JurnalPost.com - The Practice License (SIP) is a crucial legal instrument in the delivery of healthcare services. The SIP is not merely an administrative document, but a formal recognition by the state that a doctor or dentist is authorized to practice their profession.
The existence of the SIP is also closely linked to efforts to ensure patient safety and maintain the quality of healthcare services.
Under the regime of Law Number 17 of 2023 concerning Health and Government Regulation Number 28 of 2024, doctors and dentists are required to hold an SIP to practice professionally. One of the requirements for renewing a practice license is the fulfillment of a sufficient number of Professional Credit Units (SKP).
Philosophically, the purpose of SKP is to maintain and improve the competence of medical personnel through continuing professional development or continuing professional development.
This concept is fundamentally aligned with modern medical practice. Scientific knowledge, health technology, diagnostic methods, therapies, and standards of care are constantly evolving, requiring doctors to update their knowledge and skills throughout their careers.
However, problems arise when the accumulated number of SKP is used as a primary benchmark for the SIP renewal process, while the correlation between specific SKP totals and improvements in clinical competence has not been clearly explained to the public or the profession.
The SKP target has even changed under current policies, from a previous 250 SKP to 160 SKP over a five-year period for doctors and specialists.
What is the Scientific Basis for Setting the SKP Number?
A valid question to ask is: what scientific parameters were used to determine that 250 or 160 SKP is the ideal figure?
Is there any national research showing that a doctor with 160 SKP has better clinical competence than a doctor who has collected 120 or 140 SKP?
This question is important because an administrative figure should have a clear evaluation basis if it is to be used as an instrument to assess the continuity of a professional practice license.
To date, in the author's view, both the profession and the public require a more transparent explanation regarding the scientific basis for setting these figures.
The issue is not with the existence of continuing education. Continuing education is clearly necessary in the medical field.
What needs to be examined is whether the number of SKP alone is sufficient to describe a doctor's level of competence.
When SKP Becomes a Numerical Target
In daily practice, collecting SKP risks shifting from an instrument for competence improvement to merely an effort to meet administrative quotas.
A doctor can attend various online seminars for hours and obtain certificates worth SKP. However, the next question is whether such participation truly results in a change in the quality of care provided to patients.
Such an impact should be measurable.
On the other hand, there are doctors who handle many patients every day, perform medical procedures, participate in clinical audits, mentor younger health workers or colleagues, and face various complex cases in their practice.
Such experience is clearly directly related to professional competence. However, if all these professional activities are not given adequate weight in the assessment system, a doctor may still face administrative issues because their assessed SKP total is insufficient.
This is where the fundamental problem arises: does the system actually measure competence, or does it merely measure compliance with administrative requirements?
Legality Alone Is Not Enough
Another question relates to the government's authority in setting the number of SKP as part of the SIP requirements.
Legally, this authority can be granted through legislation.
However, from the perspective of good governance, a regulation that impacts an individual's right to practice their profession should not only have legal legitimacy.
Such regulations also need to be built upon scientific studies that are transparent, measurable, and accountable.
In other words, a regulation is not enough just to be formally valid.
Public policy ideally also has a strong evidence-based policy foundation so that the public and the profession can understand the reasoning behind every requirement imposed.
Doctor's Competence Cannot Be Reduced to a Number
The competence of a doctor or dentist is far broader than just the number of scientific activities attended.
Professional competence encompasses knowledge, clinical skills, decision-making ability, patient communication, professionalism, ethics, and the ability to maintain patient safety.
All these elements are difficult to reduce to a single credit score.
A doctor might have a high number of SKP, but that figure does not automatically answer how high the quality of their clinical decision-making is.
Conversely, a doctor with extensive clinical experience may not necessarily have a high number of administrative SKP.
Therefore, the main focus should not be solely on how many credits are collected, but on the extent to which the professional development process truly improves the quality of care.
A More Comprehensive Assessment Model Is Needed
It is time for the professional practice licensing system to move toward a more comprehensive evaluation model.
SIP requirements should ideally not depend solely on the accumulation of SKP, but be combined with other indicators closer to the reality of professional practice.
For example, assessments could consider clinical case portfolios, medical audits, service outcome evaluations, compliance with professional standards, participation in quality improvement and patient safety activities, professional disciplinary records, and continuing education relevant to each field of practice.
Such an approach would make the assessment system more substantive.
What is being assessed is not just how many seminars were attended, but how the learning process and professional experience contribute to the quality of care for patients.
Continuing education remains important. However, such education must be truly relevant, applicable, and, as much as possible, have indicators of impact on professional competence.
Patient Safety Must Be the Main Goal
Ultimately, the state's main goal is not to ensure that every doctor succeeds in collecting a certain number of SKP.
The true goal is to ensure that the public receives medical care that is safe, high-quality, professional, and in accordance with the development of scientific knowledge.
If SKP only develops into an administrative instrument without a clearly explainable correlation with competence, the system risks losing its substantive meaning.
Therefore, reform of the SIP system needs to be directed toward a competence evaluation model that is more objective, measurable, transparent, evidence-based, and, above all, oriented toward patient safety.
With such an approach, regulation will not only function as an administrative oversight tool but will truly become an instrument to improve the quality of healthcare services.
The question then is no longer just, “How many SKP has a doctor collected?”
A much more important question is, “Is the doctor still competent, professional, and capable of providing safe care to patients?”
That is where the measure of success for a professional practice licensing system should be placed.
Author:
dr. Tedy Hartono, S.H., MCS
Member of the ISC Analysis Team (IKA Lemhanas Strategic Center)
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