Physician's self-perceived abilities at primary care settings in Indonesia

Area of Science:

• Primary Health Care
• Medical Education
• Health Systems Research

Background:

• Better-skilled primary care physicians correlate with improved health outcomes in Southeast Asia.
• Indonesia faces challenges with inappropriate referrals, impacting health outcomes.
• Physician competence is a key factor in primary care effectiveness.

Purpose of the Study:

• To investigate the reasons behind unnecessary referrals in Indonesia.
• To examine Indonesian physicians' self-assessed abilities in primary care.
• To identify factors contributing to suboptimal health outcomes.

Main Methods:

• Multiple-case study design.
• Physician self-evaluation using questionnaires based on Indonesian Standards of Physicians Competences (ISPC).
• Data collection through interviews, focus group discussions (FGDs), and clinical observations across diverse Indonesian settings (2011-2014).

Main Results:

• Indonesian primary care physicians felt competent in managing less than one-third of typical primary care cases.
• Identified reasons include limited understanding of person-centered care and narrow focus on common biomedical problems.
• Inadequate physical facilities in primary care settings were also noted.

Conclusions:

• Upscaling physician abilities through structured graduate education in family medicine is recommended.
• Standardizing primary care facilities is critical to support physician performance.
• A strong national health policy recognizing the role of primary care physicians is urgently needed.