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

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.

Challenging the status quo: results of an acceptability and feasibility study of hypertensive disorders of pregnancy (HDP) management pathways in Indonesian primary care

“…Practicing nurses or midwives are usually diploma graduates in nursing or midwifery [38], and Indonesian GPs are medical doctor (MD) graduates without any further postgraduate training. However, to practice as specialists, the MD graduates have to undertake a further three to four years of specialty training in hospitals [38,39]. Therefore, many GPs, nurses, and midwives often feel less capable, less respected and/or less trusted than specialists, and often receive less acknowledgement from specialists or patients [40,41].…”

Indonesian General Practitioners’ Experience of Practicing in Primary Care under the Implementation of Universal Health Coverage Scheme (JKN)

“…This gap of training then impacts on the GPs' confidence in managing patients, and in return resulted in the low trust from patients. 4,10 Meanwhile, GPs often perceived themselves in a higher hierarchical position than nurses, midwives, or even patients in primary care, which often make them expect patients to follow their advice with a limited mutual person-centered approach. [23][24][25] Therefore, when patients refuse the referral advice, the GPs then feel uncomfortable.…”

“…This study is part of a larger study aiming to explore the GPs views and experience of a formal family medicine postgraduate study in primary care and JKN implementation in primary care. 10 This study used semi-structured interviews with a topic guide guided by phenomenology approach and maximum variation sample design. [11][12][13][14] The data collection took place in Yogyakarta province as a representative of urban and rural settings in Indonesia, which also has a high referral rate from primary care to hospitals.…”

“…The establishment of formal postgraduate training for Indonesian GPs then becomes vital to enable primary care to create and improve its practice quality. 10,30 The GPs should also be equipped with adequate clinical resources in primary care. The practice should be supplied adequate supports for appropriate patient management and to improve trust among the patients.…”

Patient Safety in Selected Healthcare Facilities in Caraga Region: An Aiken Model Approach

“…In the nursing practise environment, these main characteristics help nurses in their jobs, increase the level of treatment patients receive, and eventually contribute to superior patient outcomes, including lower mortality (Sorra et al, 2016). In comparison, primary care training has also demonstrated that practise perspectives have improved, from the treatment of emergency care to more systematic and holistic care (Ekawati et al, 2018).…”