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Performance Appraisal Form For Doctors for Indonesia

Performance Appraisal Form For Doctors Template for Indonesia

This document serves as a standardized performance evaluation tool for medical practitioners in Indonesia, complying with the requirements set forth by Law No. 29 of 2004 on Medical Practice and related healthcare regulations. It provides a comprehensive framework for assessing doctors' clinical competencies, professional behavior, administrative performance, and development goals. The form incorporates Indonesian medical practice standards while adhering to international best practices in healthcare performance evaluation, making it suitable for use in both public and private healthcare institutions throughout Indonesia.

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What is a Performance Appraisal Form For Doctors?

The Performance Appraisal Form For Doctors is a crucial document used in Indonesian healthcare settings to systematically evaluate medical practitioners' performance and ensure compliance with national healthcare standards. This document is designed in accordance with Indonesian medical practice laws, particularly Law No. 29 of 2004 and Law No. 36 of 2014, addressing the need for standardized performance assessment in healthcare institutions. It is typically implemented during annual evaluations, contract renewals, or specific performance review periods, providing a structured approach to assess clinical competency, professional conduct, and administrative capabilities of medical practitioners. The form supports healthcare institutions in maintaining high standards of medical care while facilitating professional development and quality improvement initiatives.

What sections should be included in a Performance Appraisal Form For Doctors?

1. Personal Information: Doctor's basic information including name, medical license number, specialization, department, and period of evaluation

2. Clinical Competency Assessment: Evaluation of medical knowledge, clinical skills, patient care quality, and diagnostic accuracy

3. Professional Behavior: Assessment of communication skills, teamwork, ethics compliance, and professional conduct

4. Administrative Performance: Evaluation of documentation, record-keeping, adherence to hospital protocols, and administrative responsibilities

5. Quality and Safety Metrics: Assessment of patient safety practices, infection control compliance, and quality improvement participation

6. Research and Academic Contributions: Evaluation of research participation, publications, teaching activities, and continuous medical education

7. Performance Goals Review: Assessment of achievement of previously set goals and objectives

8. Future Development Plan: Setting new goals, identifying training needs, and creating development action plans

9. Overall Performance Rating: Final evaluation score and comprehensive performance summary

10. Signatures and Acknowledgment: Space for signatures of the evaluator, doctor, and relevant department heads

What sections are optional to include in a Performance Appraisal Form For Doctors?

1. Specialized Clinical Skills Assessment: For doctors with specific subspecialties requiring additional evaluation criteria

2. Leadership and Management Evaluation: For doctors in leadership positions or with administrative responsibilities

3. Emergency Response Assessment: For doctors working in emergency departments or critical care

4. Patient Feedback Summary: Section incorporating patient satisfaction surveys and feedback

5. Peer Review Results: Including feedback from colleague evaluations when 360-degree assessment is used

6. Financial Performance Metrics: For doctors with revenue responsibilities or private practice arrangements

7. Cultural Competency Assessment: For doctors working in areas with diverse cultural populations

What schedules should be included in a Performance Appraisal Form For Doctors?

1. Schedule A: Performance Rating Criteria: Detailed scoring guidelines and rating scales for each evaluation category

2. Schedule B: Clinical Competency Checklist: Specific checklist of required clinical skills and procedures for the specialty

3. Schedule C: Professional Development Log: Record of continuing medical education, conferences, and training completed during the evaluation period

4. Schedule D: Incident Report Summary: Summary of any medical incidents, complaints, or commendations during the evaluation period

5. Appendix 1: Self-Assessment Form: Doctor's self-evaluation form to be completed prior to the formal assessment

6. Appendix 2: Performance Improvement Plan Template: Standard template for documenting required improvements and action plans

7. Appendix 3: Required Documentation Checklist: List of supporting documents required for the evaluation process

Authors

Alex Denne

Head of Growth (Open Source Law) @ Ƶ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Jurisdiction

Indonesia

Publisher

Ƶ

Document Type

Evaluation Form

Cost

Free to use
Relevant legal definitions






























Clauses






























Relevant Industries

Healthcare

Medical Services

Hospital Administration

Private Medical Practice

Public Health

Medical Education

Healthcare Quality Assurance

Medical Research

Primary Care

Specialist Care

Relevant Teams

Human Resources

Medical Affairs

Quality Assurance

Clinical Operations

Medical Education

Hospital Administration

Performance Management

Compliance

Professional Development

Medical Committee

Relevant Roles

Chief Medical Officer

Hospital Director

Medical Department Head

Clinical Director

Senior Consultant

Specialist Doctor

General Practitioner

Resident Doctor

Medical Committee Member

Quality Assurance Manager

HR Director

Healthcare Administrator

Medical Education Director

Clinical Supervisor

Department Supervisor

Industries








Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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