Perfect timing

Some might view taking leadership of a medical organisation during a once in a century global pandemic as ‘bad timing’.

However, I feel privileged to be involved in healthcare leadership during this unprecedented time of change and opportunity.

I recognise that it has been a very challenging year for all of us – and I thank you all for the sacrifices you’ve made for your patients, and the public health of NSW. But as we emerge through this crisis, we have the unique ability to unite as a profession and shape our future.

It’s a privilege for me to take over from Dr Kean-Seng Lim as President of AMA (NSW). I want to acknowledge the tremendous effort with which he led the organisation and the support he’s given me as I step up to this role. In particular, I thank him for his generosity as we worked closely together earlier this year so I could hit the ground running from May.

As former Vice-President and previous chair of our Doctors-in-Training Committee I’ve had a backstage pass to the inner workings of the AMA. The long debates during Council meetings, the late-night emails regarding government decisions, the last-minute decisions on responses to media – I have been heavily involved in helping shape our leadership on issues such as healthcare funding, changes to private health insurance, integration of care, the Medicare freeze, the need for improved access to care for rural and regional residents, greater health equity for Aboriginal and Torres Strait Islander people, abortion law reform, improved mental health resourcing, better health IT, better working conditions for doctors-in-training, the ongoing battle against sexual harassment and bullying in medicine, doctors’ health and wellbeing, and much, much more.

These issues continue to be priorities and during my presidency I would like to make a specific contribution to gender equity in medicine, women’s health reforms and improvements to primary care.

Of course, for now, the pandemic is taking centre stage. COVID-19 is undoubtedly one of the biggest health challenges our nation will face this century. But the system was already under immense strain before COVID-19. AMA (NSW) has repeatedly called on the State Government to adequately fund public hospitals. The pressure facing emergency departments has grown steadily and the efficiency gains made in recent years are not sustainable without proper resourcing. This remains a pressing issue. The AMA has also been a vocal proponent of meaningful new investment in primary care and a plan for general practice so it can better meet the challenges of increasing prevalence of chronic disease in the community. A plan to ensure better integration between general practice, other specialists and the hospital system so we can truly work together to reduce hospital admissions and achieve better health for our patients.

There has never been a more important time for the system to work as efficiently, effectively, and appropriately as possible.

Elective surgery

When the threat of COVID-19 started to emerge in Australia, it was inspiring to see the health system pull together to strategise its response.

The shutdown of elective surgery to preserve PPE and create hospital capacity was the right decision at the right time. It meant many doctors copped a significant reduction in work, but they did so to ensure NSW was as prepared as possible should we see a tsunami of coronavirus transmissions akin to what is happening overseas.

Cancellation of surgical services also comes with a cost to patients’ physical and mental health and to the economy with patients on waiting lists often having reduced ability to work. While we are starting to turn the tap back on for elective surgery and other hospital services, research is needed to see the true impact this decision has on patient health and outcomes.

As the system struggles to work through the backlog of elective surgery we need more than just short-term funding. Even prior to COVID-19 waiting lists were unacceptably long in NSW. The current situation highlights that we need a longer-term solution to solve elective surgery waitlists, so that our patients get the care they need, when they need it.

Telemedicine

Likewise, the Federal Government’s amendments to Medicare which allowed for an expansion of item numbers for telehealth was the right decision at the right time. It ensured vital health services could continue to operate while providing protection to both patients and doctors.

It was inspiring to see so many doctors quickly mobilise to set up telehealth services in their practices and undertake additional training to ensure they were up to date on best practice with these technology tools.

The rapid expansion of telehealth access has been an amazing opportunity to see the benefits these services bring in improving care for patients. But now it’s time for us to show leadership as to where telemedicine can take us into the future. It’s much more than a consultation over a videocall – as the Government decides how it will fund these health services going forward, the AMA is advocating to cement telemedicine in a way that optimises continuity of care for best patient outcomes. In particular, ensuring that in general practice the easiest option is also the best option – for patients to see their usual GP in the right way, at the right time.

We know Australia’s economy is under immense pressure. But we also know that investment in primary care is a solid investment to keep people out of expensive hospital care.

As a profession, we must speak up for the ‘silver linings’ of COVID-19 and decide what to keep from the many rapid changes we’ve seen in the past few months. I look forward to hearing from many of you as we shape the health system of our future.

We can’t let this opportunity slip away.