Council news

August 2023

AMA(SA)

Councillor and

AMA Council of Doctors in Training

Chair Dr Hannah Szewczyk is the new Chair of AMA(SA) Council, following her election to the position at the August Council meeting.

Dr Szewczyk assumes the position vacated by Associate Professor Peter Subramaniam, who was elected AMA(SA) Vice President alongside President Dr John Williams in May.

Dr Williams, who acted as Chair in A/ Prof Subramaniam’s absence at the meeting, welcomed Dr Szewczyk, who is training with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and has served on AMA(SA) Council as the DiT and now O&G representative.

Later, former President Dr Michelle Atchison was elected to the AMA(SA) Executive Board. Dr Williams said Dr Atchison – who as Immediate Past President is not an automatic appointment to the Board – would continue to offer her years of corporate knowledge to the Board table.

The meeting included discussion over SA Health’s ongoing approach to managing COVID-19 and Long COVID. Members noted that while COVID cases are lower than earlier in the year, the number of South Australians with Long COVID continues to grow, yet there is no clear evidence of SA Health resources addressing their needs.

It was noted that there was no specific allocation for responding to Long COVID in the 2023-24 State Budget handed down in June, and that regional residents, in particular, lack health and allied health services.

Meanwhile, the burden of diagnosing and supporting people with suspected Long COVID continues to fall on the shoulders of general practitioners (GPs).

Meanwhile, one Councillor commented that while he received his flu shot from his employer at no cost, his most recent COVID vaccination was obtained (at a cost) from the local pharmacy.

It was also noted that while many doctors continue to encourage patients and friends to have boosters, events such as the trial determining the legitimacy of Warren Tredrea’s dismissal because of his refusal to be vaccinated against COVID may bring to prominence again the discrepancies between scientific information and other influences.

Council agreed that with Australians dying of COVID and the lack of action in addressing Long COVID, ‘getting the message out’ that COVID is still an issue requires more, targeted messaging.

The ‘tsunami’ of UK doctors considering and deciding to leave the NHS and accept roles in Australia presented opportunities for the AMA to offer assistance and recruit members, Council agreed. AMA(SA) is considering how to develop events, services and materials to support the IMGs from the UK and elsewhere who are vital to a health system that continues to face chronic workforce shortages.

Dr Nimit Singhal Ordinary Member

September 2023

Apresentation from AMA(SA) Vice President Associate Professor Peter Subramaniam on the Vanderbilt model and its value in peer-led workplace cultural change was an important agenda item for the AMA(SA) September meeting.

A/Prof Subramaniam detailed his experience of the program at Central Adelaide Local Health Network (CALHN), at the request of Council after earlier discussions about persisting bullying, harassment and other workplace issues in the state’s training hospitals.

Vanderbilt University’s professional accountability program is an evidencebased, organisation-wide proactive approach to improve individual’s behaviour following a peer intervention, improving workplace safety and patient outcomes.

At the core of this model is the ability to identify and respectfully share feedback with peers or co-workers of unprofessional behaviours that do not align with the values of the organisation, allowing self-reflection and personal alignment with organisation’s culture of safety and excellence. It gives any organisation the framework to define critical standards of safety and professionalism, and address behaviours that undermine them, while promoting the positive behaviours occurring within the network.

The peer-to-peer support model encourages a ‘cup of coffee’ conversation where peers – ideally at equal level of seniority and working within comparable specialities – have an informal conversation highlighting the lapse in

Council acknowledged the contribution and service to the profession and South Australian health of cardiologist Dr Phil Tideman, who died on 26 July after a long battle with bowel cancer. professionalism, in a non-judgmental, non-confrontational way.

Council recognised the importance of such models in efforts to implement the AMA(SA)-led legislation to make boards accountable for the psychosocial safety of their staff, and ultimately improve patient care and outcome.

The second item, payroll tax, occupied most of the evening. New interpretations of state tax law mean medical practices are liable to pay payroll tax on payments made to contracted general practitioners (GPs) unless an exemption applies. Recent decisions interstate have created significant uncertainty and has the potential to threaten the viability of many medical practice entities, which often operate on thin margins and retain little or no profit at the end of the year.

It is clear this tax could be a death knell for many general practices. Though the tax is state-based, AMA will take a national approach to lobby for an exemption for general practice. In South Australia, the government has announced an amnesty on payments made to contracted general practitioners until 30 June 2024.

There is no council meeting in October and Council will reconvene in November.