disertasi

Mayjen TNI (Purn) Dr. dr. Prihati Pujowaskito, Sp.JK, FIHA, M.M.R.S., FIMMMA, the esteemed President Director of BPJS Kesehatan, served as a distinguished external examiner for the doctoral dissertation defense of Dr. Johan Akbari. The closed-door session took place at Campus I of Universitas Bhayangkara Jakarta Raya, located in Pasar Minggu, Ragunan, South Jakarta, on Friday, July 17, 2026. Dr. Akbari successfully defended his dissertation, titled "Reconstruction of Strengthening the Authority of the Professional Disciplinary Council as an Effort to Enforce Doctor Discipline and Protect Healthcare Workers." A critical point of discussion and emphasis during the rigorous examination came from Dr. Pujowaskito, who underscored the paramount importance of expanding the scope of individuals or entities authorized to file complaints regarding alleged disciplinary violations by medical and healthcare personnel with the Professional Disciplinary Council (Majelis Disiplin Profesi, or MDP). This intervention highlights a pivotal concern within Indonesia’s burgeoning healthcare landscape, particularly as the nation strives to enhance the quality and accountability of its vast health services under the Jaminan Kesehatan Nasional (JKN) program.

The Significance of Dr. Akbari’s Dissertation

Dr. Johan Akbari’s research delves into a highly pertinent and complex area of healthcare governance: the dual imperatives of professional discipline and worker protection. The dissertation’s title, "Reconstruction of Strengthening the Authority of the Professional Disciplinary Council as an Effort to Enforce Doctor Discipline and Protect Healthcare Workers," suggests a comprehensive analysis of the existing framework for professional accountability within the medical and healthcare sectors in Indonesia. It posits that while disciplinary mechanisms are crucial for maintaining standards and safeguarding patient well-being, they must also be balanced with robust protections for healthcare professionals themselves, who operate under immense pressure and often face significant risks. The concept of "reconstruction" implies a critical re-evaluation of current legal and operational frameworks, aiming to identify weaknesses and propose reforms that would make the MDP more effective, equitable, and transparent.

This research comes at a time when public expectations for healthcare quality are escalating, fueled by greater access to information and the widespread implementation of the JKN program. As millions of Indonesians rely on the JKN scheme for their medical needs, the integrity and efficacy of healthcare providers become a matter of national importance. A well-functioning disciplinary system ensures that practitioners adhere to ethical guidelines, clinical standards, and professional conduct, thereby fostering public trust and enhancing the overall quality of care delivered. Simultaneously, providing adequate protection for healthcare workers—shielding them from unwarranted legal action, ensuring safe working environments, and supporting their professional development—is essential to retain talent and maintain a resilient healthcare workforce.

Prihati Pujowaskito’s Crucial Intervention: Expanding Complaint Avenues

The intervention by Dr. Prihati Pujowaskito, a figurehead in Indonesia’s healthcare administration, carries substantial weight. His emphasis on broadening the categories of parties eligible to lodge complaints with the MDP directly addresses a perceived limitation in the current system. Historically, access to disciplinary complaints against medical professionals has often been restricted to specific entities, such as professional organizations (e.g., the Indonesian Medical Association – Ikatan Dokter Indonesia, or IDI), the Ministry of Health, or direct referrals from courts. This narrow scope can inadvertently create barriers for patients, their families, or even other healthcare institutions like BPJS Kesehatan, which have a vested interest in ensuring quality services, from initiating formal disciplinary proceedings.

From the perspective of BPJS Kesehatan, as the administrator of the universal health insurance program covering over 250 million Indonesians, the quality of healthcare services provided by its network of facilities and personnel is directly linked to the program’s success and public confidence. If BPJS Kesehatan identifies systemic issues or repeated instances of alleged malpractice or ethical breaches by a provider, but lacks the direct legal standing to formally report these to the MDP, it complicates its oversight role. Expanding the subjection of complaints would empower entities like BPJS Kesehatan to act more decisively in upholding service quality for its participants, translating into improved patient safety and greater accountability across the board. Furthermore, it would allow patients and their advocates to have a more direct voice in seeking recourse, thereby democratizing the disciplinary process and reinforcing the rights of healthcare consumers.

The Role and Challenges of the Professional Disciplinary Council (MDP)

The Professional Disciplinary Council (MDP) in Indonesia is established primarily under Law No. 29 of 2004 concerning Medical Practice and subsequently reinforced by Law No. 36 of 2014 concerning Health Workers. Its fundamental mandate is to uphold professional ethics and discipline among medical doctors, dentists, and other health professionals. The MDP acts as an independent body, typically comprising members from professional organizations, legal experts, and government representatives, tasked with investigating alleged violations, conducting hearings, and imposing sanctions ranging from warnings to temporary or permanent revocation of practice licenses.

Despite its critical role, the MDP faces several inherent challenges. One significant hurdle, as highlighted by Dr. Pujowaskito, is the often-limited scope of who can initiate a complaint. This restriction can lead to situations where legitimate concerns regarding professional misconduct or negligence go unaddressed, either because the aggrieved party lacks the necessary legal standing or is unaware of the complex procedural requirements. Moreover, the effectiveness of the MDP hinges on its independence, transparency, and the perceived fairness of its proceedings. Concerns regarding potential conflicts of interest, the speed of investigations, and the consistency of sanctions can undermine public trust and the council’s overall authority.

A "reconstruction" of the MDP’s authority, as proposed in Dr. Akbari’s dissertation, would likely entail not only broadening the complainant base but also potentially streamlining investigation processes, enhancing inter-agency cooperation (e.g., between the MDP, professional organizations, BPJS Kesehatan, and the Ministry of Health), and strengthening its legal enforceability. Such reforms are crucial for ensuring that the MDP can effectively serve as a cornerstone of quality assurance and accountability in the Indonesian healthcare system.

Broader Context: Indonesia’s Healthcare Landscape and BPJS Kesehatan’s Mandate

Indonesia’s healthcare system is undergoing rapid transformation, largely driven by the JKN program, which aims to provide universal health coverage. Launched in 2014, JKN is one of the largest single-payer health insurance programs globally, striving to ensure equitable access to healthcare for all Indonesian citizens. This ambitious undertaking necessitates a robust and well-regulated healthcare ecosystem. BPJS Kesehatan, as the implementing body for JKN, plays a central role not only in managing funds and participant enrollment but also in overseeing the vast network of healthcare facilities (FKTP and FKRTL) that serve JKN participants.

The quality of care provided within this network is paramount to the JKN program’s success. Substandard care, medical errors, or professional misconduct can erode public trust, lead to adverse health outcomes, and ultimately strain the financial sustainability of the system through repeated treatments or complications. Therefore, BPJS Kesehatan has a direct and profound interest in strengthening mechanisms that ensure provider accountability. Its involvement in discussions surrounding the MDP’s authority is a logical extension of its mandate to protect the interests of its participants and ensure they receive high-quality, ethical care.

Furthermore, the Indonesian healthcare sector faces a myriad of challenges, including uneven distribution of healthcare professionals, varying quality standards across regions, and the increasing complexity of medical technologies and treatments. In this dynamic environment, a strong regulatory and disciplinary framework is not merely punitive but serves as a preventive measure, encouraging continuous professional development, adherence to best practices, and a culture of patient safety.

Inferred Statements and Reactions from Related Parties

While the dissertation defense was a closed session, the implications of Dr. Prihati Pujowaskito’s statement and the dissertation’s focus invite logical inferences about potential reactions from various stakeholders:

• Patient Advocacy Groups: These groups would almost certainly welcome the proposal to expand the avenues for filing complaints. They have long championed greater patient empowerment and transparency in addressing medical grievances. Enabling direct patient or family complaints, possibly through simplified procedures, would be seen as a significant step towards patient-centered care and accountability.
• Medical Professional Organizations (e.g., IDI, PPNI): While professional organizations generally support ethical practice and discipline, they would likely emphasize the need for due process, fair investigation, and protection against frivolous or malicious complaints. They might also stress the importance of ensuring that any expanded complaint system does not inadvertently create an overly litigious environment that could lead to defensive medicine or discourage practitioners from working in high-risk areas. However, they would also acknowledge the profession’s commitment to self-regulation and upholding standards.
• The Ministry of Health and Other Regulatory Bodies: These governmental entities would likely view the "reconstruction" of the MDP’s authority as a positive step towards improving national healthcare governance. Strengthening disciplinary mechanisms aligns with broader governmental efforts to enhance public services and ensure accountability. They might also see it as an opportunity to review and update existing legislation to reflect contemporary challenges and best practices in healthcare regulation.
• Academic and Research Institutions (like Universitas Bhayangkara Jakarta Raya): The university would highlight the importance of such rigorous academic research in informing public policy and contributing to the advancement of professional standards. They would emphasize their role in fostering critical thinking and evidence-based solutions for societal challenges, particularly in vital sectors like healthcare.
• BPJS Kesehatan: Beyond Dr. Pujowaskito’s direct statement, BPJS Kesehatan as an institution would likely reiterate its commitment to ensuring quality services for JKN participants. Strengthening the MDP, particularly by allowing BPJS Kesehatan or its participants more direct avenues for complaint, would be viewed as a crucial tool in its ongoing efforts to monitor provider performance, enforce contracts, and ultimately improve health outcomes for millions of Indonesians.

Implications for Healthcare Quality and Patient Safety

The potential "reconstruction" of the MDP’s authority, especially with an expanded complaint subject, carries profound implications for healthcare quality and patient safety in Indonesia:

1. Increased Accountability: By broadening who can file complaints, the system becomes more responsive to grievances. This increased scrutiny can foster a greater sense of accountability among healthcare professionals and institutions, encouraging adherence to high standards of practice.
2. Enhanced Patient Trust: When patients perceive that there are accessible and effective mechanisms for addressing grievances, their trust in the healthcare system generally improves. This trust is fundamental for effective healthcare delivery, as it encourages open communication and patient compliance.
3. Deterrence of Malpractice: A more robust and accessible disciplinary system can act as a stronger deterrent against professional misconduct, negligence, and unethical practices. The increased likelihood of detection and sanction can compel practitioners to be more diligent and ethical.
4. Improved Service Quality: As a direct consequence of increased accountability and deterrence, there is an impetus for healthcare providers to continuously improve their service quality. This can manifest in better clinical outcomes, enhanced patient experience, and more efficient healthcare delivery.
5. Data for Systemic Improvement: An expanded and more active complaint system would generate valuable data on the types and prevalence of disciplinary issues. This data can then be analyzed to identify systemic weaknesses, inform policy changes, and guide targeted interventions for professional education and training.
6. Balanced Protection and Discipline: The dissertation’s title itself emphasizes "protection of healthcare workers" alongside "enforcement of doctor discipline." A well-reconstructed MDP would not only hold professionals accountable but also ensure that due process is followed, protecting ethical practitioners from unwarranted accusations and providing a fair hearing. This balance is crucial for maintaining morale and retaining a dedicated healthcare workforce.

Future Outlook and Policy Considerations

The discourse initiated by Dr. Akbari’s dissertation and particularly highlighted by Dr. Pujowaskito’s commentary signals a potential shift in Indonesia’s approach to healthcare regulation. It underscores the ongoing evolution of legal and ethical frameworks in response to a dynamic healthcare environment. Moving forward, policymakers, professional organizations, and patient advocacy groups will likely engage in further discussions regarding the practical implementation of such reforms.

Key policy considerations would include:

• Legislative Amendments: Any significant expansion of the MDP’s authority and complaint avenues would likely require amendments to existing laws and regulations, such as the Medical Practice Law and the Health Workers Law.
• Procedural Clarity: Developing clear, accessible, and transparent procedures for filing and investigating complaints, ensuring fairness for both complainants and the accused.
• Capacity Building: Strengthening the MDP’s institutional capacity, including resources for investigations, expert panels, and administrative support, to handle a potentially increased volume of cases.
• Public Education: Informing the public and healthcare professionals about their rights and responsibilities regarding disciplinary processes.
• Inter-agency Coordination: Establishing seamless coordination mechanisms between the MDP, BPJS Kesehatan, the Ministry of Health, professional organizations, and law enforcement agencies to ensure a holistic approach to healthcare governance.

In conclusion, the doctoral dissertation defense of Dr. Johan Akbari, with the insightful contribution from BPJS Kesehatan President Director Dr. Prihati Pujowaskito, marks a significant moment in the ongoing dialogue about healthcare accountability and quality in Indonesia. The emphasis on reconstructing and strengthening the Professional Disciplinary Council, particularly by broadening who can file complaints, points towards a future where patient safety, professional integrity, and the overall quality of the JKN program are further fortified through robust and accessible regulatory mechanisms. This academic endeavor, coupled with high-level administrative endorsement, sets the stage for potential transformative reforms that will ultimately benefit millions of Indonesians.