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"The elephant in the room is a collection of short stories that creatively communicate the cancer patient’s journey. The stories, based on real-life accounts, are built around the idiosyncratic relationships between patients and their doctors. Using humor, empathy and wisdom, Jonathan Waxman explores the very human side of cancer as well as providing expert commentary on the clinical aspects of diagnosis and therapy of this disease. These stories comfort and entertain, inform and engage, and are a treat to read for anyone whose life has been affected by cancer."

"In the healing effort by the physician, there are high risk which cannot be eliminated. The risks can be in the form of loss suffered by physician or patient. According to loss suffered by patient, there are different opinion about physician's liability, as a consequences of medical action. One interesting discourse in this problem nowadays is the possibility of applying of UU No. 8 Tahun 1999 about Consumer Protection to physician-paticnt relationship. The purpose of the writing of this thesis was to discuss the discourse and to reveal how contractual terms between physician and patient in law and regulation in Indonesia, and how they implemented in some court decisions in Indonesia. The research use normatif yuridis type research, namely more related to research of bibliography steming to written law norms, either regulations or court decisions, by using primary and secondary data, including interview wherever needed. The data analysed by using analytical descriptive method, especially to describe, analyse, and explain the physician's liability regarding the contractual terms between physician-patient, to loss suffered by patient. From the analysis which had been done, it can be concluded that contractual terms between physician and patient were happened due to therapeutic-transaction or therapeutic-agreement and due to comand of law, namely zaakwarneming. In therapeutic-transaction or therapeutic-agreement the physician's duty is the healing effort, not the result Therefore therapeutic-agreement has the character of inpannmgverbintenis. One important factor in therapeutic-agreement is the informed-consent, that is the patient's agreement for the medical action after receiving proper information from the physician. In informed consent, given approval have to pursuant to information of physician concerning medical action to be conducted. In the case of loss suffered by patient, the physician's liability can be blamed if the physician can be blamed due to brake the standar operation procedure or the physician no execute its obligation, and the patient suffer a loss, and there is causality relation between those two (brake the standar operation procedure and patient's loss). Beside that, it was also found that physician's liability can ¿so be insist using UU No. 8 Tahun 1999 about Consumer Protection. In implementation, as analysed from court decisions collected for this thesis writing, there are differences in looking at physicians* liability. However, there are consideration of Judges which using fault based liability principle with presumption of negligence and presumption liability principle, base on 'res ispa loquitor' doctrine."

"Pengelolaan hipertensi dan diabetes melitus yang memerlukan pengelolaan terkoordinasi, menjadi perhatian karena prevalensinya semakin meningkat. Kemampuan dokter sebagai care coordinator tidak terlepas dari kemampuan kepemimpinan, dan belum ada penilaiannya di Indonesia. Penelitian ini bertujuan mengembangkan intrumen penilaian kinerja dokter di layanan primer sebagai care coordinator dan kaitannya dengan kepemimpinan.Pendapat pakar dan metode Delphi digunakan untuk mengembangkan dimensi dan butir penilaian. Validasi instrumen dilakukan dengan analisis faktor eksplorasi. Kurva ROC digunakan untuk mencari titik potong skor care coordinator pada pasien hipertensi atau DM terkontrol dibandingkan tidak terkontrol. Korelasi Pearson dilakukan untuk melihat korelasi antara skor care coordinator dengan skor kepemimpinan klinis, kepemimpinan transformasional, komitmen, kepuasan kerja, dan budaya organisasi, serta faktor-faktor sosiodemografis dokter dan praktik keprofesian.Pengumpulan data dilakukan selama periode April−November 2015. Melalui penggalian pendapat 19 orang pakar (akademisi, praktisi, pengandil), 2 kali putaran Metode Delphi (110 sampel dan 81 sampel), dan 249 sampel analisis faktor, didapatkan instrumen penilaian kinerja dokter pengelola kasus PTM di puskesmas sebagai care coordinator yang terdiri dari 11 dimensi dan 33 butir penilaian dengan koefisien alpha sebesar 0,94 dan korelasi butir penilaian dengan dimensinya lebih dari 0,4. Terdapat perbedaan skor care coordinator antara pasien hipertensi atau diabetes terkontrol dan tidak terkontrol (p = 0,02) dengan titik potong sebesar 7,7. (skor maksimal 9). Terdapat korelasi positif antara skor kepemimpinan klinis, skor kepemimpinan transformasional, skor kepuasan kerja, usia dokter, lama lulus dokter, lama bekerja di puskesmas, pelatihan dokter keluarga, dan status kepegawaian terhadap skor care coordinator. Faktor yang paling berperan terhadap peningkatan skor care coordinator adalah skor kepemimpinan klinis dan skor kepemimpinan transformasional (R square 0,47).Telah dikembangkan instrumen penilaian kinerja dokter sebagai care coordinator di layanan primer yang valid dan handal. Walaupun dokter pengelola kasus dalam kesehariannya berinteraksi dengan pasien dan tidak menduduki jabatan struktural sebagai pimpinan, namun mereka harus tetap memiliki kemampuan kepemimpinan klinis serta kepemimpinan transformasional untuk menunjang kinerja sebagai care coordinator dalam pengelolaan masalah kesehatan pasien.

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Hypertension and Diabetes Mellitus management that need coordination of care is vital because of their increasing prevalence. To become care coordinator, primary care physician should have leadership capabilities. However, there is no instrument available to measure care coordination and leadership for primary care physician in Indonesia. This research aims to develop instruments for primary care physician's performance as care coordinator in primary care facilities and its correlation with leadership.Data collection was conducted from April to November 2015. Expert opinion and Delphi method were conducted to develop dimensions and item indicators. Exploratory Factor Analysis was performed for instrument validation. ROC curves were used to gain cut-off point of care coordinator's score from controlled and uncontrolled hypertension or diabetes mellitus patient. Pearson correlation was conducted to determine correlation between care coordinator score and clinical leadership, transformational leadership, commitment, job satisfaction, and organizational culture, as well as doctor's sociodemographic factors and professional practice.Nineteen experts panel (academics, practitioners, health policy makers), 110 participants of 1st round Delphi Method, 81 participant of 2nd round of Delphi Method, and 249 samples for factor analysis were gathered to create 11 dimensions and 33 items with loading factors at least 0.4 and alpha cronbach as high as 0,94. There was care coordinator score difference between controlled and uncontrolled hypertension or diabetes mellitus patients (p = 0.02) with cut-off point 7,7 (maximum score 9). There was positive correlation between care coordinator score and clinical leadership score, transformasional leadership score, satisfaction score, age, graduation period, working period, family medicine training, and employment status. Dominant factors correlate to care coordinator score were clinical leadership score and transformational leadership score (R square 0.47).A valid and reliable instrument of care coordinator performance for Indonesian primary care physician has been developed. Although the main activity of practitioner is very much relate to patient interaction, they should also have leadership capacities to support their role as care coordinator for patient?s health management."

"Pelatihan Pratugas Dokter/Dokter Gigi PTT merupakan program pelatihan prajabatan khusus yang wajib diikuti oleh seluruh dokter umum maupun dokter gigi yang akan melaksanakan masa bhaktinya. Dalam pelatihan pratugas ini Dokter/Dokter Gigi PTT mendapatkan materi dasar, inti dan penunjang. Materi yang dianggap paling penting dalam pencapaian tujuan pelatihan adalah materi inti yakni manajemen puskesmas. Pelatihan pratugas Dokter/Dokter Gigi PTT dimulai sejak tahun 1991 di Balai Pelatihan Kesehatan Padang, namun sampai saat ini belum pernah dievaluasi pada saat pasca pelatihan, sehingga tidak diketahui data tentang penerapan hasil pelatihan.Penelitian ini bertujuan memperoleh informani tentang kompetensi Dokter/Dokter Gigi PTT yang meliputi pengetahuan, sikap dan keterampilan dalam pelaksanaan manajemen puskesmas dan untuk melihat peran serta dokter/dokter gigi PTT dalam manajemen puskesmas.Penelitian ini menggunakan pendekatan kualitatif melalui wawancara mendalam, obsevasi dan test objektif dengan informan dokter/dokter gigi PTT sebagai informan utama. Dilanjutkan dengan triangulasi sumber kepada pimpinan puskesmas, staf puskesmas dan KaSubdin Yankes Dinas Kesehatan Kabupaten Padang Pariaman.Hasil penelitian menggambarkan, bahwa pelatihan pratugas sangat bermanfaat dalam menunjang tugas Dokter/Dokter Gigi PTT di puskesmas. Hasil evaluasi kompetensi Dokter/Dokter Gigi PTT dalam manajemen puskesmas, pengetahuan dokter/dokter gigi PTT cukup baik pada perencanaan tingkat puskesmas, selanjutnya penilaian kinerja puskesmas dan lokakarya mini puskesmas. Sebagian besar Dokter/Dokter gigi PTT menunjukkan sikap positif antara lain dalam disiplin kerja, kepemimpinan, kerjasama, prakarsa dan keterampilan yang baik dalam melaksanakan tugas di puskesmas. Peranserta Dokter/Dokter Gigi PTT dalam manajemen puskesmas sangat bervariasi, yang utama adalah pada perencanaan tingkat puskesmas, penilaian kinerja puskesmas dan lokakarya mini puskesmas.Untuk kesempurnaan dalam penyelengaraan pelatihan hendaknya dilakukan evaluasi pasca pelatihan secara berkesinambungan, dalam penyusunan kurikulum diharapkan selalu menyesuaikan dengan kebutuhan puskesmas, agar materi yang diberikan bermanfaat dalam pekerjaan dokter/dokter gigi PTT di puskesmas.Daftar Pustaka : 45 (1984 - 2004 )

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Evaluation of Physician/Dentist Competency as Temporary Employee on Public Health Center Management Assessed After Pre-Work Training in Padang Pariaman District year 2004Pre work training of temporary employee (PTT) physician/dentist is a special training program which is obligatory before physician/dentist could go the work field. During the training, physician/dentist obtain basic, core, and supporting materials. Core material of public health center management is considered as the most important material. The training firstly started in 199i in Padang Health Training Center but has never been. evaluated in a post-training evaluation, thus no data on training result and application were available.

This research aimed to obtain information on physician/dentist competency including knowledge, attitude, and skill in implementing public health center management and to investigate the participation of PTT physician/dentist in public health center management.

The study used qualitative approach through in-depth interview, observation, and objective test with PIT physician/dentist as main informants. This was followed up by source triangulation to public health center management and staff, and Head of Health Service Office in Padang Pariaman District Health Office.

The results show that pre work training was extremely useful in supporting PTT physician/dentist at their work in public health center. Results on competency evaluation indicate good knowledge on public health center level planning, public health center performance evaluation, and public health center mini workshop. The majority of PTT physician/dentist showed positive attitude e.g. in work discipline, leadership, cooperation, initiative, and also showed good skill in doing their work in public health center. However, participation of PTT physician/dentist in public health center was quite varied, with significant participation in planning at public health center level, evaluating public health center performance, and in public health center mini workshop.

In order to improve the training, it is suggested to conduct post-training evaluation routinely. Materials are to be updated and adjusted according to the needs of public health center as to provide most benefit to PTT physician/dentist as training participants and to further support their work in public health center.

References: 45 (1984-2004)"