Kembali : Masalah Komunikasi Dokter – Pasien Menjadi Penyebab Petaka

Dalam salah satu millist profesi, saya pernah menulis tentang lemahnya kemampuan komunikasi dokter dan pasien. Menurut saya, pokok persoalan dari kasus Bu Prita sesungguhnya sederhana, yaitu bahwa dokter tidak mampu berkomunikasi dengan baik dengan pasien. Ini terbukti dari tulisan Bu Prita dalam surat elektronik yang dikirimnya : “Saya lalu di-infus dan diberi suntikan obat tanpa ada PENJELASAN dan tanpa adanya persetujuan dari saya “. Komunikasi yang dimaksud adalah komunikasi dengan bahasa awam yang mudah dipahami dan dimengerti oleh pasien dan keluarganya. Dokter kerap kali tidak mampu menterjemahkan atau meng-konversikan bahasa-bahasa medis menjadi bahasa publik yang dimengerti oleh masyarakat. Sehingga yang terjadi adalah sebuah kesalahpahaman atau miskomunikasi. Dokter merasa sudah mejelaskan dengan sebenar-benarnya, akan tetapi si pasien menterjemahkan dengan informasi yang berlaian pula, yang pada akhirnya pasien akan mengambil sebuah kesimpulan sendiri yang celakanya justru bertentangan dan bertolakbelakang dengan apa yang ada di benak dokter.

Sungguh persoalan komunikasi memang sangatlah penting. Terbukti sekali lagi bahwa persoalan komunikasi bisa merembet ke ranah hukum yang prosesnya begitu panjang dan melelahkan. Saya mencoba untuk bersikap netral dan memandang persoalan ini dari sebuah frame yang mungkin nampak sederhana, padahal begitu berat implikasinya. Kesimpulan saya tetap bahwa persoalan ini bermula dari KETIDAKMAMPUAN DOKTER UNTUK BERKOMUNIKASI DENGAN BAIK KEPADA PASIEN DAN KELUARGANYA….Seorang dokter ternyata gagal menterjemahkan isi pikiran dan infromasi menjadi sebuah bahasa yang mudah ditangkap oleh pasien.

Sama dengan tulisan saya di millist tersebut, saya juga mengkritik sistem pendidikan dokter di Indonesia. Saat itu ada temen sejawat yang membantah bahwa sistem pendidikan dokter di Indonesia salah. Saya tekankan bahwa ada sesuatu yang salah dengan Kurikulum Pendidikan Dokter Indonesia (KIPDI). Ukuran kompetensi seorang dokter itu meliputi : Aspek Knowledge/sciene, aspek skill dan aspek attitude. Ok kita anggap bahwa konwledge atau science cukup bagus bahkan lebih dari cukup, tetapi bagaimana dengan skills nya??? Bahasan saya tentang skills di sini bukan skill medis nya yang saya yakin sudah bagus bahkan di atas bagus lah, akan tetapi skills yang saya maksudkan adalah skills atau keterampilan berkomunikasi dengan pasien/masyarakat secara baik dengan bahasa yang mudah dipahami dan dimengerti….

Saat ini metode pembelajaran di pusat-pusat pendidikan dokter sudah banyak yang menggunakan Skills Lab (laboratorium Keterampilan)…sayangnya titik berat dari skills lab itu hanya pada aspek skill medis nya saja, tetapi khusus skills komunikasi dengan pasien agak terlupakan. Kita harus jujur mengakui hal ini….Andai saja di skills lab tersebut mata ajar tentang kemampuan berkomunikasi dengan pasien diperkuat, terus metode ujian dibanahi dengan benar-benar mendatangkan orang awam dan si calon dokter tersebut diuji untuk berkomunikasi dengan bahasa awam….mungkin saja produk2x dokter Indonesia memilki kemampuan yang lebih mumpuni….Mohon Dirjen DIKTI Depdiknas bersama-sama dengan organisasi profesi dapat duduk bersama dan ber-rembug merumuskan sebuah Kurikulum Pendidikan Dokter yang lebih bagus dan komprehensif.

Akhirnya, tanpa ada pretensi apapun juga, saya salut dengan keberanian Bu Prita, hanya sayangnya memang kasus ini terlalu premature diseret ke ranah publik oleh Bu Prita, akan tetapi yang jauh lebih disayangkan lagi adalah respon RS yang langsung menyeret kasus ini ke ranah Hukum….Jujur saja dalam benak saya yakin bahwa dokter sudah melakukan hal yang benar menurut sudut pandang medis, yakni merawat pasien atas indikasi medis, bukan indikasi laboratorium. Kita harus ingat bahwa pemeriksaan penunjang adalah “Good Servant, But Bad Father” artinya pemeriksaan penunjang adalah PELAYAN YANG BAIK, TETAPI TUAN YANG BURUK…maknanya adalah bahwa pemeriksaan penunjang memang sangat membantu kita, tetapi jangan jadikan sebagai pengambil keputusan, jangan sekali-kali hasil dari pemeriksaan penunjang itu dijadikan pijakan dokter dalam mengambil keputusan medis, karena ini adalah sebuah kesalahan yang fundamental. Hanya persoalan-nya adalah dokter tersebut dalam memberikan alasan kenapa dia memutuskan untuk merawat pasien ternyata tidak menggunakan bahasa verbal yang mudah dipahami oleh pasien. Yang terjadi adalah pasien salah dalam mengartikan dan mengambil kesimpulan….sehingga seperti yang kita lihat sendiri bahwa akhirnya kasus ini berkembang ke mana-mana…..Saya pribadi hanya ingin menikmati saja jalannya kasus ini dan bagaimana bagian akhir atau ending-nya. Mari kita lihat dan kita nikmati saja….

Semoga banyak hikmah yang dapat kita petik dari kasus ini, saya sependapat sekali dengan statement Bu Menkes terbaru bahwa kasus ini mungkin tidak akan melebar kalau RUU Rumah Sakit sudah disahkan oleh DPR menjadi UU. Menurut saya tepat sekali bahwa kasus ini adalah sebuah momentum yang paling tepat bagi kita semua untuk mendesak Legislatif sesegera mungkin mengesahkan RUU Rumah Sakit yang terkatung-katung selama hampir 3 tahun. Setiap tahun selalu menjadi agenda PROLEGNAS, tetapi tidak pernah dibahas dengan serius oleh DPR. Apakah kita harus menunggu sampai muncul “Bu Prita-Bu Prita” susulan ??? WallahuAllam….
Wass…

Purwakarta, 4 Juni 2009.

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