1 Chapter I Introduction The first chapter of this thesis is the foundation of the final project. This chapter will provide a background of the writing of this thesis as well as a deeper comprehension of the company of the research namely Postur Clinic. Other than that, this chapter will cover the business issue, research questions and research objectives, along with the research scope and limitation. I. 1 Background The Micro, Small, and Medium Enterprises (MSMEs) have a prominent role in the nation’s economy. According to the data provided by the Ministry of Cooperatives and Small and Medium Enterprises (KUKM) in 2021, there are a total of 64.2 million MSMEs in the country with a contribution to the Gross Domestic Product as much as 61.07% or Rp. 8,573.89 Trillion. 117 million people were employed by MSMes, contributing 97% of the total employment of the business sector. Additionally, MSMEs attract 60.42% of the total investment in the country. This sector has proved its resilience during economic crises, thus has a strong potential in the national economy according to the large number of these enterprises (Direktorat Jenderal Kekayaan Negara, 2022). Figure I. 1 Average Per Capita Healthcare Expenditure (Badan Pusat Statistik, 2018) 2 The healthcare industry has shown significant growth over the years. As shown in Figure I.1, the average growth for healthcare expenditure per capita in Indonesia each year is 10% between 2018 to 2022. This signifies that Indonesian people put more interest in healthcare and are more aware towards it as the year goes by. This could potentially boost the healthcare industry, especially those who run MSMEs in that sector. Although the expenditure from 2021 to 2022 slightly decreased due to the decline of COVID-19 in Indonesia. The recovery of COVID-19 impacts the government spending on healthcare, thus impacting on the average per capita healthcare expenditure. Based on Indonesian Law UU No. 8/1999 about consumer protection, businesses consist of individuals and business entities conducting business activities either individually or collectively through agreements to engage in various economic sectors. Conforming to the law, medical services that are performed by physicians in providing healthcare services to patients are also a part of MSMEs. Physicians must have their Certificate of Registration (STR) issued by the Indonesian Medical Council and a Practice Permit (SIP) issued by the health office of the district granted to physicians who met the requirements (Kementerian Kesehatan Republik Indonesia, 2021). 3 Figure I. 2 Organization of Health System in Indonesia (Mahendradhata et al., 2017) The Indonesian health system consists of public and private healthcare providers (Figure I.2). Private sectors are growing and developing as they provide healthcare services for the public. As there are many provisions of services in this sector, medical rehabilitation services are essential in giving physical therapies in order to restore or improve physical and functional ability of patients (Mahendradhata et al., 2017). Restoring patients' functional abilities will increase their quality of life and enable them to reintegrate into society and participate actively in their personal and professional lives. 4 Scoliosis is a spinal deformity that occurs in three dimensions in which the curvature of the spine should be at least 10° (Vaiva Seleviciene et al., 2022). Scoliosis is a part of the medical rehabilitation sector. Scoliosis usually occurs in adolescence between the age of 10 and 18 years, calling it adolescent idiopathic scoliosis (AIS). Approximately 4 out of every 100 people have scoliosis (Erika, 2017). One of the medical rehabilitation service providers that specialize in scoliosis specific treatment is Postur Clinic located in Surabaya. In Surabaya, the prevalence rate for Adolescent Idiopathic Scoliosis is 2.93% (IS, SB, & A, 2017). The research was conducted for patients within the age of 9-16 years, where AIS first detected. In 2019, Surabaya has a total population of 3,095,026 (Dispendukcapil, 2019) and if we apply the prevalence rate for scoliosis (2.93%) then the market for scoliosis is approximately 90,684 people in Surabaya. The market share for scoliosis healthcare service is promising. The increase of health awareness over the years will create an opportunity for this enterprise to reach a larger market. Being the only private practice in Surabaya that offers scoliosis specific treatments (Schroth Best Practice & Gensingen Brace by Dr Weiss), Postur Clinic has a large market opportunity. Postur Clinic’s patients are mostly younger children and teenagers that have just been detected with scoliosis. Scoliosis treatment is not a onetime thing, the therapy should be done in a certain amount of time to achieve the optimal result. Without treatment, the curvature may increase in size 0.5° to 2° per year (Scoliosis | Scoliosis Research Society, 2023). Patients with scoliosis will have to do a lifelong scoliosis treatment to keep the curvature from increasing. Postur Clinic is a medical rehabilitation service provider that specializes in scoliosis. This healthcare provider could accompany scoliosis patients through the years to help prevent their curvatures from increasing and even correct the curvature to improve the patient's quality of life. 5 I. 2 Company Profile Postur Clinic is a Physical medicine and rehabilitation (PM&R) healthcare service that provides consultation with doctors and treatments to correct the patient's posture, especially Scoliosis conservatively and holistically (without surgery). Physical medicine and rehabilitation, also referred to as physiatry or rehabilitation medicine, aims to improve and restore functional ability and quality of life for people with physical impairments or disabilities affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons (“Physical Medicine and Rehabilitation: MedlinePlus Medical Encyclopedia,” 2019). Postur Clinic is the first and only clinic in Surabaya that has a scoliosis specific program (Schroth Best Practice & Gensingen Brace by Dr Weiss) for scoliosis treatment. Postur clinic also handles other physical rehabilitation therapy to alleviate pain and restore foot, spine, joint and muscle function. Postur Clinic was established on December 2, 2020 and is located on Jl. Music No.