AMA should take a cold shower

Australian Medical Association retiring president, Dr Rosanna Capolingua, has used her final speech at the national AMA conference (Weekend Australian 30-31 May 2009 P6) to denigrate burgeoning expertise in the health industry for some vague protection of GP status in Australia.

This most recent salvo from the AMA is further evidence of an organisation that is out of contact with its clients, and the industry as a whole. The AMA proves time and again that it prefers to live in a world of its own. If anyone of the GP members had a client like the AMA, they would be advising that client to socialise more, asks others for honest opinion about how they are travelling and their relationships in life. The AMA is caught in an isolationist spiral by which it is becoming more paranoid, less community orientated, less networked, and less resilient. If the AMA continues down this course it will, like many who fail to feel part of a bigger community, commit a type of suicide.

The AMA is fortunate to have many members who could care less about the paranoias of the hierarchy of the organisation. It is these hard working, community orientated people who will continue to shore up the AMA, even at the same time presidents work hard at demoralising GPS. These members need to take a stand within their own organisation, They need to ask the organisation to take a cold shower and get some perspective on the contemporary health challenges and health industry.

The next 20 years will see an extraordinary demand on GP services. GPs are already unable to fulfil this demand. Meanwhile a number of other professions, some new to Australia such as physician assistants and nurse practitioners, some old such as physiotherapists, are developing training programs that will increase their knowledge and skills to take a higher responsibility for diagnosis and therapy. There is no concept among any health professions in Australia for any professional to take on roles for which they are anything but trained to world’s best practice, and that means clients best welfare.

Of course many health professions such as physiotherapy and psychology, have long designed training and accreditation programs that, in their specific fields, far outstrip the knowledge and therapeutic safety of GPs. Even while the AMA curses others for supporting the diminution of professional skill, General Practice endeavours to play the schizoid games of trying to make GPs into, on one hand, a ‘man’ for all seasons, by which a GP can do everything from counselling a depressed client to solve a sportsman’s injuries, all by a weekend course in the Whitsundays, and on the other hand, being a 5 dollar a minute medicare funded script writing, specialist referral point.

GP practice has become a stressful place. Not because other professionals are taking their roles. Not because they won’t make take home pays of $100 an hour. They are stressed because they are not coping well with the increased complexity of GP practices, their relationships with other GPs and other staff, and the burgeoning suffering of clients they are exposed. The AMA would do well to fully understand its own role in this stress and its neglect of designing strategies for this stress, for its members. The many other health professionals in the industry can also help alleviate some of this stress by being encourage by GPs and the AMA to become even closer involved in developing more effective systems for getting the client access to the best services. To come to that mindset, GPs and the AMA will have to admit that they don’t always know what ‘best’ is, and in some areas, others have a far better understanding.

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