Showing up

Showing up

When the medical profession came under attack, which organisations came to the defence of doctors? AMA (NSW) CEO, Fiona Davies on the importance of ‘showing up’ when things get difficult.

MOST DOCTORS I KNOW can recall a moment in which they realised that they were in charge, that no matter how difficult the situation they were facing, they were ultimately responsible. Obviously, this situation ideally reflects a suitable period of training and development, but it is the essence of what it is to be a doctor, a sense that even when things are difficult, you keep going.

I have been reflecting on what it means to be a professional following the events of October when, seemingly out of nowhere, the medical profession in its entirety suddenly became the focus of a media onslaught around the suggestion of $8billion being “rorted” by doctors. The AMA responded on behalf of doctors with complete and understandable outrage, only to find our own organisation and office bearers also attacked. It was suggested by some that the outrage was concocted and inappropriate when all the media were doing was reporting.

The AMA relies on the media as one of our many tools in advocating for a stronger health system. It’s not our only tool and in fact we think carefully about how we use the media. We recognise that the media has an important role. When dealing with the media, it’s sensible to know that they are not on your team but that usually they will be fair, particularly health journalists. We are used to the fact that the AMA has an important role in being available to media to educate and inform or simply provide background. During Covid, AMA (NSW) President, Dr Danielle McMullen did 570 media engagements on her own – that does not count the thousands done by the Federal President and Vice President, other state presidents and other Councillors.

We even know when there will be “bad doctor” stories – we are used to them, and we plan for them the way we plan for our “don’t eat too much at Christmas” media releases. Every year, the media covers on the report of the Professional Services Review. 

The Professional Services Review is the organisation which is responsible for oversight of doctors with regard to Medicare billing. Ironically, most of the “evidence” contained in the media coverage about the failures with Medicare came from this year’s Professional Services Review report. 

It is important to note that the AMA does not and never has condoned fraud. However, in making that statement, it is even more important to be clear what fraud is. Fraud is claiming for a service not provided or a similar level of criminal behaviour. The majority of conduct associated with Medicare is the misuse of item numbers, often as a result of the significant confusion around the Medicare system. Those held to account by the PSR are required to repay the amounts and may also face other sanctions, such as in some instances the loss of their provider number.

The $8billion figure has now been widely discredited by many sources.
It is not hard to understand why – $8billion represents a significant proportion of the overall billings undertaken in Australia calling into question how anyone could have suggested it was a valid number. However, neither the media outlets who promoted the figure nor other media outlets were willing to correct the inaccurate reporting, so the AMA will continue to press on this.

In my more than 20 years of working for the AMA, I have seen few issues unite the profession like this attack. From my exhausted surgeon husband arriving home late at night who said “it makes me wonder why we bother” to the amazing doctors of Lismore who felt it was yet another blow, to the medical students and DITs. Many doctors talked about how it will sadly change the way they practice, although most also said where patients raised it, they knew that their doctor did the right thing.

In response to this distress, the AMA did not step back but stepped up when many other organisations did not. AMA President Professor Steve Robson chose to front up to the 7.30 Report knowing he would be stepping up to a difficult media challenge. He did that because that’s what doctors do, they show up, even when it’s hard. The AMA will keep showing up for the medical profession.