I suffer from an exceedingly rare condition: election fever.
From the outset, I’ll admit that – excepting the six candidates actually running – I am quite possibly the only person on earth who cares about the upcoming RACGP and AMA elections.
This is my pitch to get you, dear reader, to join my party of (presumably) one.
The crux of the matter is this: the federal government is determined to change the way in which it funds doctors. It is going to progress toward this end no matter what the medical advocacy bodies think.
When advocacy is measured to the standard of “did the AMA or RACGP stop something from happening”, both groups come out looking rather weak. It’s a sentiment reflected in the low proportion of doctors who remain AMA members, and the not-infrequent grumblings of the RACGP membership.
No amount of advocacy can change the fact that federal health minister Mark Butler has publicly set a goal to get GP bulk billing up to 90% by the end of the decade, nor will it stop the curious machinations of the Department of Health, Disability and Ageing.
But even if this is the case, disengaging with organisations like the AMA and RACGP (say, by deciding not to vote in the elections at all) isn’t the answer either.
The thing is, the government can’t implement any of its plans without at least checking in with the AMA and RACGP. Look at the assignment of benefit debacle for all the proof you need.
If we accept that the goals are already set on the department’s end, I would argue that the chief function of groups like the AMA and RACGP becomes shaping the method by which the government reaches its desired endpoint.
Take access to care as an example; the end goal of the government was to reduce friction for patients who felt they needed a “simple” prescription. The method which government chose to use to solve this problem was pharmacist-led prescribing. What the AMA and RACGP had the chance to do was convince the government that GPs, not pharmacists, were the better option to fund.
So, you should probably make sure that the people the government is interacting with as the face of the profession are the scrappiest, most convincing ones available.
Now, I won’t tell you who to vote for. It’s not really my style, and I chat with nearly all of the candidates on a semi-regular basis outside of their capacity as would-be medical advocacy body presidents. Backing one over the others would make this aspect of my job rather awkward.
But here are three questions which – if I were allowed to cast a vote – I would be asking myself.
Are the threats internal or external?
There are a lot of people who have problems with the way the AMA and RACGP do things.
Fair enough.
In both races, there is at least one candidate whose focus seems to be just as much on changing the way that the organisation runs as it is on how and what to advocate on.
I’d consider whether the role of the president, at this point in time, should be more focused on keeping members happy and keeping the organisation running smoothly or on responding to external threats.
There’s no incorrect answer. The very public RACP leadership breakdown earlier this year showed just how ineffective an organisation becomes when its membership is disconnected from its leadership.
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What can we shift direction on?
Working on the theory that the RACGP and AMA can’t stop the government from doing whatever it wants to do, the job of these organisations is to convince the DoHDA to take the least-worst option.
It’s a strategy game as much as it is an endurance game.
There are a few remaining reform pieces on the board. We’re yet to see some of the big moves promised by the scope of practice report, assignment of benefit will rear its ugly head once again next year and doctors will soon have their fees made public.
Which candidates are best placed to pick these battles?
Do you catch more flies with honey? Or do you end up covered in goo?
There has been discussion, in some circles, about whether it’s the AMA or RACGP president’s role to be friendly and constructive with government, or whether it would be better to get mad.
Undoubtedly, there is a time and place for both approaches. Some of the more effective past presidents have had the wisdom and conviction to try and combine them.
Near the end of her term as president, the RACGP’s Professor Karen Price famously called on GPs to stop bulk billing.
It’s worth asking which of the candidates for RACGP and AMA president might have the guts to do something like that.
Vote for whoever you wish. But for your own sake, please vote.
