The AMA, says its president Dr Andrew Pesce, should be seen as the “Chief Health Policy advisor to all political parties”.
That’s according to the latest issue of Australian Medicine, the AMA’s news magazine, which gives a rather large splash to an AMA dinner held at Parliament House last month. Dr Pesce also told the dinner that it was “with some pride that a lot of our policy was reflected” in the Government’s recently announced Health and Hospitals Network policy.
Meanwhile, for another view on the AMA, here is a piece from Dr Simon Quilty, who questions whether the organisation really represents the interests of the public’s health or even the majority of doctors.
“I am a senior medical registrar half-way through my specialist training in the public hospital system. As my experience and understanding of healthcare and this system has grown, so too has my concern over the perception that the AMA is the rational voice of Australian doctors.
My unease escalated last year after the ophthalmology debacle and reading an editorial by the editor of the Medical Journal of Australia, Dr Martin Van Der Weyden, where he strongly defended opthalmologists’ rebates. I was puzzled by his logic and disturbed by his conclusions. As I understand, most opthalmologists would earn much more than half a million dollars a year through a combination of supply-demand and a technologically dated and grossly over-valued Medicare rebate. This seemed very clear-cut to me.
My real concern, however, was that the AMA was blatantly representing the pecuniary interests of doctors and at the same time completely ignoring the real issue of limited resources. More importantly, there was no serious attempt by the AMA to engage in the problem of unsustainable growth of healthcare expenditure, and the pivotal role our profession plays in this complicated equation.
Instead of contributing to this challenging problem, the AMA, and Dr Van Der Weyden in particular, attacked the Government for its attempt to rationalise a limited health budget, the shortcomings of which Van Der Weyden blamed almost entirely on government inefficiency. Dr Van Der Weyden blamed healthcare expenditure blow-outs on just about everyone but his own profession.
Having seen first-hand the speed at which doctors find loop-holes to prescribe the latest exorbitantly expensive chemotherapy, throw in a $30,000 defibrillator, or prescribe a 90 year old with twenty life-prolonging tablets, I felt our profession was just a little more responsible than alluded to by Dr Van Der Weyden, and knew that many of my colleagues had similar reservations.
So I started to ask my peers, almost all in the public hospital system, what they thought of the AMA.
Firstly, very few are members. Some are simply disinterested, but most have a well-considered reason for not joining.
A straight-forward reason that a number of my colleagues gave for non-membership was that they want a professional body that represents more than just doctors’ livelihoods. They do not want representation by a body that barely pays lip service to the ideal of equitable provision of healthcare in a world of limited resources.
And some junior doctors just want to work less hours and feel the AMA has nothing to offer in this regard. It is true that the long hours are improving, partly thanks to the AMA. But many junior doctors still work bloody long and hard. It’s not easy to feel part of the ‘club’ when you work your absolute arse off for a slightly above-average wage and watch your “poor” ophthalmologist colleagues successfully over-rule the Prime Minister – all in the name of money.
The ultimate solution to this problem, the over-stretching of the public system, is to prevent people coming into hospital in the first place. More emphasis on public health and social determinants of health – even if that money doesn’t end in a doctor’s bank account.
The AMA may say and do some very good things. But overall it seems much more concerned about maintaining ophthalmologists’ ludicrous incomes and preventing Nurse Practitioners from helping relieve the strain on junior doctors than, for instance, supporting an increase in public health spending beyond the pathetic 2% of total health expenditure it currently receives.
It would be a mistake for politicians, the public and the media to assume the AMA represents the opinion of all Australian doctors.”