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Work experience with the AMA

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BY RICHE MOHAN, MEDICAL STUDENT, FLINDERS UNIVERSITY

In April of this year I was given the opportunity to spend a 6-week placement with the medical practice team at federal AMA in Canberra. I chose this placement to gain some insight into what the AMA does and how it is done. While there, I was able to see first-hand how advocacy happens, and meet the people working behind the scenes to pull it all together.

From day one of medical school we all begin to form an idea of what the AMA does and for some, this impression doesn’t evolve beyond a subscription with some perks. My time with the AMA helped me understand why it is so important for both doctors and patients and I hope to share my experience to spread this understanding.    

During my placement, I met with directors and policy advisors, and was interested by the scope and breadth of their portfolios, as well as their ability to mobilise on any given topic depending on the priorities of the day. The 24-hour news cycle brought a new issue to the front pages of newspapers around Australia and the AMA was often called to inform debate. Some of the hot topics during my placement included the appropriate timing of vaccinations, out of pocket expenses for privately insured patients and mandatory reporting legislation for doctors. All these issues required evidence based, honest responses delivered in a manner which would not betray the trust of Doctors or the public.

Meanwhile, Government, private health insurers, hospitals, stakeholders and doctor and patient advocates are continuously formulating and debating policy which can change the way health care is delivered in Australia today and years from now. The challenge was in insuring that any changes would continue to empower excellent doctors to provide excellent patient care.  I learned that this is a key difference between the AMA and other organisations; as the AMA is not just looking to improve working conditions for doctors as a union might, but instead looks to service the needs of its members and the people they serve, the patient. This is highlighted by the AMA Code of Ethics, hung on every office wall, which states: “Consider first the well-being of the patient”. 

The above does not occur but for countless hours of hard work by both AMA staff and volunteer doctors around Australia who sit on the various councils and committees. The policy directions decided on at these meetings inform position statements and media releases; the potency of which should not be underestimated, as they form the basis of high level discussions which can result in real outcomes nationally. I came to realise that there are competing forces out there trying to fundamentally change how medicine is practiced and delivered in Australia, and that without diligent oversight, we are all at risk of being part of broken system.

The focus of my time at the AMA was to examine the evidence behind quality and safety-based hospital funding. The Independent Hospital Pricing Authority, in conjunction with the Commission for Safety and Quality in Healthcare (directed by COAG), has been tasked with implementing measures which will see hospitals being penalised with funding deductions for adverse events. These include sentinel events, hospital acquired complications and avoidable readmissions. Though introduced to achieve quality and safety improvements, evidence from around the world suggests that such penalties do not lead to long term outcome improvements. Instead, they ask that hospitals improve their standards, despite reduced funding.

The big take away for me was that those at the beginning of their careers, such as students and junior doctors, have the most to gain or lose by the decisions being made today. Though our learning and careers often become all consuming, it is important to stay engaged with these issues and support those acting on our behalf – particularly if we cannot participate ourselves. My placement allowed me to see firsthand how advocacy issues are raised, dissected, discussed and actioned and I gained an appreciation for the influence the AMA has; an influence we should support and guide through our participation.   

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