PDKI Responds to the Challenge of Increasing the Competence and Skills of Primary Service Doctors in Facing the Covid-19 Pandemic

In the covid-19 pandemic situation, the role of doctors in primary care is much more complex than before. Doctors in primary care are the first contacts who must provide curative services as well as educator to prevent the spread of disease in the community. For this reason, it is necessary to master sufficient knowledge and skills in the fields of community medicine and family medicine, as well as the ability to adapt to information on the rapid development of science and technology related to the management of patients with covid-19.

Family medicine in Indonesia has been very often discussed among medical practitioners, but not all doctors in primary care understand and apply the principles of family medicine in their services. To accommodate family medicine practitioners, in Indonesia there is the Indonesian Family Doctors Association (called PDKI). Then in each province, there are also branch organizations, including in Bali Province. The Bali branch of PDKI has been established since 2000 and has gone through organizational transformations. Until 2016, there was very little interest in family medicine in Bali, even though the material for family medicine has begun to be given at the medical faculty. This is because the PDKI organization is still unknown among practicing doctors in primary care.

Meanwhile, our health system has also undergone very significant changes with the implementation of the national health insurance (JKN) through BPJS Kesehatan, which directly or indirectly leads the direction of public health services prioritizing preventive promotive actions to reduce medical costs.

The need for promotive, preventive and comprehensive services requires doctors in primary care, both public and private health centers, to have the competence and ability to apply family medicine. The family doctor in question is the one who meets the family doctor service standards as in developed countries in Europe, Australia, America and others, namely:

·        Ability to handle personal aspects of the patient

·        Prioritizing the Approach and empowerment of families

·        Prioritize prevention

·        Holistic approach

·        Comprehensive care

·        As well as helping families make the right decisions for their health.

The momentum of the need for BPJS was welcomed by the central PDKI together with the Ministry of Health of the Republic of Indonesia with plans for family doctor certification to start the opening of the family doctor education path at universities. So that in february 2020 this certification process begins.

This momentum brought us doctors, most of whom are doctors in primary care, both public health centers and private health centers, to revive the Bali PDKI organization. At the direction of our senior Prof. Dr.dr. Nyoman Mangku Karmaya, Sp. KKLP, M. Repro, dr. I Made Dharmadi, MPH., and dr. Made Ayu Witriasih, Sp.KKLP, M.Kes, so we re-established the bali branch of PDKI and we set its re-establishment on february 2, 2020. Since that day we have coordinated to take part in the National Congress of PDKI which has been held at the end of february 2020.

After the national congress, unexpectedly, we all face a very complex test this year with the Covid-19 pandemic. This pandemic carries the implied message that we need strong primary care physicians. This is the basis for decision-making for seniors at the central PDKI to accelerate the certification program for family doctors and primary care by holding covid-19 response training for 6 months. This training was attended by more than 600 primary care doctors from all over Indonesia who met the requirements, including 25 of us from Bali province. In the training, various materials regarding covid-19 from the aspect of disease management, prevention efforts included adaptation of public education using online media and telemedicine. This certification process does not only provide new degrees for free and free of charge, but there is a process of adding new knowledge, competencies and skills for doctors in primary care. This competency is expected to be sufficient provision to manage the community, especially in making efforts to prevent the covid-19 disease from the individual and family level.