Common Perception Between Doctors and the Government is Needed

Ministry of Health Regulation (Permenkes) No. 24 of 2020 concerning Clinical Radiology Services issued by the Minister of Health, dr. Terawan has reaped controversy from several specialist doctors and professional colleges because it affects patients and health services. Responding to this issue from the side of medical academics, Dr. dr. Wiwik Kusumawati, M.Kes, Dean of the Faculty of Social and Political Sciences, Universitas Muhammadiyah Yogyakarta (FKIK UMY) gave an opinion on Permenkes No.24 of 2020.

When interviewed on Saturday (10/10), dr. Wiwik Kusumawati, M.Kes stated her opinion that the Ministry of Health Regulation No. 24/2020 has certain objectives that must be communicated to several stakeholders who will implement the regulation, because it is related to the competence of specialist doctors. “I think that a policy should have a specific purpose, so it must be discussed in more detail, to reach a common perception, so that in practice the Permenkes can be accepted by all parties. Looking at the Permenkes that involves a clinical radiology service, that service is closely related to the competence of specialists in a particular field, such as radiologists, internal medicine specialists, obsessive specialists and gyminologists, surgeons, people who have certain competencies according to their profession, the regulation should be considered more so as not to cause problems in practice,” she explained.

Dr. Wiwik also explained the flow of diagnosing patients through several procedures performed by specialist doctors, using radiology to support disease diagnosis for patients. “Regarding radiology, in a clinical context, it relates to examinations by doctors and patients. Several things must be done to establish a diagnosis, which needs to be done through a series of examinations, starting from analysis, physical examination, and supporting examinations. This supporting examination includes radiological examinations, such as x-rays, ultrasound, MRA, CT-Scan, and others. All in order to establish a definite working diagnosis of the patient’s disease. A working diagnosis, if done properly, then the therapy for the patient will also be appropriate according to the patient’s condition. This is a series of events that a doctor should go through. On the other hand, it is true that in certain conditions there is an intersection between specialist fields, such as the fields of ob-gyn, surgery, and internal medicine. This requires supporting examinations in order to establish a diagnosis. This is done by a specialist doctor using radiology. For example, a pregnant woman whose examination uses ultrasound performed by a specialist in the field of Obstetrics and Gynecology, will be examined by the specialist. However, according to the Regulation of the Minister of Health No. 24/2020, what is done is the supporting examination will be done indirectly under the authority of a radiology specialist,” she explained.

Permenkes No.24 of 2020 concerning Clinical Radiology Services can be a quotation mark in the sense that it can be used to support service to patients, if there are communication and coordination between radiology specialists and other specialist doctors. “On the other hand, I still don’t know if the government policy will include radiology department or installation in health services such as the clinics or Puskesmas. When radiology medical personnel are present in every health service, then applying Permenkes No. 24 will not be difficult, but we don’t know how long these radiology specialists will be available. If this rule is applied in an important condition and there is an urgent need to carry out an examination, for example ultrasound or radiology to make a quick diagnosis and there are still certain procedures that must be passed, of course this can cause potential problems in patient management. This then becomes the pros and cons between radiologists and other specialists,” she added.

The Policy must Focus on Patients

During the interview session, Dr. Wiwik emphasized that the policy of Permenkes No.24 of 2020 should prioritize patient care. “We should focus on the patient’s well being in handling the patient’s disease or health problem, so that the treatment of the patient can really be applied in practice or at any level of service, especially the primary, secondary, tertiary levels,” she concluded.

Application of Permenkes No.24 of 2020, should be considered carefully and not done hastily, especially because this Permenkes is issued in the midst of the Covid-19 pandemic. “We need to concentrate on handling Covid-19, so the regulation should be made relevant to the current conditions. This means that government policies, especially the minister of health, should support solving problems related to the current condition of society. If indeed it is considered to be risky and can potentially cause conflict, it is necessary to carry out communication and coordination between stakeholders carefully and not in a hurry,” she concluded. (Sofia)

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