Penerbitan Surat Izin Praktik (SIP) bagi dokter spesialis merupakan aspek krusial dalam menjamin legalitas dan mutu pelayanan kesehatan. Terbitnya Undang-Undang Nomor 17 Tahun 2023 tentang Kesehatan membawa perubahan signifikan terhadap kebijakan perizinan, salah satunya adalah penghapusan kewajiban memperoleh rekomendasi dari organisasi profesi. Penelitian ini bertujuan untuk menganalisis kesesuaian penerapan kebijakan pembuatan SIP dokter spesialis di DKI Jakarta dengan peraturan terbaru tersebut. Penelitian menggunakan pendekatan kualitatif dengan desain studi deskriptif komparatif melalui wawancara mendalam terhadap informan dari DPR RI, Dinas Kesehatan, DPMPTSP, rumah sakit, dan dokter spesialis di DKI Jakarta. Hasil penelitian menunjukkan bahwa masih terdapat ketidaksesuaian antara norma, standar, prosedur, dan kriteria (NSPK) dengan pelaksanaan di lapangan, terutama dalam aspek komunikasi kebijakan, keterbatasan pemahaman dari sumber daya manusia dan teknologi informasi. Selain itu, masih terjadi kebingungan terkait perubahan regulasi dan lemahnya sosialisasi kepada tenaga medis. Dari sisi output, implementasi kebijakan belum sepenuhnya efektif dalam memastikan percepatan dan efisiensi layanan perizinan, meskipun proses digitalisasi telah mulai diterapkan. Kesimpulannya, penerapan kebijakan pembuatan SIP dokter spesialis di DKI Jakarta pasca terbitnya UU No. 17 Tahun 2023 masih belum sepenuhnya sesuai dengan harapan regulasi dan membutuhkan perbaikan dari aspek struktur birokrasi, dukungan teknologi, dan peningkatan koordinasi lintas sektor.

The issuance of a Practice License (SIP) for medical specialists is a crucial aspect in ensuring the legality and quality of healthcare services. The enactment of Law Number 17 of 2023 on Health has brought significant changes to licensing policies, one of which is the elimination of the requirement to obtain recommendations from professional organizations. This study aims to analyze the conformity of the implementation of SIP issuance policy for medical specialists in DKI Jakarta with the new regulation. The study uses a qualitative approach with a comparative descriptive study design through in-depth interviews with informants from the House of Representatives (DPR RI), the Health Office, One-Stop Integrated Service (DPMPTSP), hospitals, and medical specialists in Jakarta. The results show that discrepancies still exist between the norms, standards, procedures, and criteria (NSPK) and their implementation in the field, particularly in aspects of policy communication, limited understanding among human resources, and inadequate information technology systems. Furthermore, confusion persists regarding regulatory changes and weak socialization efforts toward medical personnel. From the output perspective, policy implementation has not yet been fully effective in ensuring the acceleration and efficiency of licensing services, even though digitalization processes have begun to be adopted. In conclusion, the implementation of the SIP issuance policy for medical specialists in DKI Jakarta following the enactment of Law No. 17 of 2023 has not yet fully aligned with regulatory expectations and requires improvements in bureaucratic structure, technological support, and enhanced inter-sectoral coordination.

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.