If you agree that Indonesia’s health care sector is ailing, then you would also likely agree that the cure is more people like Dr. Madan. After earning his medical degree in India, Madan returned to Indonesia, rolled up his sleeves and got to work helping to fix up a system that he knows could be so much better.
Today, the good doctor tells My Jakarta just where he thinks we have gone wrong with health care, what India has over Indonesia and why we would all be better off if we stopped seeing specialists so often.
Why would someone choose to go to a family practitioner first if they could see a specialist instead?
You must understand that a family practitioner will always give you more time than a specialist, providing patients with everything they need to know about their comprehensive diagnostic results and condition and advising them on what needs to be done next.
But you would eventually go to a specialist anyway, right?
Eventually, depending on the situation, you may have to see a specialist, but by first consulting with a family doctor, you eliminate the chance of all the extra costs you might incur by visiting a specialist. Another thing worth considering is that you have to go to a hospital to visit a specialist and if you don’t already know, infection rates are higher in hospitals and the waiting time is longer, which results in more exposure to diseases. By coming to a family practitioner, chances of cross-infection decrease, along with costs and your time spent.
You look young. How many years have you been a family practitioner?
I’ve had five years of experience — a year in India and the rest in Jakarta.
Why did you choose India and what differences did you find between the health sectors in India and Indonesia?
I chose India simply because it’s one of the best places in the world to study medicine and has a proven track record of producing world-class doctors and surgeons. India has a health care sector that runs like a well-oiled machine and is relatively cheaper than medical destinations like Singapore, Malaysia and the US, and over the past few years the medical tourism industry there has also begun to bring a fresh dynamic to the economy. Meanwhile, in Indonesia we are still far behind in terms of equipment and the way the whole sector is being operated.
About the costs, why is health care in Indonesia so expensive?
In Commonwealth countries, you cannot meet a specialist without a family doctor or a general practitioner’s reference. At the first sign of trouble, many Indonesians head straight to the specialist. Subsequently, this results in the specialist being pressed for time and this leads to high consultation fees because said specialist is being overworked. When you’re pressed for time and overworked you don’t always give optimal care and this may result in you having to visit the doctor over and over again. All these factors lead to very expensive health care costs, leaving many Indonesians to pursue medical treatment abroad where you get what you pay for.
How do we change the mind-set then?
The government should make general practitioners and family practitioners the focal point of the health care industry.
Any interesting health care statistics you can tell us about in Indonesia?
Statistics show there is one general practitioner for every 10,200 people in Indonesia. One out of three Indonesians over the age of 40 have hypertension and there are only 400 qualified cardiologists in the country. If these statistics are true, then it is quite overwhelming and speaks volumes of the quality of health care we find here. But, on the bright side, our doctors are really experienced and work well under pressure, and at the same time things are improving so we are hopeful.
Finally, what is your approach to medicine and what is your advice to younger doctors across the nation?
I believe in preventive medicine not curative, and if I could share a thought to doctors across the nation, it would be that good doctor-patient communication is the most effective way to diagnose and manage disease.
Dr. Madan was talking to Sahil Punjabi.