Unila Dissertation Offers New Legal Model for Doctor-Hospital Working Relationships

A doctoral dissertation from the Faculty of Law at the University of Lampung (Unila) introduces a novel legal model designed to regulate the working relationship between doctors and hospitals. This proposed framework is intended to be more adaptable to the distinct nature of the medical profession, which Iskandar Zulkarnain, an Ad Hoc Judge for Industrial Relations Disputes at the Banjarmasin Class IA District Court, argues is not adequately covered by existing regulations.

Zulkarnain's research highlights that current labor regulations fail to fully accommodate the dual nature of a doctor's role. While doctors operate within a hospital's organizational structure, utilizing its facilities, adhering to service standards, and meeting quality targets, they also retain professional autonomy in making medical decisions. This autonomy, he stresses, cannot be legally or ethically overridden by hospital management.

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On one hand, doctors work within a hospital's organizational system. They use hospital facilities, are subject to service standards, work schedules, governance, and service quality targets. However, on the other hand, doctors retain professional autonomy in making medical decisions that legally and ethically cannot be intervened in by hospital management.

The dissertation points out that existing labor and health laws do not sufficiently address this complex relationship, potentially leading to legal uncertainty, weak protection of labor rights, and unclear lines of responsibility in cases of medical disputes. The study specifically focuses on full-time specialist doctors with a single practice permit at one private hospital, excluding civil servants and those with multiple practice locations.

Based on normative, empirical, and comparative research, Zulkarnain proposes a "sui generis hybrid" legal model. This model acknowledges a working relationship between doctors and hospitals without compromising the doctor's professional independence. It aims to ensure doctors receive normative protections as workers, including legal certainty, social security, occupational safety and health guarantees, and industrial dispute resolution mechanisms, while also respecting their professional autonomy in healthcare services.

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As a result, various issues arise, ranging from the ambiguity of a doctor's status as a worker or partner, the protection of normative labor rights, legal responsibility in cases of medical disputes, to legal protection for hospitals as healthcare service institutions.