IMPACT Law PRACTICE OF MEDICINE

ON

HOSPITAL AND DOCTOR.

By

SETYA HERRY Yudhautama, dr, Spb, FInaCS

Legal provisions medical practice, many arranged in a variety of product legislation; Law among others. 23 of 1992 on Health, PP. 32 Year 1996 regarding Health Workers. Besides, there's more regulation in the form of Minister of Health, who is often questioned because of the juridical aspect PERME (KES) excluding khierargi the laws of Indonesia. But "funny" its Constitution Act Praktektek medicine (BFL) No. 29 of 2004 mengamanahi that comes by candy (Article 43 BFL) so came the sweets (KES) on the Implementation 1419/menkes/per/X/2005 number (should the implementation) Practice Doctors and dentists as well as remove Permenkes 916/menkes/per/VII/1997 numbers, to "cute" it's probably one of the ambiguities in the implementation gap later. But even so because of BFL already passed and enacted by the Indonesian State Gazette No. 116 of 2004 will inevitably have been binding on the parties to any deficiency and excess. One drawback of the above rules are not yet able to answer all the challenges and issues that arise relating to implementation of the practice of medicine, is still not well integrated, as well as the uncertain shape regulation and supervision and is not optimal in the empowering potential of the profession and the institutions involved.

How will the implementation of the BFL?

Often missed by state law subjects and objects in the care of her. Society now by dr. Sofwan:

Better understand their rights, but unfortunately less offset by increased understanding of medical logic and the logic of the law, so consequently all forms of adverse event as a generalized case of malpractice. (Adverse events are events that do not match expectations caused by medical intervention rather than by the disease itself and nature of injury) .
Increasingly litigious (sue and sue fond of hospitals or physicians).
Smakin doctor looked at not as a partnership in addressing health problems.
Increasingly accepted the concept of human rights as the basis for determining the field of social policy and law
The higher appreciation of the principles of consumerist-me, among others, the principle of "he who pays the piper calls the tune" (flute musician who pays then he determines the tone or song).

Medicine itself, in recent decades, also experienced significant changes, among others: (dr.Sofwan).

1. Increase the rapid progress of science and technology (as a result of changing the world of medicine become research oriented ) that led to medical paradoxes (ie what was previously impossible is now possible and what was previously considered asymptomatic medical condition and risk is now considered a disease so consequently more difficult to distinguishIllnesses and non-Illnesses ) and the emergence of technological compulsion ("if we can do, let do it").

2. occurred due to a shift in the value of conceptual transformation of advanced technology and the emergence of "the slippery slope argument" to be used as a justification for medical treatment ethically questionable.
Paternalistic attitude in therapeutic relationships degraded.
The intervention of legal concepts in the practice of medicine.
The principles of consumerism began to interfere with the autonomy of the profession.

presence Medical Practice Act should be welcomed with open (although there are still many shortcomings) given the very important function in creating quality medical practice, safe, orderly and organized so it is expected to protect all parties. Community as users of medical services; are certainly lay on medical issues to be protected interests and their rights (how to protect patient) and the physician as health care providers also need to be protected the dignity, honor and at the same time his rights. All this will be achieved if the Medical Practice Act itself is able to present the values that can give effect to the protection of all parties;among others, the value of fairness, balance, honesty, morality, certainty, utility and so on.

So far the interpretation of the Medical Practice Act that recently passed the 2005 enactment 6 0ktober meet these values, we should reconsider carefully, because many NGOs Health Medical Practice Act which assesses more favorable doctors and dentists rather than true community their assessment? Is it not the opposite, which is very detrimental to the doctors and dentists? So how does the perpetrator alternative medicine (traditional medicine) are completely untouched by the Medical Practice Act (both of aspects of regulation, supervision and pembinanaannya) so that the law favors them and menganaktirikan impressed the medical community?

Actually, with the enactment of the Medical Practice Act it is actually a bad precedent when considering the idea of the Health Act is designed to bring together the various rules in the health field spread (diversification) in a variety of product legislation (Act On Principles of Health, Health Workers Act, Act Mental Health, Pharmacy Law, the Law on Occupational Health, Hygiene and Sanitation Law, the Law on Epidemics and many more). It should be about the practice of medicine (also on Health Facilities including hospitals) shall be in government regulation as mandated by the Health Act. With invited her Medical Practice Act (Act also plans Hospital) that have previously been successfully incorporated into the Health Act, even broken down again as before.

Actually the Medical Practice Act (also Health Act) states that people who want to practice medicine based must have the authority (the fact this is a subject matter of public law because there is a public interest to be protected., but if the doctor already has the authority (read: pick License or STR) and intends to work as a professional in a hospital then he should not need to ask permission from local health authorities (public bureaucrat) in the form of SIP considering the relationship between the doctor and the hospital is the subject matter of private law. With no clear criminal sanctions obscure administrative issues so that problems occur criminalization criminal matters in excess of this medical practice.

OVERVIEW Law PRACTICE OF MEDICINE

PRACTICE OF MEDICINE:
R ANGKAIAN ACTIVITIES UNDERTAKEN TO DOCTOR PATIENT IN IMPLEMENTING HEALTH EFFORT

PROFESSION OF MEDICINE: MEDICAL WORK CONDUCTED science, COMPETENCE OBTAINED THROUGH EDUCATION tiered, CODE THAT IS SERVING THE COMMUNITY. Ps. 1 (11) of Law no.29 Th. 2004

Liability doctors and dentists have STR (29 ps). PRACTICAL IMPLEMENTATION and physician authority (article 35). Physicians must have a SIP (Article 36).

PS. 39 Act NO. 29 TH. 2004:
THE PRACTICE OF MEDICINE HELD UNDER THE AGREEMENT BETWEEN PHYSICIANS IN PATIENTS WITH HEALTH MAINTENANCE EFFORT , DISEASE PREVENTION, IMPROVED HEALTH, DISEASE TREATMENT, RECOVERY AND HEALTH

LEADER HEALTH CARE FACILITIES DO NOT ALLOW THE DOCTOR THAT DOES NOT HAVE TO PRACTICE MEDICINE SIP IN THE HEALTH CARE FACILITIES. (Ps 42)

SERVICE STANDARDS: PS. 44: DOCTOR OF CONDUCT MUST FOLLOW THE PRACTICE OF MEDICINEMEDICAL SERVICE STANDARDS. APPROVAL OF ACTION OF MEDICINE
(INFORMED CONSENT)

PS. 45: EVERY MEDICAL ACTION TO BE TAKEN BY A DOCTOR TO PATIENT MUST OBTAIN APPROVAL .

PS. 50: THE RIGHT DOCTOR: OBTAINING LEGAL PROTECTION ALONG IMPLEMENT APPROPRIATE DUTIES AND SPO SP; PELMED PROVIDE BY SP AND SPO; OBTAINING INFORMATION FROM PATIENT FULL & HONEST AND / OR THEIR FAMILIES;. RECEIVE BENEFITS SERVICES .

PS. 52: PATIENT RIGHTS: CAN FULL EXPLANATION OF MEDICAL ACTION TTG; ASK DOCTOR OTHER OPINION; ACCORDING TO NEEDS MEDICAL SERVICES; MEDICAL ACTION REJECT;CONTENTS MAY MEDICAL ASSOCIATES.

PS. 51: DOCTOR OF LIABILITY: GIVE ACCORDING PELMED SP, SPO MEDICAL PATIENT NEEDS;
REFER PATIENTS TO ANOTHER DR D HAVE GOOD SKILLS LBH; TTG secret the PATIENT, ALSO DIED timeout; DO PERTLGAN HUMANITARIAN EMERGENCY AD; ADDED ILPENG & FOLLOW PERKEMBGAN IL. KEDOKTR .

PS. 53: PATIENT LIABILITY: GIVE TO INFORM TTG CGC & JJR MSLH KESNYA; FOLLOW ADVICE & TIPS ON DR; COMPLY IN TERMS OF HEALTH FACILITIES; GIVE BENEFITS SERVICES ..

75-80 ps: about the criminal provisions.

Law PRACTICE IMPLICATIONS OF MEDICINE

1. Against Doctor .

Medical Practices Act implications, as well as having severe sanctions that must be addressed properly by any doctors who perform medical practice, both in and outside health facilities health facilities; among others:

1. Must have a certificate of Competency from the college.

2. Must have STR (LICENSE) of the Indonesian Medical Council.

3. Should always KEEP competence by continuous wheeze-

kuti continuing education.

4.harus update STR (LICENSE) is expired.

5. Must have a SIP if private individuals want to practice.

6. In practice run should always:

a. Meet the applicable Service Standard.

b. Running procedure Informed Consent correct.

c. Medical Record Management Implement well.

d. Keeping Secrets of Medicine.

e. Respect the rights of all patients.

7. Should put signpost practice.

It should above all liabilities do not need no criminal sanctions. Should administrative sanctions. Unfortunately in BFL already existing criminal provisions for administrative matters'

As we know, in general competencies that could be interpreted as a condition or requirement to be able to carry out tasks and roles (the condition of being capable or the capacity to perform a task or role) . Aspects that must be mastered in order to carry out the duties and role as a doctor in New South Wales Medical Board are:

1. Clinical judgment.
2. Medical knowledge.
3. Clinical skill.
4. Humanistic quality.
5. Communication skills.

By mastering these aspects above, doctors will be able to perform its role as:

1. The Medical Expert.

2. Professionals.

3. Communicator.

4. The Health Advocate.

5. Scholar.

6. Collaborator.

7. Manager.

B. Implications Against Hospital .

Medical Practice Act provisions also provide implications for hospitals, among others:

1. Should employ only licensed physicians (STR).

In order to maintain the quality of safety, the Council needs to limit the amount of use STR to work on how Health Facilities. Of course, taking into account a variety of variables (eg type of license the general practitioner or specialist, which functions as the only consultant orconsultant with management , local conditions and so on).

2. Provide Clinical Privilege appropriate physician competency.

3. Facilitate that doctors always carry appropriate health care service standards.

4. Implement:

a. Management informed consent right.

b. Medical Records Management is good and neat.

c. Confidential Medical Management orderly.

d. Quality Control Management (Medical Audit etc.).

5. Facilitate implementation of all patient rights.

6. Perform corrective action against doctors who breach.

field impacts that may arise to the health institution:

1 relative shortage of doctors and dentists in general.

2. Relative shortage of doctors and dentists with special competence (specialist / super specialist). In this case permenekes through chapter 7 gives an opportunity: for the sake of the office, the health department can be assigned. for 3 months and can be extended. There are several opinions regarding this article there who think the health department can directly appoint doctors to work in health facilities both public and private possession. But there was only sighted for the government health facilities because there is the word "for official interest" which means not to be a private matter. Advice for writers and leaders IDI Heart Health should not be too bold first create task letters before legal certainty. Due to the unclear Permenkes law enforcement agencies would then return to the article in laws 36 and 42 of the article has a SIP obligations and sanctions section (chapters 75-80) So that the doctor or hospital leader who will be a victim.

3. Changes in the regulation of physician acceptance and control patterns of doctors and dentists in the hospital. Equalization will be achieved with the necessity of regeneration HR doctor if health facilities do not want to miss.

4. The need for the application of the principles of prudence in the hospital so that the excess will lead to passive medicine

5. Doctor will be conducting concentrated maintain audit quality through the use of medical and support for diagnostics that can cause a rise in the cost of treatment.

Provisions concerning the practice of limiting the number of places can be positive and negative, use the opportunity positivenya young medics so they can thrive and recruitment of foreign medical personnel will be much ogled hospitals, doctors at the hospital have a lot of time in performing medical services so as to enable the increased quality of service and time that while the can to improve and develop their knowledge (no time runs out on the street).

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The author is a physician specialist surgeon, graduate post graduate health programs S2 Law Univ. Soegija Institution. Semarang. E-mail: herrysyu @ gmail.com

Dr Herry Setya Yudha Utama SpB. FInaCS. MHKes. ICS

Saturday, 17 May 2014