Indonesian Doctors Association), but has changed to the Indonesian Doctors Association (PIDI). So for us they are no longer in the law, because what is written in the law is IDI, not PIDI (current name). Doctors don't need to be afraid to join PDSI, no one has the right to revoke their license to practice, I'm still practicing.

So far, there are many doctors' associations, how do you observe them?

It's true, so far there have been many doctors' associations, but all of them are under the auspices of IDI. After 70 years new PDSI emerged and not under IDI. This is the first time and the eggs are broken. In the past, the Minister of Law and Human Rights would not give permission for a doctor's organization if there was no letter from IDI.

Is the permit issuance for PDSI due to political factors, because there is Doctor Terawan in this context?

For us, no, there is clearly no written rule that requires permission from IDI to form an organization. So far this has happened out of habit, eventually becoming jurisprudence. But his level is under the law, he is not written.

Doctor Terawan finally joined PDSI even though he was not included in the beginning, in what position?

He has officially joined PDSI as the PDSI Protective Council.

Regarding the recommendation for a doctor's practice permit, is there anything other than IDI has been issued?

How come, maybe without a recommendation from IDI, it can be a recommendation from the association. That's okay. Because there was also one of our colleagues who was not given a recommendation, it ended up being a polemic. That's why this is dangerous, this recommendation might not come out because of the likes and dislikes factor. There must be a clear reason for not being given this recommendation.

So how about standardization, this is a crucial matter, patient's life?

The standard is still from the Medical Council and the Ministry of Health that issued it. Why should there be a double standard, later PDSI, IDI or any medical organization will only provide suggestions. So far, to be honest, why are all medical seminars given to IDI? The council only had a stamp or stamp, because so far the council had been co-opted by IDI. So far, by law, IDI has not much authority. Just because of a license to practice, the Council also reduced its authority secretly. After all, it is a state agency. Therefore, when he became Minister, Mr. Terawan replaced the concurrent member of the Council. And IDI put up a fight. So we have nothing to do with standardization. We, PDSI only provide input, if the Ministry of Health wants it.

What PDSI is doing is to return to ideal conditions like abroad, that the Medical Council should not come from a professional organization. This is actually why PDSI emerged, what has happened so far is beyond tolerance.

There is another problem, a new specialization should have emerged, but it was constrained at the IDI Mukhtamar. As is well known, the congress forum is political, there may be certain doctors who are disturbed if a new specialization emerges. Even though this specialization is needed by the state, abroad there is already a new specialization. A concrete example is Dr. Adib Khumaidi who works as an Emergency specialist, he just went out of his way to graduate this specialist. Imagine that IDI administrators want to start a specialization, and they just keep on going. Especially the others. Doctor Terawan is just one example. This means that there is something that needs to be straightened out. IDI mixes political elements with education.

What are the future targets for PDSI?

We would like to propose an amendment to the Medical Practice Act. This revision is not only related to the organization, but is more comprehensive. For example, about medical education, how to make it affordable for ordinary people.

Doctor Erfen Gustiawan Suwangto's Holiday Style, After a New Seminar on Tourism
Sibuk dengan segudang aktivitas,  dr. Erfen Gustiawan Suwangto, Sp.KKLP, SH, MH (Kes) punya trik sendiri untuk berwisata. (Foto: Rifai, DI: Raga /VOI)
Busy with a myriad of activities, dr. Erfen Gustiawan Suwangto, Sp.KKLP, SH, MH (Kes) has his own tricks for traveling. (Photo: Rifai, DI: Raga /VOI)

Busy as a doctor, lecturer, lawyer and various other activities does not make PDSI Secretary; dr. Erfen Gustiawan Suwangto, Sp.KKLP, SH, MH (Kes) lost his mind to travel. With the accurate tricks he does, the formal activities that he carries out are carried out while tourism activities can also be carried out, making him even more refreshed to conduct seminars or other official events.

While other people are busy fiddling with their schedules and looking for travel opportunities, what this man who also teaches at a private university in Jakarta does, is calm. "I'm just waiting for the schedule of seminars or work visits to be carried out at home and abroad. Let the organization or place I work think about. After an event is held in an area or country, I just need to look for a tourist attraction not far from the event where I conduct a seminar or work visit,” said the man who was born in Pangkal Pinang, August 5, 1985.

In this way, he does not have to bother looking for and which places he will visit. In addition, the costs incurred are also relatively cheaper. Because he did not deliberately just to visit the place. But he did it while working or seminars.

With a model like this, Erfen actually wants to be productive in every time he leaves. “So if I travel somewhere I can still be productive. You can still make presentations or present papers to seminar participants or present research results in certain forums. So it's not purely a walk, it starts with an event," he said.

However, he could not do this method at all when the COVID-19 pandemic was at its peak in the world. Almost the whole world was affected by the pandemic, so the travel schedule of this single man was forced to be postponed. The problem is that the planned events are also canceled and replaced with online activities.

“Some time ago I was getting ready to join the Asia Pacific Family Doctors Congress in New Zealand. I have prepared my paper and everything, but it was canceled because of the pandemic. The activity was canceled even though I had planned to invite my parents and sister, “he said.

In addition there is also a congress event held in Dubai UAE, because it is still in a pandemic situation, the event is undergoing adjustments. “For those in Dubai, it is not canceled, but there are changes. All events are live, converted to online. Yes, that's the situation because it's not possible. Thankfully, things have started to slow down now," he said.

Erfen hopes that the international congress he will be participating in in Bali in the next few months will be held as before the pandemic. “I will also join the Asia-Pacific international congress in Bali in December. This congress is still held in connection with the G20 event held by Indonesia as the organizer of its activities," he continued.

When traveling, he not only has fun, but also adds knowledge and new relationships. “So one way I can get a few things. Even though sometimes I get a little muffled, when I see in the photos the place I'm going to visit is really good. Eh, after being visited, it's not as beautiful as the photos. There are better places in the country,” he said with a laugh.

Culture

Salah satu tempat yang kerap disambangi  dr. Erfen Gustiawan Suwangto, Sp.KKLP, SH, MH (Kes) di macanegara adalah tempat pelayanan kesehatan setempat. (Foto: Rifai, DI: Raga /VOI)
One of the places that dr. Erfen Gustiawan Suwangto, Sp.KKLP, SH, MH (Kes) in Macanegara is a local health service place. (Photo: Rifai, DI: Raga /VOI)

Not only is Erfen a popular tourist spot when he travels, the culture of the local community is also interesting for him. “Because I am not only a doctor but also a humanities person, I am also interested in community activities. If there is an international seminar in a country, we always see what the practice of doctors there is like, what kind of puskesmas facilities are there,” he continued.

One of the interesting things, Erfen said during a working visit to Thailand. “At the puskesmas in one of the villages in Thailand, it turned out that it accommodated traditional birth attendants and shamans with broken bones. There are no professions like this in Indonesia that are accommodated in puskesmas. It's interesting what the Thai government has done to accommodate the two professions. Because they are easier to direct, because they already have experience. This also makes the public there not hesitate to come to the puskesmas, because they can also find traditional birth attendants and shamans with broken bones in health facilities managed by the government,” he said.

Through this method, he said, several goals can be achieved. “Through this activity, we can invite the community to access health facilities and also respect local wisdom. All can be combined in one container and the same activity, “continued Erfen.

Another finding which he said could be a lesson during his visit and tour to Australia. “When I went to Australia I asked for that country's Health Act. It turned out to be very simple, only a few sheets. Compared to in our country, the length is unbelievable. The Ministry of Health is among the ones that issue the most regulations," he said.

Still in Australia, some health facilities, such as ambulances, are assisted by nearby companies, such as mining companies. "CSR, a mining company in Australia, helped procure ambulances for public health facilities," said Erfen.

Organization

Di akhir pekan  bagi dr. Erfen Gustiawan Suwangto, Sp.KKLP, SH, MH (Kes) adalah waktu untuk berkumpul bersama keluarga. (Foto: Rifai, DI: Raga /VOI)
On weekends for dr. Erfen Gustiawan Suwangto, Sp.KKLP, SH, MH (Kes) is a time to gather with family. (Photo: Rifai, DI: Raga /VOI)

Erfen admits that his hobby is organizing and defending the truth. “I can at least see people around me being oppressed. One time one of my colleagues who was taking a gynecology specialist was reported to have committed a crime. Me and some friends are doing advocacy,” he said.

The case of his colleagues who experienced inappropriate treatment was not just that. There are also those who are bullied, blackmailed by their seniors and so on. "I will open up about things like this," said the man who also likes running in his busy schedule.

Family for Erfen is very important even though he himself is not yet married. “Every weekend I have time to get together or eat with my parents. Frankly, during this pandemic, I suggest they just stay in Jakarta so it's easier to monitor them. And my parents accepted my argument for asking to live in Jakarta,” said the doctor who specializes in family medicine.

He invited his colleagues who could not take family medicine specialist education. The problem is that this field has no less potential than other medical specialties that were previously popular. “I invite my fellow doctors, both senior and junior, to want to pursue this specialty, this field is no less promising. Moreover, the requirements are not as difficult as if you specialize in other fields,” said Erfen Gustiawan Suwangto.

“The MUI itself already has a fatwa, the MUI terrorist fatwa is haram with all kinds of attributes used, such as using the word khilafah, the word jihad, or other words that are misused in the form of violence and other forms such as the practice of suicide bombings. It is against the teachings of Islam.”

dr. Erfen Gustiawan Suwangto, Sp. KKLP, SH, MH (Kes)


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