The Indonesian general practitioners\u2019 perspectives on formal postgraduate training in primary care

Fitriana Murriya Ekawati,Adi Heru Sutomo,Mora Claramita,Wahyudi Istiono,Hari Kusnanto

doi:10.1186/s12930-018-0047-9

Fitriana Murriya Ekawati, Adi Heru Sutomo + Show 3 more

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https://doi.org/10.1186/s12930-018-0047-9

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Abstract

BackgroundTo be recognized as a primary care physician (PCP), an Indonesian general practitioner (GP) has to follow a formal postgraduate training in primary care. However, 4 years since the regulation was published, the progress of the training is slow. There is a need to deeply investigate the doctors’ perspectives, particularly to explore factors associated with their willingness to follow this training.AimThis study aims to explore the GPs’ views and perspectives related to the formal postgraduate training in primary care that may influence their enrolment in PCP program.MethodsWe conducted semi-structured interviews with a topic guide. The study took place in Yogyakarta from January to December 2016. The participants were GPs practicing in Yogyakarta primary care clinics who were recruited using purposive-maximum variation sample design. The interviews were audio-recorded and transcribed. The data were analysed using interpretative phenomenological analysis approach.ResultsNineteen GPs participants were involved in this study. Three major themes were identified, namely unfamiliarity, resistance, and positivism. Almost all the GP participants were unfamiliar with the primary care training program. They were also pessimistic if the training could change the health service in the country while it lacked resources and infrastructures. However, exposure to the training brought positive insights that it could improve the doctors’ knowledge and skills in primary care practice.DiscussionThe government intention to establish PCP training is currently on the right tract. However, information dissemination and more supports in primary care are also essential.

Highlights

To be recognized as a primary care physician (PCP), an Indonesian general practitioner (GP) has to follow a formal postgraduate training in primary care
Nineteen GPs participants were involved in this study
Almost all the GP participants were unfamiliar with the primary care training program

Summary

Introduction

To be recognized as a primary care physician (PCP), an Indonesian general practitioner (GP) has to follow a formal postgraduate training in primary care. In response to the above WHO suggestions, the Indonesian government has been implementing the universal health coverage policy-which is known as Jaminan Kesehatan Nasional (JKN). In line with the JKN implementation, the Indonesian government had prepared a structured formal postgraduate training for general practitioners (GPs) to upgrade their skills in Ekawati et al Asia Pac Fam Med (2018) 17:10 primary care. The training was stipulated in Medical Education Act number 20-year 2013 [5] In this regulation, the terminology of ‘primary care physician’ (PCP) was introduced as a doctor having an equivalent position as a specialist. To be recognized as a PCP doctor, the GPs have to follow a formal postgraduate training in primary care conducted by 17 medical faculties licensed by the Indonesian Ministry of Education. The PCP curriculum content was designed according to international recommendations of family medicine training, consisting of advanced training for the GPs to have more person-centred care, continuity of care, community-oriented, holistic and comprehensive care for their patients, leadership in general practice, and primary care management [6, 7]

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