A new AMA leadership team will step out later this month into a volatile landscape of politicians on an election footing and doctors fed up with years of austerity budgets.
Contesting the AMA presidency, current Vice-President Dr Tony Bartone aims to become the first general practitioner in four years to lead the association.
Dr Bartone has lined up against Brisbane obstetrician Dr Gino Pecoraro and Sydney immunologist Dr Brad Frankum in a three-way race to be decided at the AMA’s national conference on May 27.
The AMA’s advocacy and the “Mediscare” campaign waged by Labor at the 2016 election have “led to a desire by the government to be more collaborative and be seen to be engaging more with the profession”, Dr Bartone said.
But after a five-year Medicare rebate freeze, no amount of reindexing could make up for the damage done to the viability of general practice.
“Let’s be very frank about that,” the Melbourne GP said.
“We really need to sit down and reframe the whole conversation about what genuine investment looks like in health and, in particular, in general practice.”
Australia’s healthcare system, regarded as among the best in the world, was potentially at risk, he said.
“We need to ensure the appropriate investment and the appropriate reform of that system to make sure it maintains that high standard, especially in the face of the significant twin issues of increasing age and increasing complexity.”
Dr Bartone said GPs were well aware that patients were also doing it tough in a climate of stagnant wage growth and rising out-of-pocket costs for healthcare.
“In that environment, we’ve just begun the conversation, and the conversation needs to become more robust,” he said.
Dr Pecoraro, a former president of the AMA’s Queensland arm and a seasoned media performer, wants to work for better health workforce planning at national and local levels.
“We need to look at the maldistribution of doctors. We need to open up our minds and think about different ways of looking at this,” he said.
“We don’t need more medical schools. We need guaranteed funding so that doctors can continue their training in specific specialties, but also the rural generalist program.
“We need federal government money for that. The problem is that the federal government’s commitment stops after medical school.”
While junior doctors cared about social justice, they were also concerned about getting jobs, Dr Pecoraro added.
Mental health and indigenous health were two areas where he would like to see more focused investment.
Dr Frankum has put up his hand for the federal leadership after a prominent role in arguing for doctors’ health as the AMA’s NSW president.
He has also been a strong critic of the neglect of general practice and the disconnect between primary care and the hospital system.
“What we need to talk about is not just the amount of Medicare rebates, but how to reward quality general practice and how we can better integrate general practice with the rest of the system, whether that be hospital or private specialists,” he said.
“There’s still an awful lot of lack of integration, that means patients are suffering and don’t have as smooth a journey through the system as they need.
“I want to really have that visionary look at general practice leading up to the next federal election and hope we can have some undertakings from both sides of politics about how we are going to fix this.
“I am not sure we have seen any vision about general practice from our current federal government.”