It beggars belief that the RACGP would support something that so smacks of revalidation.
Is the RACGP trying to destroy itself?
Recently health ministers signed off on a new CPD system. Judging by comments around the coffee machine at morning-tea time, this new proposal is deeply unpopular, so it beggars belief that the RACGP would come out and support these new changes. There simply is no logical reason for doing so.
Let’s just take a step back and look at what is going on. I’ve been in general practice for 27 years, and I worked with senior doctors who started work back in the 1950s and who told me how good things were in the olden-days.
There seems to have been a trend over the past half-century of increasing government control. First came Medibank, which started interfering with the fees doctors charged. Then came Medicare, then the government started giving money to the RACGP, we had the vocational register (a list of names held by the government, not the profession), then training programs were transferred from the colleges to the government, then the government removed funding from the RACGP and it nearly went broke.
More recently we have seen the inexorable rise of government departments who go by acronyms such as BERT, the PRP, the PSR and AHPRA, all designed to ‘regulate’ and ‘control’ the profession. Now the profession is about to lose control of ongoing education.
Make no mistake where the latter is going: it is towards the UK model of revalidation. The board may of course deny this, but the pattern is clear. The first step is to transfer control from the profession to the government. The second step is the government simply does what it likes.
So why would the RACGP support this?
There was always an alternative path the College could have taken. It could simply have told AHPRA that the 130 point system, done over a triennium, was the gold standard that was supported by the profession, and given the RACGP is the largest medical college in the land, AHPRA would need to conform to the RACGP’s system. It could still do this if it chose to.
There is little question there are other players in this Machiavellian game. AHPRA’s new system means that anyone can set themselves up as a ‘CPD home’. The new system breaks the RACGP’s monopoly over CPD and with that monopoly there have been membership fees of over $1000 a year, and lots of organisations want a piece of that pie. I personally know of four organisations planning to tally CPD points under the new system, and that is in addition to the AMA and ACRRM. Each of these organisations plans to offer something more than the RACGP – whether that be a better website or better in-house courses or simply lower fees. There is no question that all of these new CPD homes have a business model that involves growth, and every member that joins has likely left the RACGP.
So why would anyone want to leave the RACGP? It was only a few short years ago that the college decided to introduce PLAN. Nobody really knows why it did this, but it was very unpopular and members let themselves be heard at the next presidential election.
AHPRA’s new system is PLAN on steroids. It involves self-criticism (sorry, reflection), it takes much more time, and there is no evidence that it will actually improve outcomes. Some doctors are going to leave simply because they are so annoyed that the RACGP is trying to introduce PLAN again. Some will leave because the RACGP didn’t even try to oppose the new model. Of course, it doesn’t matter where you go now, the CPD is the same, but at least these doctors are going to be saving over a thousand dollars a year.
So if the new AHPRA model is going to be introduced regardless, why would the RACGP antagonise its current members by saying it supports this new model? Are they so out of touch that they actually believe most members support doing 150 hours of CPD per triennium? Do they think AHPRA will give them some sort of special favour in return for their support? Do they think fewer doctors will leave the RACGP for all the other CPD homes? None of these suggestions make any sense.
As doctors, we have the interests of our patients at heart. I am not entirely convinced that AHPRA or any other government agency truly has our patients’ interests first and foremost.
Dr James Moxham is a South Australian GP
