Pengesahan Undang-Undang Nomor 17 Tahun 2023 tentang Kesehatan memicu transformasi fundamental dalam tata kelola (governance) pembinaan dan pengawasan tenaga kesehatan di Indonesia. Regulasi ini menandai pergeseran paradigma dari model self-regulation yang didominasi oleh otonomi profesi menuju state regulatory governance yang terpusat pada otoritas negara. Penelitian ini bertujuan untuk menganalisis perubahan tata kelola kewenangan regulatif, rekonfigurasi relasi kelembagaan antara Kementerian Kesehatan RI, Konsil Kesehatan Indonesia (KKI), Kolegium, dan Organisasi Profesi (IDI, IBI, dan PPNI), serta implikasinya terhadap kepastian hukum, akuntabilitas negara, dan perlindungan publik. Penelitian kualitatif ini menggunakan pendekatan sosio-legal yang memadukan analisis normatif (law in books) dan empiris (law in action). Pengumpulan data dilakukan melalui triangulasi studi dokumen dan wawancara mendalam dengan informan kunci di tingkat pusat. Hasil penelitian menunjukkan bahwa negara telah mengatribusi kembali kewenangan strategis, mengintegrasikan Kolegium ke dalam struktur KKI, serta menghapus instrumen rekomendasi Organisasi Profesi (OP) dalam pengurusan izin praktik. Reformasi ini terbukti berhasil menyederhanakan birokrasi perizinan dan mempertegas kepastian hukum secara administratif. Namun pada tataran operasional, sentralisasi ini memicu beban kapasitas (overload capacity) di tingkat pusat dan melahirkan "area abu-abu" (governance grey areas) berupa dualisme Kolegium sebagai bentuk resistensi pasif. Direduksinya peran OP di tingkat daerah melumpuhkan sistem peringatan dini (early warning system) melalui pengawasan antarsejawat (micro-surveillance), yang berisiko menciptakan perlindungan yang kurang efektif (pseudo-protection) bagi masyarakat. Penelitian ini menyimpulkan bahwa model state regulatory governance yang terlampau sentralistis kurang adaptif dalam menyangga kompleksitas ekosistem kesehatan. Oleh karena itu, direkomendasikan transisi lanjutan menuju Collaborative Regulated Governance, yakni tata kelola yang menyinergikan ketegasan otoritas hukum negara dalam administrasi publik dengan pendelegasian wewenang pengawasan teknis lapangan kepada Organisasi Profesi guna menjamin keselamatan pasien yang optimal.

The enactment of Law Number 17 of 2023 concerning Health has triggered a fundamental transformation in the governance of the development and supervision of health workers in Indonesia. This regulation marks a paradigm shift from a self-regulation model dominated by professional autonomy towards a state regulatory governance model centralized under state authority. This study aims to analyze the changes in regulatory authority governance, the institutional reconfiguration among the Ministry of Health, the Indonesian Health Council (KKI), Collegiums, and Professional Organizations (IDI, IBI, and PPNI), as well as their implications for legal certainty, state accountability, and public protection. This qualitative research employs a socio-legal approach combining normative (law in books) and empirical (law in action) analyses. Data collection was conducted through document studies and in-depth interviews with key informants at the central level. The results indicate that the state has reclaimed strategic authority, integrated Collegiums into the KKI structure, and eliminated the recommendatory instrument of Professional Organizations (OP) in processing practice licenses. This reform has proven successful in simplifying administrative bureaucracy and affirming formal legal certainty. However, at the operational level, this centralization has triggered overload capacity at the center and created governance grey areas, such as the dualism of Collegiums as a form of passive resistance. The reduction of OP's role at the regional level disables the early warning system via peer monitoring (micro-surveillance), which risks creating pseudo-protection for the public. This study concludes that an overly centralized state regulatory governance model is less adaptive in sustaining the complexity of the health ecosystem. Therefore, a further transition towards Collaborative Regulated Governance is recommended a model that synergizes the assertive authority of state law in public administration with the delegation of field technical supervision to Professional Organizations to ensure optimal patient safety.