medicSA Winter 2025

Volume_38 Number_02 | WINTER 2025 | AMA South Australia

Changing of the guard A celebration of AMA SA’s leadership

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• Round Table: next steps • Budget breakdown • Healthscope fallout • New AI tool for doctors

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VOLUME_38 Number 02

CONTENTS Winter 2025

06 President’s column 07 The CEO’s report 09 From the Medical Editor A TOAST TO LEADERSHIP

12 Presidential handover 14

Doctors of distinction

15 A night to remember 16 Legacy of leadership

Business & technology

44 AI tool for doctors wealth 46 Building through property 48 Diversifying investments Wellbeing

58 Crazy socks for a cause 60 Ahpra advice for doctors 65 Fresh is best

Advocacy in action

Lifestyle and legacy

24 28 Healthscope fallout 29 Bupa ‘alarm bells’ 32 Hospital Health Check

68 70 Motoring: Off-road EV 72 A doctor’s heartfelt mission 78 Preserving AMA SA’s history

Round Table: Next steps

Travel: Japan’s cultural tapestry

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FROM PRACTICE TO PAPERWORK ACCOUNTING & BUSINESS ADVISORY EXPERTS FOR MEDICAL PROFESSIONALS

www.hoodsweeney.com.au

1300 764 200

2025

medicSA is produced by Australian Medical Association SA

AMA SA COUNCIL & BOARD AMA SA Council

Australian Medical Association South Australia Inc. Level 7, 431 King William St, Adelaide SA 5000

President: A/Prof Peter Subramaniam Vice President: Dr Louis Papilion Immediate Past President: Dr John Williams Chair: Dr Karen Koh

PO Box 685, Fullarton SA 5063

Ordinary Members

Telephone: (08) 8361 0100 Email: medicsa@amasa.org.au www.ama.com.au/sa Membership: membership@amasa.org.au

EXECUTIVE CONTACTS President A/Prof Peter Subramaniam: president@amasa.org.au CEO Nicole Sykes: nsykes@amasa.org.au

medicSA Editorial Medical Editor: Dr Roger Sexton editor@amasa.org.au Advertising medicsa@amasa.org.au

Dr Vikas Jasoria Dr Emily Kirkpatrick Dr Bridget Sawyer Dr Krishnaswamy Sundararajan A/Prof William Tam Dr Isaac Tennant Dr Hannah Szewczyk

Specialty Group Representatives Anaesthetists: Dr Louis Papilion Dermatologists: Dr Karen Koh Doctors in Training Representative: Dr Hayden Cain Emergency Medicine: Dr Cathrin Parsch Ophthalmologists: A/Prof Michael Goggin Intensive Care: Dr Raj Ramadoss Orthopaedic Surgeons: Prof Edward (Ted) Mah Surgeons: Dr Christopher Dobbins Gynaecologists: Dr Fariba Behnia-Willison Private Specialist Practice: Dr Simon Clark Public Hospital Doctors: Dr Jayanthi Jayakaran Physicians: Dr Chelsea Patterson Public Hospital Doctors: Dr Chetan Pradhan General Practitioners: Dr Mark Ralfe Paediatrics: Dr Gillian Watterson Pathologists: Dr Kathryn Harvey

ISSN 1447-9255 (Print) ISSN 2209-0096 (Digital)

Regional representatives

DISCLAIMER: Neither the Australian Medical Association South Australia Inc. nor any of its servants and agents will have any liability in any way arising from information or advice that is contained in medicSA. The statements or opinions that are expressed in the magazine reflect the views of the authors and do not represent the official policy of the Australian Medical Association South Australia unless this is so stated.

Although all accepted advertising material is expected to conform to ethical standards, such acceptance does not imply endorsement by the magazine. All matter in the magazine is covered by copyright, and must not be reproduced, stored in a retrieval system, or transmitted in any form by electronic or mechanical means, photocopying, or recording, without written permission. Images are reproduced with permission under limited license.

A/Prof Peter Subramaniam Dr Louis Papilion Dr Shriram Nath Prof Tarun Bastiampillai Ms Megan Webster Dr Emily Kirkpatrick

STAY IN TOUCH

@ama_south_australia

Southern: Dr Jerida Keane Northern: Dr Alice Fitzpatrick

AMA SA Board

@AMASouthAustralia

Australian Medical Association SA

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President’s Report A/Prof Peter Subramaniam As I begin my tenure as President of AMA SA, I recall George Bernard Shaw’s observation that ‘all progress depends on the unreasonable man’. The ‘unreasonable’ person pushes the world to be a better version of itself, rather than passively accepting the world as it is. It is this ‘unreasonable’ person who is likely to be an agent of change. This resonates strongly with my vision of the AMA – an organisation that is empowered to understand, challenge, question and advocate for improvements of the healthcare system that cares for the patients we serve.

Unity will never mean consensus. In a profession as diverse as ours, we will not always agree – and this is important as it brings different and important perspectives to issues. The AMA will navigate these differences with our colleagues – with intellectual curiosity for each other’s perspectives and a willingness to resolve our differences with evidence for the good of our patients.

PRESIDENT

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The challenges facing South Australian healthcare are well documented – workforce shortages, infrastructure gaps, systemic pressures that burden clinical care with growing complexity, among other challenges. Merely cataloguing problems without working toward solutions serves neither our profession nor our patients.

At a time of challenges and uncertainty, the AMA, with its history, stature and reach, maintains its important purpose by being united with our members, our colleagues in other states and our federal colleagues.

When we speak with one voice, we are an effective and powerful influence that governments, health departments and policymakers cannot ignore.

My vision for AMA SA extends beyond the notion of a traditional membership base. The AMA is an organisation that advocates for all doctors in this state, recognising that strengthening the medical profession benefits everyone – from rural GPs to nonGP specialists in the city, from junior doctors navigating early careers to experienced GPs and other specialists.

A strong medical workforce provides the best care to our patients.

This inclusive approach means working with specialist colleges and other medical associations and representative organisations (including industrial organisations representing doctors) whose inputs help us shape good policy. When purpose aligns, the medical voice is strongest.

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The next 12 months are important for healthcare in South Australia. With an upcoming state election on a background of ramping, burgeoning surgery waiting lists and planning underway for the major infrastructure of a new Women’s and Children’s Hospital, careful and considered decisions are needed to secure the longterm investment in our health system.

Infrastructure and capacity are only parts of the equation. Without a strong medical workforce to staff new facilities, infrastructure and capacity will become failed investments of a precious health budget. Our focus must be on securing a workforce for now and the future – in primary health, specialist care, outpatient and inpatient care, and both public and private hospital systems – to ensure the workforce is aligned with the needs of patients across South Australia.

We will engage in considered, evidence-based and constructive dialogue with government, opposition parties and all stakeholder organisations, including the media, while remaining clear-eyed about the highly charged political nature of health policy. We will remain steadfast at our core mission: advocating for doctors so we can deliver the best possible care to our patients.

We know that the health system is too important to be left to politics alone. It requires a persistent but considered voice of an expert medical profession, united in purpose and unwavering in a commitment to excellence.

AMA SA can play its roles in shaping a positive future for healthcare in our state.

From the

CEO Nicole Sykes As the first half of 2025 ends, I’m struck by the power of people, our people to drive meaningful change.

The recent period has been one of reflection and renewal, marked by extraordinary contributions, inspiring leadership transitions and exciting momentum for what lies ahead.

At our recent AGM, we farewelled several longserving Councillors who have each played a pivotal role in shaping AMA SA’s purpose, resilience and impact over many years. Their dedication, expertise and unwavering commitment to the medical profession have laid the foundations for where we are today. While saying goodbye to such significant contributors is difficult, it has also ushered in an exciting new chapter. I’m thrilled to welcome a dynamic and talented group of new Councillors who bring energy, fresh perspectives and a clear commitment to strengthening the medical profession in South Australia.

One of the most powerful moments this quarter was the successful delivery of our Access to Care Round Table. Led by Dr John Williams, Dr Bridget Sawyer and Dr Emily Kirkpatrick, and supported by the outstanding AMA SA team, this event brought together a broad cross-section of healthcare stakeholders with a shared goal of improving access to primary care for South Australians.

The real achievement was not the depth of discussion but the unity of purpose. Agreement was reached on a set of core priorities, and we are now working swiftly to translate those into recommendations for government. These coming weeks will be critical, as we engage key decisionmakers to ensure real, tangible reform follows. We are under no illusions about the scale of the challenge, but the opportunity to be part of the solution is one we embrace wholeheartedly.

Throughout this change we have seen the formal transition of AMA SA leadership. I offer my heartfelt congratulations to Associate Professor Peter Subramaniam and Dr Louis Papilion on their appointments as President and Vice President.

Both bring exceptional professional credentials and a deep commitment to AMA SA’s values. Their leadership will be instrumental as we continue the work of revitalising our organisation, amplifying the voice of our members, and delivering on the strategic initiatives now underway.

At the same time, we bid a fond farewell to Dr John Williams, whose presidency was marked by both strength and humility. John’s ability to lead with integrity, build bridges, and remain focused on longterm outcomes has left a lasting legacy. It has been a genuine honour for our team to work alongside him.

We were delighted to formally celebrate these leadership transitions at our Gala Dinner, which was an evening full of fun, recognition, and style.

Thank you to all who joined us, helping to mark this special occasion and acknowledge the immense contributions of our outgoing and incoming leaders.

In closing, I want to recognise the hard work happening every day behind the scenes, often unseen but always impactful. Across policy and advocacy, member services, communications and operations, our team continues to give their all in pursuit of better outcomes for doctors and the communities they serve. It’s this collective effort from our Councillors, committee members, professional partners and secretariat that provides AMA SA its strength. And for that, I am deeply grateful.

There’s still significant work to be done. But with a united purpose, strong leadership and a shared commitment to making a difference, we are ready.

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From the

Medical Editor

Dr Roger Sexton

The focus on health during this year’s federal election campaign indicated how health has remained a significant concern for voters and a point of sensitivity for all sides of politics.

When Medibank (later Medicare) started, it was promoted as the national insurance scheme to assist the lowest 20% of income earners, who were struggling with the cost of medical care and for whom private hospital insurance was out of reach.

A lot has changed since then. Medicare has become a safety net to the point where many Australians now do not expect to pay any out-of-pocket costs for GP services. Bulk-billing had been introduced to make it affordable to care for the poor (something the profession had often traditionally offered anyway) and as an administrative benefit to help practices with the burden of accounts and billing, but it has ultimately placed a ‘price point’ upon and controlled the fees structure of primary medical services. Bulkbilling has become something governments promise to ‘guarantee’, as if GPs are under their control and the government should be thanked for ‘providing’ it!

The reality is that the funding pool for general practice has been diluted. Other health professionals have been granted access to the limited Medicare funding pool as their scope has evolved. Selected item numbers have been quietly removed (think joint injections in general practice). Public hospitals have also been granted access to the federal Medicare funding pool for outpatient services (a most contentious development in my view) and the administrative and regulatory oversight of the profession’s billing practices has intensified.

In this setting, general practice has been providing comprehensive holistic care to the community while needing to operate viable, responsive and sustainable businesses that allow GPs to care for patients safely and effectively.

However, it has become increasingly difficult to offer traditional services and employ skilled colleagues and team members in a working environment that is

well equipped and encourages excellence. Doctors find it increasingly difficult to offer the care they used to, as demonstrated by a lack of same-day or emergency appointments, shrinking scope of practice, and the cessation of home visits and visits to residential facilities. At the same time, doctors and other health colleagues join other workers in seeking a life-work balance.

This creates a service vacuum that others are only too happy to fill. Non-clinicians consider selected aspects of primary care as easy and seize the opportunity to enhance their scope of practice and access the Medicare funding pool. Politicians are only too happy to listen to their offers of help to fill the vacuum and introduce new models and methods to bring more accessible health care to the voters.

It is time for the scope of general practice to expand again. GPs must be ambitious and aspire to build models that enable them to offer extended hours, home visits, more same-day appointments, broader clinical and preventive services, and emergency treatment and treatment rooms.

We all know patients are prepared to pay for good service, underpinned by their desire for greater value and benefit. The four T’s they seek have not changed: time, talent, trust and TLC. Taking charge of our own destiny requires leadership, courage, investment and ambition.

Our place in the health system is up to us. We must invest in ourselves, professionally and politically, and support those colleagues who sit at decision-making tables.

Our voice must be heard at those tables. Your support for the AMA is critical.

Enjoy this fine edition of medicSA and read what your AMA is doing for you. As usual, I welcome your correspondence.

Dr Roger Sexton roger.sexton@bigpond.com

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FINANCIA AD

GALA

A TOAST TO LEADERSHIP Heartfelt speeches, prestigious awards and show-stopping entertainment - the ‘Reimagine AMA SA Gala’ had it all.

It was a vibrant celebration of collegiality to mark the official start of a new era of AMA SA leadership.

GALA Photographer: Matthew Kroker

PASSING THE TORCH

AMA SA Vice President Dr Louis Papilion, President Associate Professor Peter Subramaniam and Immediate Past President Dr John Williams

It was billed as ‘the night of nights for South Australia’s doctors’, and those who attended the ‘Reimagine AMA SA Gala’ agreed it lived up to the hype.

Addressing the gala audience, A/Prof Subramaniam outlined his presidential priorities, emphasising the AMA’s place in the medical profession and the community.

More than 200 people from all sections of the medical community gathered for the event at Adelaide’s SkyCity Ballroom on 28 June. South Australia’s Health Minister Chris Picton attended with representatives from general practice, the public and private hospital sectors, the state’s medical schools and its cultural and heritage-based medical organisations.

‘Louis and I begin our term with optimism and a sense of urgency,’ A/Prof Subramaniam told guests.

The evening marked the official beginning of a new chapter in leadership for AMA SA, with Dr John Williams formally presenting the presidential reins to his successor, Associate Professor Peter Subramaniam.

‘The AMA has a responsibility to shape the system – to shape good policy, to help shape the culture of our hospitals, and, most importantly, to shape the trust of our community in our doctors and our health system.

‘The next 12 months are critical – not just because of the upcoming state election, but because the longterm sustainability of the South Australian health system depends on making the right decisions today, across a range of issues that will impact the future.

GALA

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Looking to the future AMA SA Vice President for the past two years, A/Prof Subramaniam is a vascular surgeon working in private practice and the public hospital system. He begins his term with the support of incoming Vice President and Adelaide anaesthetist Dr Louis Papilion.

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‘We will work constructively with others, even when we do not agree; we will seek evidence when we cannot see it; we will challenge the system when it needs challenging; and we will always support our patients when they need supporting.’

While outlining his vision for the future, A/Prof Subramaniam also reflected on the past, sharing poignant aspects of his personal history.

‘The professional journey of this Malaysian born, ethnic Sri Lankan Tamil, cricket-loving, Marcus Bontempelliworshipping, Western Bulldogs fanatic would not have been possible without the extraordinary sacrifices of my late parents, Maniam and Esme,’ A/Prof Subramaniam said.

‘Forty-four years ago, they made the difficult and courageous decision to send me to Australia to study – a decision that carried emotional and financial cost.

It was a decision rooted in faith and belief in a better future for their son.’

A/Prof Subramaniam thanked Dr Williams for his ‘thoughtful and respectful focus’ on advocacy and his commitment to ensuring members’ voices were heard in the ‘debates that matter’.

He told guests that being AMA SA President is both a privilege and a responsibility.

‘The privilege is the opportunity to serve. And the responsibility is to perform that service well. I thank you for the privilege of serving as your president and it is my hope that I will serve you well.’

A fond farewell In his farewell speech, Dr Williams reflected on his two years at the helm of AMA SA, describing the role as an honour ‘and a very steep learning curve’.

‘When I stood on the stage two years ago, I said that as President, I wanted to be a voice for all our members. I have strived to be that voice,’ he told gala guests.

‘Our membership covers so many areas … We are independent thinkers with an abundance of opinions and ideas. But when talking about patients and their health, we are united.’

Dr Williams thanked AMA SA staff and volunteers, including members of AMA SA and its committees, for their work and contributions. He also acknowledged CEO Nicole Sykes for establishing the organisation’s strategic plan and strengthening its governance.

The final words of his speech were dedicated to the new leadership team.

‘My best wishes go to Peter and Louis as they begin their terms,’ Dr Williams said. ‘I hope you will all join me in supporting them, every step of the way.’

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GALA A/Prof Subramaniam and guests at the ‘GIF Booth’

Dr Williams addressing gala guests

DOCTORS OF DISTINCTION The ‘Reimagine AMA SA Gala’ provided a special moment to honour three highly respected, talented and dedicated members of the AMA SA community.

Dr Bridget Sawyer – AMA SA President’s Award Dr John Williams selected Dr Bridget Sawyer as the recipient of the 2025 President’s Award, recognising her exceptional contributions to the organisation’s mission and leadership.

Addressing the gala audience, Dr Williams praised Dr Sawyer as a long-standing ambassador and advocate for the AMA, general practice and evidence-based care, both in South Australia and nationally.

‘In roles on state and federal AMA councils and committees Bridget devoted her time, attention, considerable expertise and patience and good humour to supporting AMA objectives. In doing so, she helped improve the health and wellbeing of all Australians,’ Dr Williams said.

Dr Bridget Sawyer and Dr Williams

A letter from the President also included congratulations from AMA President Dr Danielle McMullen, who thanked Dr Sawyer for her ‘contributions to positions on “cradle to grave medicine”, aged care and sports medicine, among other special interests, over many years’.

Dr Hayden Cain – AMA SA Rising Star Award 14

The inaugural Rising Star Award was presented to the former chair of AMA SA’s Doctors in Training (DiT) Committee, Dr Hayden Cain.

Dr Williams told attendees that the award was established this year to recognise doctors who show exceptional promise, innovation, or leadership early in their careers.

‘Hayden brings an infectious energy to everything he does,’ Dr Williams said.

‘His enthusiasm, humour, and authenticity have made him a standout presence among his peers and a powerful advocate for change.’

Dr Williams and Dr Hayden Cain

‘We look forward to watching him address the challenges of our profession with confidence, creative thinking and empathy.’

Dr Tom Turner – AMA SA Outstanding Achievement Award The late Dr Tom Turner was posthumously recognised with the Outstanding Achievement Award, which celebrates members who have consistently gone above and beyond the ordinary standard of service and set a strong positive example.

GALA

Dr Turner died on 10 September 2024 after nearly a decade as a member of the AMA SA History Committee. In a special tribute, his wife Jan was presented with his award at the AMA SA President’s Breakfast on 29 November 2024. Mrs Turner also attended the gala and heard Dr Williams and the audience acknowledge her husband’s legacy.

Posthumous honour: Dr Williams acknowledges Dr Tom Turner as the recipient of the Outstanding Achievement Award.

‘Dr Turner played a vital role in producing the book Heroism, Humanity and Sacrifice, which documented the service of British Medical Association (BMA) and AMA members in wars,’ Dr Williams said.

‘This project eventually led to Tom leading the development of a remarkably comprehensive public website detailing the history of the BMA and AMA SA, including a virtual museum of medical and surgical artefacts he curated.

‘It is a wonderful legacy, and we hope this award in some way recognises Tom’s contribution, service and commitment to our organisation and our profession.’

IN THE SPOTLIGHT Beyond the formalities, the AMA SA gala offered medical professionals and colleagues an opportunity to relax and unwind outside the confines of their often-stressful clinical settings.

Adelaide-based musical group ‘Gospo Collective’ set the party tone with powerhouse vocals and a saxophoneinfused DJ set. Off the dance floor, guests posed for photos at the ‘GIF booth’ and tried their luck at the Wine Direct wine wall, where the top prize was a $550 bottle of 2018 Kilikanoon Revelation Shiraz.

CEO Nicole Sykes thanked the gala and AMA SA partners that contributed to the success of the evening, including Radiology SA, Adelaide Vascular, Avant, Wakefield Orthopaedic Clinic, Miga, Jones Radiology, the University of Adelaide, Hood Sweeney, Norman Waterhouse, Financia, FRP Capital, MDA National and Wine Direct.

AMA SA was also pleased to support the Medical Benevolent Association of South Australia as our selected charity partner.

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David Kilmartin and Dr Johanna Kilmartin

Guy Biddle and Amanda Trudgian

Lauren Travers and Dr Edward Travers

Dr Louis Papilion, Dr Bridget Sawyer, Dr John Williams, Chris Picton MP and A/Prof Peter Subramaniam

Dr Laura Willington, Dr Rebecca John and Dr Lisa Biggs

Dr Emily Kirkpatrick and Dr Daniel Kirkpatrick

Dr Michael Herbert, Dr Bianca Wong and Dr Albert Kota

Dr Martin Bruening and Julianne Bruening

Dr Hannah Szewczyk and Dr Bethany Ferguson

GALA

A legacy of leadership Immediate Past President Dr John Williams reflects on two transformative years at the helm of AMA SA.

AMA SA Immediate Past President Dr John Williams

Recently I stumbled across the very first President’s Report I penned for medicSA. It was the Spring 2023 edition, I’d been AMA SA President for just four short months, and I was reflecting on the theme of ‘change’.

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At the time, it seemed change was everywhere.

South Australia’s healthcare system was emerging from the worst of COVID-19. Simultaneously doctors were confronting the prospect of payroll tax and the stress and confusion that came with it.

AMA SA was also undergoing major transitions, including a new CEO and a shift toward greater transparency. As the new President, I was adjusting to a whirlwind of responsibilities – ministerial meetings, media appearances, Zoom calls with AMA leadership, and frequent travel from Port Lincoln.

Change has been a constant throughout my two years. Not all of it has been positive, but I’m proud of how AMA SA has responded to the challenges and the progress we’ve made together.

As AMA SA’s first regional President, shining a spotlight on regional healthcare has been one of the biggest rewards. Securing a new pay deal for rural GPs and GP registrars in 2023 was a highlight.

My rural tour across South Australia deepened my understanding of the challenges regional doctors face and strengthened my advocacy. I visited the Adelaide Hills, the Riverland, the Limestone Coast, Kangaroo Island, The Iron Triangle, and practices closer to my home on the Eyre Peninsula. My final stop was in Murray Bridge on 8 May. Ensuring South Australia has enough doctors working in the right places has also been a focus

of my presidency. I’ve been a staunch advocate of general practice and have supported the Federal AMA’s calls for more GP training places and fair salaries and leave conditions for GP trainees. During my presidency, AMA SA also launched its first International Medical Graduate Committee to break down barriers for overseas-trained doctors work.

Improving hospital culture has been another priority. Levels of bullying and harassment remain high, but we’re working with SA Health and the State Government to improve reporting and tackle systemic issues. Junior doctors’ wellbeing depends on it.

Being AMA SA President isn’t just a title. I see it as a responsibility to speak out for those who spend their careers looking after others. Whether it was advocating for safer workplaces, better systems, or fairer fees, I’ve tried to ensure your voices were heard – by government, by the media, and by the broader community.

Special thanks to AMA SA CEO Nicole Sykes, Vice President Peter Subramaniam, and the AMA SA Councillors, committee members and staff who have supported me in my role. There are too many of you to name-check.

And finally thank you to the members for placing your trust in me and allowing me to be your voice.

Another period of change has now begun for AMA SA. Under the leadership of Peter and his Vice President, Dr Louis Papilion, I’m confident that our organisation will remain a strong and steadfast voice for the doctors in this organisation and across our health system.

Advocacy achievements Dr John Williams’ presidency was defined by his dedication to the doctors he represented and genuine concern for patient wellbeing. Here’s a snapshot of AMA SA’s advocacy under his leadership.

Patient care • Hosted the AMA SA Access to Care Round Table that examined innovative ways to improve coordination of community care to address ramping and bed block.

• Advocated for generational Medicare reform to facilitate longer GP consultations.

• Supported the AMA’s calls for significant increases to the GP workforce, prompting a commitment from the Federal Government for increased training to add 2,000 GPs to the workforce annually.

• Lobbied for a new National Health Reform Agreement to guarantee sufficient funding for South Australia’s public hospitals.

• Challenged policies like payroll tax and scope creep, which undermine doctors’ ability to provide comprehensive patient care.

• Championed general practice as the cornerstone of Australia’s health system, emphasising the crucial role of GPs in keeping the community well and reducing pressure on hospitals.

Workforce sustainability • Supported the rollout of the Single Employer Model, increasing the security of GP trainees and supporting workforce sustainability across South Australia.

• Established an International Medical Graduate (IMG) committee to identify barriers and establish support systems for IMGs in South Australia.

Workforce culture • Published the annual Hospital Health Check, which highlights the bullying, racism and discrimination and challenging work conditions that junior doctors face in the state’s public hospitals and the effects on their health and patient outcomes.

• Made eight recommendations to SA Health to make workplaces safer for junior doctors in South Australia, including to establish clear, fit-for-purpose bullying reporting pathways.

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Fairer fees • Lobbied for fairer ReturnToWorkSA (RTWSA) fees that align with the AMA Fees List.

This advocacy led to proposed increases of 85% for anaesthetic fees.

• Meetings with RTWSA continue to ensure all doctors are compensated appropriately for their time and expertise.

• Secured the support of the South Australian Health Minister for AMA’s campaign to make Ahpra registration fees fairer for doctors on parental leave.

Payroll tax • Secured commitments from the Treasurer that non-GP specialists will not be subject to retrospective payroll tax assessments and that rural GPs won’t be liable for payroll tax.

• Worked with senior representatives from government, RevenueSA and RACGP to influence legislation and decision making to benefit members.

• Advocated for an exemption for all GPs, in line with the recent Queensland decision, and ultimately for all private specialists and clinics.

Rural health 18

• Worked with the Rural Doctors’ Association of SA to finalise details of the rural GP agreement that has improved conditions for more than 330 rural GPs and GP registrars.

• Embarked on a rural tour of the state that has enabled AMA SA to gain a deeper understanding of the challenges confronting our members and colleagues in regional centres across the state.

Photo: Murray Bridge News. Pictured (L–R): Dr Sophia Gao, Dr Joe Scalzi, Dr Madeleine Brenner, Dr Richie Madden, Dr Martin Altmann, Dr John Williams, Dr Kyle Ratcliff, Dr Mitch Morby, Dr James Martin, Dr Alex Main, Dr Megan Wild, Dr Nish Athukorale

Women’s healthcare • Increased awareness of South Australia’s abortion legislation as an appropriate framework for what is and should be a women’s health issue.

• Recommended action to support women seeking endometriosis diagnoses and treatment.

• Recommended medications for reproductive care, including emergency contraception, be added to the ‘PBS Prescriber Bag’.

Children’s healthcare • Represented AMA SA on the South Australian Government’s Autism Assessment and Diagnosis Advisory Group that seeks to break down barriers for early autism assessment and intervention.

• Supported a South Australian Government campaign to ensure toddler and infant food meets best international standards for nutritional content, labelling and promotion.

Public health • Wrote to all national and state parliamentarians to reinforce the need for legislation to minimise the impacts of online and television gambling advertising.

• Supported state and national efforts to reduce access to and availability of vaping and nicotine pouch products.

• Supported South Australian Government initiatives to combat smoking and methamphetamine use.

• Raised serious concerns with the South Australian and Australian Health Ministers about the increasing use of unregistered medicinal cannabis in South Australia and the impacts of this on the safety of patients and treating health practitioners.

Road safety • AMA SA’s Road Safety Committee (RSC) is liaising with key stakeholders from the Department for Infrastructure and Transport, South Australia Police, and Optometry Australia about possible updates to the ‘fitness to drive’ form to increase the safety of all road users. The RSC also contacted ministers and the media to express concerns about e-scooters and the need to mandate certain vehicle safety technologies.

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SETTING THE AGENDA AMA SA has welcomed new appointees to its Board and Council.

Each brings fresh insights and energy to the organisation’s leadership.

AMA SA Board Dr Emily Kirkpatrick - AMA SA Board Member ‘I’m honoured to join the AMA SA Board and contribute to shaping the future of medicine in South Australia. As an experienced board director, GP, public health advocate, and medical administrator, I am passionate about supporting doctors and amplifying the voice of our profession. I look forward to working with my fellow Board members to advocate for connected, clinician-led healthcare within a sustainable and forward-thinking AMA SA.’

AMA SA Council Dr Fariba Behnia-Willison - Gynaecologists ‘As the gynaecology representative on AMA SA Council, I am committed to championing the needs of marginalised women, expanding access to comprehensive care for pelvic pain and endometriosis, enhancing surgical training opportunities in private settings, and advancing infertility services beyond IVF.’

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Dr Simon Clark - Private Specialist Practice ‘Private practice is an integral part of the Australian health system. Without it, the already struggling public hospitals will buckle under the increased workload. Doctors are facing rising costs to deliver care, while patients are bearing a growing financial burden - at a time when insurers’ profit margins continue to expand. The AMA must advocate for doctors so they can continue to provide their essential services while lobbying the government to bring the insurers to the table.’

Dr Mark Ralfe - General Practitioners ‘As the GP representative on AMA SA Council I want to ensure we help general practitioners navigate the increasing number of national and state issues affecting us, our practices and our patients. This could involve streamlining connections with non-GP specialist colleagues, SA Health and the PHNs. I’m keen to hear GPs’ thoughts – your concerns, challenges and ideas for change. Our voice is louder when it represents all our members.’

Dr Jayanthi Jayakaran – Public Hospital Doctors ‘I am committed to contributing to a unified body that shares a clear vision and dedication to supporting our colleagues across the state, as well medical students and the broader communities we serve. I am particularly passionate about contributing to key areas such as health financing and funding models, health policy, legal and risk frameworks, the medical workforce, and medical education and training.’

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Dr Chelsea Patterson – Physicians ‘I am a palliative medicine physician currently working at Flinders Medical Centre. I hold Fellowships with both the Royal Australasian College of Physicians (FRACP) and the Australasian Chapter of Palliative Medicine (FAChPM), and I completed a Master of Medicine in 2023. My clinical experience spans across both NALHN and SALHN, where I’ve served as a consultant physician. I look forward to harnessing my varied experience so I can effectively represent South Australian physicians on Council.’

Dr Chetan Pradhan – Public Hospital Doctors ‘I’m a full-time public hospital doctor with extensive advocacy experience across local health networks, as well as at state and national levels. I’m passionate about representing and empowering the medical profession, and I look forward to using this experience to strengthen the voice of doctors in South Australia through the AMA.’

Dr Gillian Watterson – Paediatricians ‘I have been practising as a paediatrician for nearly 30 years, and my passion lies in advocating for infants, children, and young people in South Australia. I am committed to supporting their optimal functional independence within society, regardless of their cultural background, socioeconomic status, or any physical, mental, or emotional challenges they may face.’

Dr Kathryn Harvey (not pictured) has also joined Council, representing Anatomical Pathologists.

AMA SA Council News 3 April 2025

22 May 2025

Dr Christopher Dobbins, Specialty Group Representative – Surgeons

Dr Alice Fitzpatrick, Regional Representative Northern

Council Chair Dr Karen Koh led a discussion on the importance of workforce planning, particularly in light of Australia’s ageing population. She highlighted that dermatology is currently understaffed, with only 47 dermatologists across South Australia, including fellows.

Dr Cathrin Parsch, the Council’s Emergency Medicine Representative, spoke about the challenges within her specialty, citing difficult working conditions and the extra efforts she and her colleagues are making to support junior staff. She expressed gratitude for the contributions of International Medical Graduates (IMGs) in emergency departments, while acknowledging the added complexity required for the training, oversight, and mentorship of IMGs. CEO Nicole Sykes provided an update on the work being undertaken by Dr Louis Papilion and Dr Oscar Brumby-Rendell to establish equitable pay rates for all specialists working with ReturnToWorkSA (RTWSA).

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Council Chair Dr Karen Koh opened the meeting by welcoming the new Councillors and thanking the outgoing members: Dr Michelle Atchison, Prof Tarun Bastiampillai, Dr Chris Moy, Dr Shriram Nath, and Dr Andrew Russell.

It was noted that several specialist vacancies remain on Council, including positions for a radiologist, anaesthetist, and psychiatrist. The importance of filling these roles was emphasised, particularly in light of major upcoming health projects such as the new Women’s and Children’s Hospital.

Dr Elise Witter, Chair of the Doctors in Training (DiT) Committee, provided an update on the Hospital Health Check, the limitations of the professional development allowance - especially in relation to exam fees - and strategies to enhance engagement with medical students.

Dr Koh acknowledged the efforts of the AMA SA Secretariat in delivering a successful Round Table.

Council discussed the strong consensus on priority health issues and the need to refine and prioritise these before determining next steps.

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ADVOCACY

in

ACTION

Bringing the system to the table AMA SA Councillor and Board member Dr Emily Kirkpatrick explains why AMA SA’s Access to Care Round Table must be the start of system change.

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The day opened with framing remarks from then-AMA On 9 May 2025 I had the privilege of facilitating SA President Dr John Williams, followed by Health and the AMA SA Access to Care Round Table. It was Wellbeing Minister Chris Picton. Minister Picton, who an important event that brought together more dedicated his day to participating in the discussions, than 30 senior leaders from general practice, reflected on the progress made in reducing ramping and public and private hospitals, aged care, mental ambulance transfer times for care across South Australia. health, ambulance services, government and lived AMA SA acknowledged the positive changes made experience. It was designed to be more than just over the past few years and the commitment to working another meeting to talk about ‘ramping’ or access with our membership to improve system flow. Minister to care – rather, a chance to bring new perspectives Picton made it clear that long-term system improvement on the challenges faced by broader stakeholders will depend not only on hospitals functioning better, in the health system. We met to confront a shared but on the broader health ecosystem moving together, challenge of how to improve access to timely, particularly with the aged care sector. connected and person-centred care in South From there, Dr Danielle McMullen, the Federal AMA Australia’s increasingly strained health system.

While our state exhibits distinct dynamics, such as geography, the issue of access is not solely a South Australian concern. At both national and international levels, health systems are grappling with escalating demand, overextended workforces and outdated frameworks that no longer adequately address the complexities of care required by the population.

The effectiveness of this roundtable discussion was significantly enhanced by the inclusion of voices representing lived experiences, especially as we explored the mental health and aged care sectors.

These perspectives grounded our conversation in the daily realities faced by patients and their families and carers.

President, provided a vital national lens. She outlined how federal reform levers, such as changes to Medicare funding, multidisciplinary care models and support for general practice, must align with state-level action. Dr McMullen’s contribution emphasised that we need to look closely at what works and how we can replicate it in this state. She challenged us to think about what needs fixing locally and how we can influence national momentum.

Professor Keith McNeil of the Commission for Excellence and Innovation in Health followed, focusing on the roles of data and digital innovation. He reminded us that reform will succeed only if it is underpinned by quality data and real-time information sharing, which South Australia is well-positioned for with its statewide electronic medical record and data lake. However, he Outpatient departments (OPD) were mentioned throughout the day as exemplifying the failures that arise also cautioned that we must be in sync as a system to succeed, with data and technology as key enablers to from technology’s inability to effectively communicate reduce duplication and forecast future demand. with patients regarding appointment times, where access to general practitioner notes is non-existent and As the facilitator, what stood out most was the appetite where duplication in investigations and care remains for change. There was no reluctance in the room; no a persistent issue. Whether it involves a caregiver defensiveness or determination to maintain the status struggling to navigate a fragmented health system or quo. Sector leaders acknowledged where the system is an elderly individual being transferred to an emergency failing and offered practical, actionable ideas. We have department because their Advanced Care Directive heard again and again how critical it is to address the wasn’t found, patient experiences serve as a poignant information gaps between hospitals, GPs and aged-care reminder of the urgent need for systemic reform. providers. The SA Virtual Care Service was referred to

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More than 30 healthcare leaders, including Health and Wellbeing Minister Chris Picton, attended AMA SA’s Access to Care Round Table

repeatedly as a key lever to bridge gaps and contribute to change, with its construct as an interprofessional team and its forward approach to AI and analytics. If we’re serious about delivering person-centred care, we need seamless data-sharing to support continuity and dignity, especially in end-of-life care.

We also heard a resounding call for state-wide coordination on care transitions and for investment in the workforce that underpins access. The extension of scope of practice is not a single solution to the current workforce crisis. Care teams that collaborate as a unified group were identified as a fundamental solution to workforce issues. Existing models demonstrate this.

Victoria’s virtual specialist consults within Northern Health and WA’s GP ASK service are examples South Australia can consider and adapt. However, we also need to look inward.

Many of the Round Table’s most compelling proposals are achievable within months, including: • Read-only Sunrise access for GPs, non-GP specialists treating public patients and residential aged care facilities (RACF). But let’s start simple with a pilot GP cohort with base credentialing to meet privacy requirements.

• A digitally focused OPD with a single state-wide outpatient referral portal that enables transparency and reduces duplication, especially when LHN clinical boundaries vary – one that also enables twoway SMS communication to confirm or reschedule appointments with consumers, which enhances OPD efficiency, and AI tools supporting clinical note-taking

These are not abstract ideas, but achievable wins that could make a meaningful difference within months. It’s no longer a matter of recognising the problem, instead it’s about being willing to lead the change. That will require more than an operational mindset from our management teams. It will require structural shifts. We must invite new perspectives, challenge legacy systems and ensure primary care is at the table, not left on the margins. Clinicians across the state are ready and we thank our members for supporting us on this mission.

They’re asking for leadership, visibility and accountability.

What we need now is a clear and realistic, time-bound action plan from SA Health. The plan should be public, measurable and co-owned across sectors. Visible to every clinician and health worker in the state, so we can play our part to help our health system be sustainable and future-fit.

AMA SA has committed to publishing a summary of the Round Table recommendations and will continue to advocate for these ideas to become operationalised through policy and partnerships. We are incredibly grateful to SA Health and the Minister’s office for supporting our Round Table and acknowledge once again the gains that have been made. There’s simply no single fix for our access crisis. However, we need a path forward. Let’s ensure the next 12 months are characterised by action.

• Virtual clinician advice lines to support realtime decision-making and prevent unnecessary emergency department presentations or representations, as well as specialty advice that doesn’t require an OPD appointment • A central database for Advanced Care Directives, accessible to all relevant providers, that focuses on dignity at the end of life.

Health Minister Picton addresses the Round Table

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Budget 25-26: ‘A missed opportunity’ AMA SA President Associate Professor Peter Subramaniam was inside the ‘lockup’ when the South Australian Treasurer released the 2025-26 State Budget. He says it failed to invest in innovative reform to a health system under strain.

Budget Day is always a significant day on the political calendar - especially when a government is unveiling the costings for the policies and decisions it’s taking to an election less than a year away. It’s fair to say doctors, patients and everyone in the health sector was looking to the 2025-26 State Budget as one that would hint at the measures that would help the government outline the measures needed to keep voters happy as we approach that election on 21 March 2026.

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But it’s also fair to say that the Budget handed down

by Treasurer Stephen Mullighan on Thursday 5 June was a missed opportunity for new and innovative measures to build the sustainable health workforce this state needs.

AMA SA President A/Prof Peter Subramaniam at the budget lock-up

It contained $1.9 billion in healthcare funding, including $1.7 billion allocated to ‘additional hospital activity’. There were also investments in mental health, including $13.9 million to expand the Mental Health Co-Responder Program that pairs mental health clinicians with police officers responding to Triple Zero call-outs involving individuals with perceived mental health needs.

I welcome this level of funding – and the acknowledgement that hospitals and mental healthcare need attention. But the Budget doesn’t include necessary investment in system capacity and management, and workforce support, to make a real difference. I am concerned that the funded measures will become part of a cycle of promise without progress. Budget announcements on services and programs cannot bring about health outcomes unless the foundations are present to make the system work.

AMA SA Senior Media, Communications and Policy Advisor Karen Phillips digests the Budget papers with A/Prof Subramaniam

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In recent years, South Australia has experienced a disconnection between funding, policy and results.

Despite record investment in healthcare under the

Malinauskas Government, the system – and the medical professionals keeping it running –remain under immense pressure. It is not clear how this Budget will alleviate this pressure.

Ahead of the release of the State Budget, AMA SA recommended the following investments to increase access to world-class care, now and in future generations.

Ramping hours have reached record highs. The AMA’s Ambulance Ramping Report Card released in April shows that South Australian patients spent a staggering 45,399 hours ramped outside hospitals during the 2023-24 financial year, up from 15,239 hours in 2019-20. This equates to more than five years of lost time waiting for care.

Building a resilient workforce

Elective surgery waiting times have also ballooned.

According to the AMA’s Public Hospital Report card released in February, the median waiting time for planned essential surgery was 47 days during the 2023-24 financial year, 12 days longer than it was a decade prior. On Budget Day, 23,608 patients were waiting for planned surgery at Adelaide’s public hospitals – 5,440 of those were listed as overdue.

The health system needs more than a ‘business as usual’ approach. Investment must be backed by implementable policies that contribute to a connected, well-resourced health system with enough doctors, nurses and allied health professionals to give South Australian patients the care they expect and deserve.

The payroll tax effect There is no doubt that the recent introduction of payroll tax on medical specialists has further strained the system. It has significantly increased GPs’ operating costs, potentially leading to the closure of clinics and reducing access to care.

AMA SA has consistently asked the government to clarify how much revenue it is raising through the payroll tax on medical specialists. That figure is not immediately clear in the health papers of this budget.

As we look ahead to the 2026 South Australian election, our opposition to the payroll tax on medical specialists remains steadfast. It’s the firm view of AMA SA that our leaders should be supporting GPs – not adding to their tax burden – so they can continue to keep people healthy and reduce preventable hospital admissions.

We stand ready to work with the South Australian Government, and all partners in the health sector, to ensure that the billions of dollars of taxpayer money invested in healthcare translate into improved patient care.

South Australians need a health system that performs, not one that is promised and fails to deliver.

• Develop and implement strategies to address the geographic and specialist maldistribution of doctors • Invest in evidence-based programs to boost junior doctors’ psychosocial safety • Work with the universities to increase medical students’ exposure to general practice and rural medicine during their undergraduate studies • Fully fund the recommendations of the SA Psychiatry Workforce Plan to grow the specialist psychiatry workforce to provide and lead needed mental healthcare • Establish funded training positions for IMGs in general practice, rural hospitals and the private sector (including pathology) • Identify how to attract, retain and integrate international medical graduates (IMGs) in South Australian communities, including in remote regional areas, and advocate for dual recognition pathways (i.e., general and specialist registration) in areas of need • Establish incentives to add to the Australian Government’s commitment to train more GPs, attracting world-class doctors and other health practitioners to 27 South Australia’s regions

Health services and infrastructure • Funding to support clinical involvement in the planning and ‘future proofing’ of the new WCH, including ensuring workflow designs and workspaces promote safe, modern and connected care • Invest in digital systems to improve connections between and access to services across the state, including centralised e-referrals for GPs and non-GP specialists • Invest in infrastructure and resources to maintain standards of care at the existing Women’s and Children’s Hospital (WCH) • Invest in mental health services in the community, including monitoring and evaluating the impact of the Urgent Mental Health model • Funding to measure and report on the impacts on patients of recently introduced policies such as pharmacy prescribing of UTI medications • Increase community health services for Indigenous communities

Other portfolios • Invest in road, footpath and other transport infrastructure to support safe driving, walking, cycling and other road use

Healthscope fallout Healthscope’s financial woes have highlighted broader concerns about the sustainability of the private healthcare sector.

The Australian Medical Association is closely monitoring the precarious situation unfolding at Australia’s second largest private hospital group, Healthscope.

Uncertainty about the company’s long-term viability reached new levels on 26 May 2025 when CEO Tino La Spina announced that its parent entities had gone into receivership.

‘All 37 of our hospitals continue to operate as normal,’ Mr La Spina said in a statement at the time.

‘Our incredible teams are all working as normal, providing the high standard of care they always have.’

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The Commonwealth Bank has provided an additional $100 million in loan funding to help keep Healthscope’s hospitals operating while the receivers seek buyers.

In South Australia, the company has ties to Ashford, Flinders Private, Memorial and Griffith Rehabilitation hospitals. Healthscope operates the first three as an agent for the Adelaide Community Healthcare Alliance (ACHA), which retains responsibility for strategic direction and governance.

AMA SA President Associate Professor Peter Subramaniam and CEO Nicole Sykes met with ACHA CEO Paul Evans, Burnside Hospital CEO Alan Morrison, and St Andrew’s CEO Eileen Sawyer on Wednesday 18 June to discuss concerns about the viability of South Australia’s private hospital sector.

‘AMA SA has been assured by ACHA management there will be no disruption for patients at this time, and we acknowledge the professionalism and focus of staff and doctors who continue their work without interruption,’ A/Prof Subramaniam said.

‘But we remain deeply concerned about Healthscope’s financial challenges and the broader structural issues facing Australia’s health system.

‘More than two-thirds of elective surgeries in Australia are performed in the private system. Beyond elective

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surgery, private sector hospitals provide a range of clinical care to a significant number of patients.

‘If the private health system becomes unsustainable, the pressures on the public system will worsen with greater delays and longer waiting lists.’

The Australian Government’s Private Hospital Sector Financial Health Check Summary, released in October 2024, highlights a concerning trend: private hospital expenditure is increasing at nearly twice the rate of revenue growth.

A/Professor Subramaniam said a major factor behind this imbalance is the insufficient contribution from private health insurers.

‘The structural fragility of the private sector is clear from the closure of private hospitals in Adelaide over the past few years. The cost spiral in wages, energy, and supplies is not being matched by insurer contributions,’ he said.

‘The AMA’s Private Health Insurance Report Card 2024, released in February, shows only 84% of private hospital insurance premiums were returned to patients in the form of rebates and other benefits for hospital treatment last financial year. The AMA has been calling for at least 90% of premiums to be returned to patient care.’

The AMA continues to call on the Federal Government to establish an independent Private Health System Authority – a national body to oversee, support and regulate the private health sector to ensure the system is meeting community needs and expectations.

‘We need a long-term plan to ensure the viability and sustainability of the private healthcare system so that this sector can continue to care for its patients,’ A/Prof Subramaniam said.

‘We need the health fund rebates to match the real costs of care, including for our South Australian private hospitals.’

‘Alarm bells’ over Bupa’s growth plans AMA President Dr Danielle McMullen writes that the shift towards insurer-dominated care could erode clinical independence, compromise patient trust, and reshape the very foundations of our health system.

Patients should be very worried when private health Australia stands at a critical juncture for private insurers are setting up an environment where they healthcare. Bupa’s reported aggressive plans to expand its network of medical centres by a further could access more information about a patient’s health. There is also a risk they may interfere with 130 centres and create 60 of its own mental health clinics should concern all Australians. This decisions that should be made by a patient after talking with their doctor in the safety of a private is not simply a business expansion – it represents consultation. a fundamental shift in our healthcare system that threatens to undermine the doctor-patient Bupa’s plans to roll out whole genome sequencing for selected customers in Australia also poses additional relationship and quality of care.

The AMA is deeply troubled by Bupa’s reported agenda to funnel 25-30% of cases through its own ‘ecosystem’ of Bupa-controlled facilities. We are concerned Australia is hurtling towards a US-style system of vertically integrated managed care, where health funds have too much say over the clinical care that patients receive.

The evidence from America is clear: when insurers control both payment and provision of healthcare services, profits often come before patients. The results can be disastrous. Clinical decisions must remain in the hands of doctors and their patients – not influenced by insurers or corporate ownership – so that care is guided by need, not by financial incentives.

Bupa already owns 180 dental clinics, 50 optical stores and 22 medical centres in Australia. And it’s not alone in exploring new opportunities for growth. Medibank has been pursuing similar strategies, moving to own or have shares in more health services. Yet there is little that can be done to stop this march by insurers in the current regulatory environment, which allows private health insurers to set up, take over and own health service delivery businesses.

The conflict of interest when an insurer both funds and delivers care is incredibly obvious. While these insurers will use spin to explain away these concerns, it is vital the Australian Government moves quickly to address this, including through the establishment of a private health system authority to oversee the sector. Private health reform should not remain on the backburner in term two of government.

serious risks. We just don’t know how this information might be used in the future, particularly as health funds like Bupa increasingly look to being both a funder and provider of health services.

As we face these challenges, I ask all Australians to consider what kind of healthcare system we want for our future. Do we want a system where clinical independence is protected and patients come first?

Or one where corporate interests and efficiency metrics drive our care?

The AMA is committed to fighting for a healthcare system that serves the needs of all Australians – one that preserves the trust, independence, and quality that have long been hallmarks of Australian healthcare.

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Medicare reform ‘falls short’ Healthcare was a dominant issue during the federal election. AMA President Dr Danielle McMullen says despite major funding promises, the Australian Government missed the chance for real reform.

Elections are always a chance to highlight the General practice and Medicare critical issues facing our nation. This year, health The $8.5 billion for Medicare announced before the took centre stage in the federal election campaign. election was called, supported by the Coalition and The major parties showed a real commitment to investing locked into the budget, set the tone for the rest of the campaign. in the nation’s health system, particularly with historic funding announced for primary care.

While this funding is welcome and will help some patients and practices, we will continue to highlight We welcomed this focus – the quantum of funding that through our ‘Modernise Medicare’ campaign the need has been committed is what we need – but sadly, a to rethink and redesign our out-of-date Medicare significant proportion of this money could have been rebate structure. better directed.

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This election represented a missed opportunity for significant, structural reforms to the health system.

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population and the growing burden of complex and chronic disease.

Throughout the campaign, Prime Minister Anthony Albanese consistently said 90% of all GP visits will be bulk-billed by 2030 under his policy to extend triple incentives to all patients.

While modelling in the years leading to 2030 is not available, this 90% figure will be the figure that this policy will be squarely judged on. We will do our best to ensure the government is held to account in improving affordable access to high-quality GP services, while still pushing hard for the broader reforms we need to improve Medicare.

Workforce Some big wins came our way on workforce. Following years of AMA advocacy, both Labor and the Coalition made commitments to increase our GP workforce.

Labor locked in funding in the budget to grow Australia’s specialist GP training places. There was also funding for additional training rotations in general practice for prevocational doctors, and to improve employment conditions for GP registrars, including the important addition of paid parental and study leave.

We will continue to be vocal about the need for an independent national health workforce planning agency to guide new policies and provide a clearer picture about the state of our workforce, including in regional, rural and remote areas. It is crucial to ensure the medical workforce is distributed where it’s needed most – but this has been a huge blind spot since Health Workforce Australia was abolished in 2014.

Public hospitals As we highlighted several times during the campaign, our public hospitals continue to be logjammed and our recent report found there is no end in sight to ambulance ramping.

There were some commitments to hospital funding made during the campaign, and indeed in the months before. But we know there is an urgent need to lock in a new National Health Reform Agreement. Without a new funding deal, these top-up funding commitments are little more than a nice idea.

We will be taking this government to task to ensure they expedite a new agreement for the sake of our patients, who are suffering, and our dedicated public hospital doctors.

Private health The issue of private health sustainability was absent in this year’s federal election campaign. We know the system is demonstrating unprecedented vulnerability — just look at the recent closures of maternity wards and other private hospital services around the country.

This is proving to be one of Australia’s big sleeper issues, and if governments don’t act quickly, there will be devastating consequences for patients (even more so than there already are). We will engage with this government and continue to champion our proposal of a new independent authority that can create a platform for all the key players in the sector to create once-in-a-generation reforms. We will also be calling for a mandated minimum payout by insurers of 90% as a proportion of their premiums to encourage greater uptake of private health insurance.

Our Vice President A/Prof Julian Rait, a specialist ophthalmologist, sits on the Private Health CEO Forum created by Labor and will continue our strong representations on this platform.

Public health We gained significant traction in the media for all our policy proposals throughout the course of the federal election campaign. And one of those was our proposal for a tax on sugar-sweetened beverages. This is a common-sense policy – backed by evidence and proven success around the world – that can address Australia’s obsession with sugar.

Sadly, no party committed to a sugar tax during the campaign, despite the clear need to help tackle Australia’s rising rates of chronic disease and the clear opportunity to raise much needed funding, which could be used for preventive health activities.

Political analysts will continue dissecting this year’s election result. For us, our mission remains the same.

Our commitment to advocating for doctors, patients and the health system is unwavering. We will continue to work tirelessly across the political divide, ensuring that the voices of medical professionals are heard and that meaningful reforms are achieved.

Dr Danielle McMullen is the President of the Australian Medical Association.

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Conditions test junior doctors The AMA SA Doctors in Training Hospital Health Check continues to reveal important issues and challenges for junior doctors in South Australia’s major public hospitals, writes Dr Elise Witter.

The AMA SA annual Hospital Health Check (HHC) collates the South Australian data emanating from the national Medical Training Survey to identify the issues and experiences of doctors in training (DiTs) across the state. It provides important information to guide the advocacy of the AMA SA Doctors in Training Committee and allows changes to be tracked over progressive years.

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This year, 1,694 junior doctors in South Australia completed the survey, providing a comprehensive reflection of the past year. In terms of location, 85% of the respondents were from metropolitan areas, with 14% in rural and regional locations. While the number of respondents does not indicate the total number of DiTs in the state, these figures can be seen to reflect the inequitable distribution of DiTs between rural locations,

and highlight the ongoing need to encourage and support them to take up positions in regional and remote areas.

Comparison with last year’s data showed small improvements in access to adequate workspaces, however there are ongoing concerns for DiTs around the adequacy of their workplaces and particularly access to computers and desks. This reflects feedback the committee has received in other forums and will be a key area of advocacy in 2025. Access to adequate workplaces is essential for DiTs to deliver timely, efficient and safe patient care, with significant implications for both DiT and patient wellbeing if spaces and facilities do not meet our needs.

Reports of bullying were alarmingly high, with 6 to 13% of respondents reporting they have experienced

Have you experienced bullying in the last 12 months

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bullying, and 16 to 28% reporting witnessing incidents of bullying. Sexual harassment was reported by up to 3% of respondents. These figures are unacceptable and indicate ongoing cultural challenges within the healthcare system and obstacles in effectively implementing a ‘zero tolerance’ bullying policy. This has significant implications for the wellbeing of DiTs, their experience at work and ability to deliver quality health care, and patient safety.

Respectful, cohesive and inclusive team structures are essential for the provision of safe and quality healthcare and should be a key focus for local health networks.

Percentages of reported experiences of racism remained fairly static between 15% and 20%, while 12% to 18% reported experiencing discrimination.

Disturbingly, senior staff and medical colleagues were most likely to perpetrate bullying, harassment, racism and discrimination. At every site, reporting of these behaviours decreased, with significant barriers to reporting identified. These include concerns around repercussions and a lack of confidence that anything would be done. This is a significant concern and reflects a culture of silence and fear among DiTs who may feel unable to report these adverse experiences. Further advocacy will be required in this area to identify and implement accessible, acceptable and responsive reporting structures, and to ensure that local health networks (LHNs) respond meaningfully to reports. We encourage any DiT who has experienced these issues to use informal or formal reporting structures and seek support wherever possible.

Patients and their family members formed the group next most likely to perpetrate bullying, harassment, racism and discrimination. This likely reflects systems pressures such as increased ramping and longer elective waitlists, with increased frustration and distress occurring among healthcare consumers. It is the responsibility of LHNs to implement environmental and other strategies to mitigate patient frustration and ensure that DiTs are protected from abuse and aggression in their workplaces.

Workload decreased at the WCH but remained static in other locations, with ongoing heavy workload reported and up to 30% of doctors working more than 50 hours a week. This is also a concern, given the wellestablished link between excessive hours worked and the development of mental health conditions. Pleasingly, most doctors reported being paid for their unrostered

overtime, with increases observed at multiple sites.

While this increase is a positive sign, close monitoring is required to ensure that progress continues in this space and that doctors are appropriately remunerated for both rostered and unrostered overtime.

Most doctors would recommend their training positions, with Modbury, the Women’s and Children’s and Queen Elizabeth hospitals demonstrating the highest levels of satisfaction. All interns at major hospitals reported having professional development plans, and higher levels of IMGs also had professional development plans.

Between 83% and 89% of DiTs also reported adequate access to teaching, suggesting reasonable opportunities for learning and professional development. Access to training and research was reported as lower, between 50 and 65%. This suggests that one-third to a half of DiTs have inadequate access to research and training, which may have a significant detrimental impact on their career progression and future aspirations. Greater investment in training and research opportunities is required to ensure these are available for DiTs to meet the evolving health needs of an increasingly large and complex population.

Overall, there has been some improvement in DiT experience, particularly at individual hospitals. However, rates of bullying and harassment remain unacceptably high, and barriers to reporting need to be urgently addressed to ensure that these can be remedied in a timely and effective fashion. Workplace deficiencies also continue to be an issue. Finally, there is a clear impetus for supporting greater training and research opportunities, to ensure that DiTs can meet their career aspirations and make the most of their training time.

The DiTs Committee looks forward to responding to the concerns raised in the HHC and continuing to advocate for ongoing improvements.

Dr Elise Witter is Chair of the AMA SA Doctors in Training Committee

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OVERCOMING IMPOSTER SYNDROME CALHN intern Dr Sebastian Ricci reflects on his first months at the Royal Adelaide Hospital and why sometimes you truly are your own worst enemy.

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I remember my first day of internship clearly – or more accurately, my first night. I had been fortunate enough to spend orientation day sleeping and entered the hospital for my shift as the sun went down.

Not long into the shift, a nurse handed me an ECG. ‘Looks good, just need to run it by a doctor to sign it,’ I said, confidently handing it back. We both stood there, staring at each other in silence for a beat too long.

Then it hit me: I’m the doctor who’s meant to be signing it.

I glanced back at the ECG, which only moments ago had seemed relatively unremarkable. Now it looked more like a cryptic mess of hieroglyphics. In that moment I realised something – what I say now actually matters. This, I think, was my first true encounter with Imposter Syndrome.

Imposter Syndrome. Noun: A psychological experience in which a person suffers from feelings of professional fraudulence.

People had warned me about it during medical school, but honestly, I never really experienced it back then. For me, university was a space where you

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weren’t expected to know everything. Mistakes were learning opportunities, not liabilities. Even when I was completely out of my depth, I never quite felt like I didn’t belong. And then internship began.

Each new rotation this year has stirred up that same familiar sense of doubt – a subtle internal questioning that creeps in just before starting something new. And each time, I’ve had the same conversation with my partner, who patiently reminds me that I’ve felt this way before and come out fine on the other side. But still, the feeling brews. Of course, soon into a new term that feeling fades away, and I come to appreciate the parts of the job that I truly enjoy.

On my nights term, I came to love the morning handovers. Firstly, they marked the end of a long shift, which meant sleep was near. Secondly, they were a rare chance to catch up with friends, as our hectic rosters often keep us on different schedules.

But with morning handovers also came the most surreal experience of handing over to other interns who are more than your peers - they are your mates.

A mate I stumbled through my first case presentation in front of; a mate who watched me flunk a million practice knee exams while studying for fourth-year OSCEs; a mate who walked across the graduation

Dr Sebastian Ricci with fellow interns Dr Emma Tidemann, Dr Hannah Subramaniam and Dr Sofijia Smiljanic

stage beside me a mere three months earlier. These co-interns had seen me when my knowledge was at its lowest, or when it took me far too long to understand how the kidneys work. Now they were listening to my reports and trusting my recommendations and workup.

There is something unique and remarkable about growing together, learning from each other and now trusting each other. These were grounding moments.

Instead of fear that they will judge my work-up, distrust my impressions or find problems with my plans, it made me realise that we are all in it together. We had done the work and the study, and now we are finally where we had hoped to be. Dare I say it, one day eventually we might even have this ‘being an intern’ business down pat.

The greatest reassurances came from senior colleagues. Again, not too long ago, these were peers we’d have beers with. Now they’re also living proof that we will survive and thrive in these careers we worked so tirelessly for. The most vital lessons these senior colleagues have passed on are those about managing the feelings of imposter syndrome. I now realise these feelings are not just exclusive to being an intern; each step up the medical ladder seemingly opens windows to self-doubt and fears of being a fraud.

Imposter syndrome doesn’t disappear overnight.

Sometimes it shows up in subtle ways – a hesitation to speak up in handover, a pause before asking a question in fear it might seem too basic. But with time I’ve come to understand it’s not a sign that you’re failing – it’s often a sign that you care deeply about doing well.

And maybe, just maybe, that means you’re exactly where you’re meant to be.

Dr Sebastian Ricci, Intern at the Royal Adelaide Hospital

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Angelina Arora and Julia Kim

NEW YEAR, NEW ENERGY

Executive team at preparatory week

The year is off to an action-packed and fun-filled start.

Retreat, bringing together medical student leaders from across the country to share ideas and strategies.

FMSS was honoured to participate in AMSA’s National Preparatory Week marked the official beginning of the Council in Melbourne, contributing to important 2025 academic year. We welcomed 170 eager medical discussions on issues affecting medical students students ready to begin their journey in medicine. nationwide.

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The ‘MD1 Meet and Greet’ – one of the first Prep Week events – allowed new students to connect with current cohorts. This was followed by a range of engaging events involving both students and staff, including a trivia night, post-team-based learning bonding sessions, a family movie night, society lunches, Q&A panels, and the Society Expo. These activities gave incoming students a chance to explore the many opportunities available at Flinders Medicine.

The welcome festivities culminated in the muchanticipated annual MedCamp, where students competed in the ‘Battle for the Brawniest Medical Team’, developed clinical skills, and formed lasting friendships under the stars at Camp Dzintari.

Academically, our peer teaching and mentorship programmes for MD1 and the newly introduced MD2 cohort have been running at full pace as students prepare for exams. MD3 students recently completed their first mock OSCE, gaining valuable experience ahead of their final assessments. Meanwhile, MD4 students have submitted their internship applications, supported by SA MET internship nights, and are preparing to transition into the next phase of their medical careers.

FMSS has also been active in advocacy. Our focus has included the AMC reaccreditation process, strategic planning for the SARM program, and infrastructure development. We’ve conducted surveys to improve campus accessibility for students with disabilities That was just the beginning. The election of a new and to ensure culturally safe spaces. Externally, we’ve Junior Committee – the backbone of the daily function participated in enterprise agreement bargaining with of the society – reignited our enthusiasm and drive to SASMOA and met with political leaders, including achieve results. the Federal Health Minister, to advocate for paid Semester One offered a diverse calendar of events. A placements and more inclusive medical school standout moment was the launch of the South Australia admissions.

Rural Medical Program (SARM) – the state’s first endIt’s a privilege to lead a committee of such passionate to-end rural medical training pathway. and dedicated individuals, all committed to making a difference in the medical student community. I’m We celebrated Pride Week alongside our peers at excited to see what the rest of the year holds.

Adelaide Medical School, and enjoyed a variety of social and sporting events, including clinical science mixers, the inter-year soccer competition, and regular Pilates sessions.

Angelina Arora The competitive spirit remained strong with the President, Flinders Medical Australian Medical Students’ Association’s (AMSA’s) Students’ Society Vampire Cup, where students enthusiastically donated blood. AMSA also hosted the National Presidents’

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STUDENTS SPREADING THEIR WINGS

2025 Medcamp second-year helpers

Right now, my cohort is scattered across the globe. One friend is scrubbing into orthopaedic theatres at the Mayo Clinic in Minnesota.

Another is deep in the bustle of Sri Lanka’s capital Colombo, immersed in obstetrics and gynaecology. Someone else is involved in psychiatry research at Johns Hopkins in Baltimore, while others are doing their best to balance learning and limoncello somewhere along the coast of Italy. And that’s just the start of it.

After six years of medical school (and more for some), this time of elective season feels surreal. This is the stretch in final year when students head off on placements around the world to chase areas of interest, discover new health systems, and reignite the spark that brought them to medicine in the first place.

For many of my peers, this elective isn’t just a professional experience. It’s a deeply personal one.

These electives also offer something we don’t always get enough of - perspective. It’s about seeing what medicine looks like outside the boundaries of the Royal Adelaide Hospital. It’s about sitting in hospitals in cities you’ve never seen before and realising that medicine might be practised differently, but compassion is spoken in every language.

Of course, not every student heads overseas - many find incredibly meaningful elective experiences right at our doorstep, from practising in the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands to learning about maternal fetal medicine at the Women’s and Children’s Hospital (like me!).

Through the day-to-day running of the Adelaide Medical Students’ Society (AMSS), one of my favourite things has been to witness the teaching culture

absolutely booming. Peer teaching is thriving in 2025 with more momentum than we’ve seen in years.

Students in senior years are stepping up to run mock OSCEs, deliver tutorials and mentor younger students in a way that speaks volumes about the culture we’ve built.

And across all year levels, the AMSS has never felt more alive. Jazz Night drew a record-breaking crowd of more than 1000 people. MedCamp attracted the biggest first-year turnout in AMSS history. MedFooty was massive. Whether it’s through sport, social connection or academic support, students are showing up, in every sense of the word.

What’s happening this year is the result of a community that cares about its events, about its education and, most of all, about each other. We’ve been relentlessly committed to making the medical student journey a vibrant and kind one, and I believe we are doing just that.

My peers and I still have a while to go before graduation, but there’s something exciting about where we are right now. We’re in the thick of things, finding our stride, and celebrating the kind of camaraderie that only six years of shared experience can build.

From electives across the globe to late-night med events here in Adelaide, it’s clear that the spirit of this society is alive and well.

Sara Bilwani President, Adelaide Medical Students’ Society

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Dedicated to care The 2025 King’s Birthday Honours list included four South Australian doctors with long links to the AMA. AMA SA President Associate Professor Peter Subramaniam thanked them for their ‘compassion and dedication to patient care’.

Dr Peter Rischbieth

Dr Carolyn Lawlor-Smith

Member of the Order of Australia for significant service to rural health

Medal of the Order of Australia for service to medicine, and to community health

Rural generalist Dr Peter Rischbieth has dedicated the past 37 years of his life to serving the Murray Bridge community, delivering care at the Bridge Clinic and the Murray Bridge Soldiers Memorial Hospital.

Dr Carolyn Lawlor-Smith has served South Australia as a GP for 42 years. The General Practice she founded in Happy Valley was twice named RACGP Australian General Practice of the Year.

‘I am very honoured to be recognised for my work in rural South Australia and thank my patients for entrusting me with their care,’ Dr Rischbieth says.

As a committee member of Doctors for Assisted Dying Choice she was instrumental in the passage of South Australia’s Voluntary Assisted Dying (VAD) laws. She was one of the first doctors to be trained in VAD in South Australia and travels the state to assess patients requesting access to VAD.

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‘I have been part of a great team of rural doctors, nurses and administration staff at Bridge Clinic, and have been supported by my incredible family who’ve allowed me to pursue my dream of serving a country community and providing primary care, anaesthesia, and obstetric and emergency care.’

During his time as President of the Rural Doctors Association of South Australia (RDASA) Dr Rischbieth worked with AMA SA to negotiate a fairer pay deal for rural GPs and GP registrars. He’s also advocated for improved health services for rural Australians.

‘I hope more of our medical students will look at rural general practice as a great career choice, and I recognise the increased opportunities doctors in training have to pursue that path.’ Dr Rischbieth says.

medicSA | KING’S BIRTHDAY HONOURS

‘I feel privileged to be able to give people with a terminal condition the power to make a choice about their death,’ Dr Lawlor-Smith says.

‘The VAD team works alongside palliative care services to deliver the best outcome for patients.

‘A third of patients choose not to take the VAD medication but feel relieved just knowing that the control is in their hands.’

Dr Lawlor-Smith says she was ‘honoured’ to receive the Medal of the Order of Australia.

‘As a GP of 42 years my experience of caring for families has brought me here, to the most rewarding point of my professional life.’

KIN G

AY

IRTHD B ’S

S R U O HON 2025

Dr Lawrie Palmer

Dr Paul Dignam

Public Service Medal for outstanding public service in palliative medicine

Public Service Medal for outstanding public service in SA Health as a consultant psychiatrist 39

Dr Lawrie Palmer has been a driving force behind the evolution of compassionate end-of-life care in Adelaide’s north. He’s served in various roles at SA Health over the past 36 years, including Director of Emergency Medical Services at The Queen Elizabeth Hospital.

Dr Paul Dignam started his career in adult psychiatry.

For the past two decades he’s led a dedicated team of professionals at the Child and Adolescent Mental Health Service (CAMHS) in Adelaide’s northern suburbs.

Over the past 25 years, Dr Palmer has focused primarily on palliative medicine. He served as Head of Unit for the Northern Adelaide Palliative Service from 2012 to 2022 and is currently a palliative medicine specialist at Modbury Hospital.

‘I was privileged to spend the last 20 years leading a dedicated CAMHS team in an under-resourced and socially disadvantaged area of Adelaide,’ Dr Dignam says.

Dr Palmer says one of his most significant achievements was leading the amalgamation of Modbury and Lyell McEwin Palliative Care to form Northern Adelaide Palliative Service.

‘We tried very hard to ensure our multi-disciplinary team was a genuinely egalitarian one.’

Dr Dignam was nominated for the Public Service Medal by his colleagues and is humble about the honour.

‘Since combining and expanding our service we’ve also had a new 20-bed palliative care unit built at Modbury Hospital,’ he says.

‘I consider my work and my colleagues’ work part of the “ordinary business” of public sector health: caring casework, teaching, supervision, advocacy and policy development to support those most at risk,’ he says.

‘The role also involves training medical students, junior medical staff, new consultants and all members of the multidisciplinary team.

‘My team seemed to think I was extraordinary, and I thank them for that.’

‘I’ve always tried to live my working life in line with public service values and to highly value each individual – patients, families, and staff – to provide a supportive environment and the best care.’

Harman Dev

Emmeline Lee

Member since 2012

Member since 1994

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BUSINESS

TECHNOLOGY

Taxing healthcare a false economy AMA SA President Associate Professor Peter Subramaniam argues that the case for reversing the payroll tax on GPs is ‘compelling’.

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The South Australian Opposition confirmed in its Budget Reply on 17 June that a future Liberal Government would scrap the payroll tax on general practitioners (GPs). AMA SA has been campaigning for the removal of this tax for three years, and with the South Australian election taking place next year we will continue to present facts and data in our lobbying efforts with the Malinauskas Government.

supporting their communities. Internal AMA analysis suggests that up to 40% of these group practices are likely to be affected by the payroll tax, although exact figures are difficult to obtain for reasons of commercial confidentiality.

The financial impact is substantial for affected practices. A large practice with five GPs and annual payroll of $2.2 million would face approximately $15,000 to $20,000 in additional annual costs. For very large practices with $3.5 million payroll, the burden reaches $75,000 to $80,000 annually. Given that practices typically operate on thin margins, additional costs represent a real threat to viability.

The evidence raised by AMA SA’s Committee of General Practice (CGP) suggests that the policy has inflicted unintended but significant consequences on healthcare access at a time when these consequences AMA’s members are also concerned that payroll tax will pose an existential threat to our health system. This affect subcontractors. While not directly liable, many is borne out by evidence from other jurisdictions in expect reduced service fees, increased administrative Australia where the payroll tax has been applied. demands and potential disruptions to their practices’ Payroll tax is driving up costs for patients, is affecting viability. attraction to and retention in the GP workforce and will create healthcare system inefficiencies that Passing on the cost could cost the state far more than the tax collects.

Analysis suggests practices, especially those operating The GPs I speak to are also concerned the tax could fundamentally reshape the landscape of primary care. on slim margins, have little choice but to pass the cost to patients. In scenarios where practices pass through 50% of payroll tax costs to maintain baseline A significant burden viability, patients face 8-12% increases in out-ofSouth Australia’s payroll tax framework imposes a pocket costs. Where practices require full cost 4.95% levy on clinic wages exceeding $1.7 million recovery to remain sustainable, the increase is as high annually, with scaled rates between $1.5-1.7 million and as 15-20%, potentially adding significantly to GP visit a $1.5 million registration threshold. Many GPs work in costs – especially for patients with chronic conditions group practices in a supportive network structure while requiring regular visits to their GPs.

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These are indicative figures based on typical GP practice revenue structures, standard profit margin requirements for practice sustainability, and the scale of payroll tax burden relative to practice turnover.

The actual impact will vary significantly depending on individual practice circumstances.

The full impact on patient care remains unclear, but AMA SA’s CGP warns that payroll tax-driven consultation increases will hit vulnerable groups hardest, compounding existing barriers to healthcare access.

Exacerbating workforce shortages AMA SA has long warned that the payroll tax will trigger the closure of general practices. Medium-sized practices in particular are under pressure and at high risk of closure. Conservative projections based on national indicative figures suggest GP numbers could be reduced by up to 10%. This is especially concerning given South Australia is already confronting a worsening GP shortage. The Department of Health and Aged Care’s GP Workforce Report, released in August 2024, shows South Australia has a shortage of 376 fulltime equivalent (FTE) GPs. According to the data, that shortfall is expected to rise to 584 FTE GPs by 2033.

The cost to the system The combined effect of rising consultation fees and reduced GP access – both direct consequences of payroll tax – suggests more patients who could have been treated in their communities will head to hospital instead, resulting in significant cost-shifting from primary to tertiary care.

The cost differential is stark. According to the Australian Institute of Health and Welfare’s (AIHW) most recent Expenditure Report, governments spend about 77% more per person on hospital care than on primary care.

The total government payment per bulk-billed GP visit for a standard Medicare Level B consultation – the most common type – is $63.50, including incentive payments. In contrast, AIHW data shows the average government contribution for each ED presentation ranges from $650 to $900. Even a 1% reduction in GP visits due to increased costs or reduced access could result in a net financial loss for governments.

Lating impacts AMA SA’s GP members warn that payroll tax could fundamentally alter general practice. Long-term risks include: • Financial pressure pushing practices towards highvolume, short consultations, reducing access to care for complex and chronic conditions

• Mixed-billing practices raising fees for nonbulk billed patients to offset the cost of the tax, effectively creating a payment divide that undermines the principle of universal access to care • Creating a system in which larger groups dominate.

Larger, vertically integrated businesses, with diversified revenue streams, can absorb the tax easier than independent practices. If smaller practices collapse, while corporatised practices flourish, it could concentrate ownership and erode the diversity of general practice, which is a strength of the existing model of primary care.

• Disrupting the workforce, as rising financial and administrative burdens drive GPs towards hospitals, urgent care clinics or corporate practices, which may offer more secure employment. Medical students and junior doctors are very likely to avoid general practice for the same reason.

While it’s too soon to know the full extent of the risks, the potential consequences are likely to be damaging and irreversible. With Australia facing unprecedented GP workforce challenges and South Australia already struggling with access to care, policies that add pressure and undermine primary care represent poor strategic planning.

The Queensland model As of February 2025, Queensland has legislated a permanent exemption from payroll tax for payments made to GPs, whether they are contracted or employed by medical practices. This is the model AMA SA will continue to advocate for in South Australia.

To help the Malinauskas Government understand our position, we plan to pursue a multi-pronged strategy combining quantitative measures with qualitative stakeholder insights. We will seek key data to reinforce our case including metrics about practice changes, compliance costs, consultation fee increases and preventable ED presentations.

Healthcare is a unique sector requiring specialised policy approaches that recognise the independent contractor model as a legitimate structure and a vehicle for practices to deliver healthcare.

Governments – despite best intentions – are not immune from deploying policies with unintended consequences and costs. Reversing such policies is not a sign of failure but rather a signal of responsiveness.

By reinstating the exemption to payroll tax for GPs, the South Australian Government will demonstrate it is a responsive and responsible government.

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AI: a new tool for doctors Research suggests most doctors are not familiar with artificial intelligence (AI) in medical settings. But a dynamic digital tool promises to offer muchneeded guidance.

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Doctors will soon have access to a groundbreaking digital resource that will help them responsibly navigate rapid advances in AI. The initiative – the first of its kind in the country – is being developed by the Digital Health Cooperative Research Centre (DHCRC) in collaboration with the Department of Health and Aged Care and two specialist AI teams from the University of Technology Sydney (UTS).

The interactive tool is based on the Organisation for Economic Cooperation and Development (OECD) AI Classification Framework and will be adapted to incorporate Australian Government policies.

DHCRC CEO Annette Schmiede says it will help doctors assess the opportunities and risks of various AI systems.

‘The availability and adoption of AI is without doubt moving at a rapid pace across all sectors, including healthcare,’ Ms Schmiede says.

‘The challenge is building clear and consistent guidance and tools, ensuring these are effective for the diverse range of audiences and AI solutions across healthcare including developers, health care providers and consumers.’

Research from the Royal Australian College of General Practitioners suggests there’s a need for the initiative.

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‘We need to provide guidance on how to use AI safely and responsibly.’

A survey of GPs found at least 80% were ‘not at all familiar’ or ‘not very familiar’ with specific AI tools.

Sam Peascod – the Assistant Secretary for Digital and Service Design at the Department of Health and Aged care – says clear guidelines will better protect doctors and patients.

‘As government looks to build community trust and promote AI adoption, we need to provide guidance on how to use AI safely and responsibly,’ Mr Peascod says.

‘Having a tool that can assist in classifying and performing a risk assessment of AI technologies will support the adoption of AI solutions by health care organisations and health care providers, ultimately leading to better health outcomes for consumers.’

Professor Adam Berry from the UTS Human Technology Institute is one of the experts developing the tool.

He says consistent guardrails will become even more important as AI expands.

‘For AI to realise its tremendous promise for all, there must be responsible practice,’ he says.

‘A critical first step is to be consistent in the documentation of how individual AI systems are used, function and deliver impact across diverse stakeholders.’

Trust issues: a barrier to digital health uptake As digital technologies become more embedded in modern healthcare, a new study indicates that trust - not technology - may be the biggest hurdle to their success.

Digital tools like telehealth, wearable monitors and mobile health apps are reshaping how healthcare is delivered. But a new study suggests that trust remains a major barrier to their widespread adoption.

Researchers from the University of Queensland’s Centre for Online Health reviewed 49 studies published over the past 13 years to better understand what influences trust in digital healthcare.

Study co-author Dr Soraia de Camargo Catapan says if people don’t trust digital healthcare tools, they won’t use them.

‘Trust is inherently difficult to define and measure but it is key to making digital health tools more effective and widely used,’ Dr Catapan says.

anything from a person’s digital literacy and education level to their income, previous experiences with technology, and concerns about privacy and data security.

The quality of the technology itself also matters. Users are more likely to trust digital health tools when they perceive them as accurate, reliable and capable of maintaining a ‘human touch’.

The report outlines several strategies for healthcare providers to build trust in digital technologies. These include increased transparency around the types of tools that are used, strong privacy and security settings, and ensuring that digital tools are used with human oversight.

Dr Jaimon Kelly, another study co-author, says the report also identified the need for a unified framework or tool to measure trust in digital healthcare.

‘Building trust can help more people use these health technologies in the long run, leading to better outcomes and making digital healthcare more sustainable.’

‘Trust positively correlates with consumers’ intention to use, adopt and find digital health technologies useful,’ Dr Kelly says.

The study examined a wide range of digital health technologies, from electronic health records and telehealth consultations to AI-driven diagnostics and mobile apps. It found that trust can be influenced by

‘Developing a comprehensive framework for trust enhances the adoption of digital health technologies, supports better health outcomes and strengthens the long-term sustainability of digital healthcare solutions.’

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Building wealth through property AMA SA’s corporate partner Financia aims to help doctors achieve financial freedom and create long-term wealth. Financia’s senior mortgage and finance brokers Leon Spadevecchia and Ben Finis explain why cashing in on real estate could be the right move in today’s market.

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As a medical professional, you’ve spent years refining your skills in patient care. But when it comes to managing your finances and building wealth, it’s just as important to have a strategic plan. If you’re considering investing or owning property or wish to unlock the potential of your current real estate holdings, you’re not alone.

More medical professionals in Australia are prioritising long-term financial freedom through property, thanks to the unique advantages available to your profession.

Australia is a nation of homeowners. Whether we already own a home or are in the process of purchasing one, most of us share a common goal: to secure a place of our own. This familiarity with the real estate market often encourages people to explore property as

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a viable investment. However, investing in property is a different experience than purchasing a home to live in, and it’s crucial to approach it with the right knowledge and structure – especially as a medical professional with specific lending opportunities.

Doctors, nurses and allied health professionals may qualify for several lending benefits including: • lower interest rates • reduced fees • lenders mortgage insurance (LMI) waivers • tailored loan structures that enhance wealth creation opportunities.

The combination of these benefits can significantly improve your financial position when it comes to securing a property or refinancing your existing

property portfolio. Whether you’re looking to buy your first home or commence investing, working with a specialist mortgage broker can help you access the best possible options for your situation.

Why is property a good investment?

Real estate in Australia has traditionally been a strong performer in terms of capital growth. Some properties have outpaced inflation over the last few decades, and while affordability and interest rates remain hot topics, property continues to be a popular choice for long-term wealth building. For medical professionals, property offers the chance to build both immediate and long-term wealth through:

rental properties, especially in areas close to hospitals, universities, or other medical hubs, the potential for a reliable rental income stream is high.

Unlocking the power of equity If you’re already a homeowner and have seen your property increase in value, there may be an opportunity to unlock equity to fund the purchase of your next property. For medical professionals, this can be a strategic move, as equity release may be offered on more favourable terms compared to other professions. A mortgage broker can guide you in leveraging your equity for maximum benefit.

Capital growth: Over time, the value of your investment property may increase, providing you with profit when you decide to sell. Typically, properties located in high-demand areas (close to the CBD, near water, or in regions experiencing population growth) enjoy more capital growth. However, it’s important to remember that capital growth isn’t guaranteed.

Rental returns: Another immediate form of return comes from rental income. As long as your property is rented out, regular rental payments can help cover your mortgage and ongoing costs. Given the demand for

Financia’s Managing Director Leon Spadavecchia and Director Ben Finis are senior mortgage and finance brokers 47

Smart investment: thinking outside the square

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Building a strong, resilient investment portfolio increasingly requires looking beyond traditional asset classes. One avenue growing in popularity among sophisticated investors is accessing commercial property through unlisted property funds. FRP Capital director Adrian Rivish explains.

Commercial property has long been recognised as a cornerstone of diversified wealth strategies, offering stable income streams and potential capital growth. In recent years, the Australian commercial property market has demonstrated strong resilience, underpinned by structural trends such as the rise of e-commerce, population growth and increasing demand for commercial assets.

Traditionally, direct ownership of commercial property has required substantial capital, specialist management expertise and a willingness to accept liquidity constraints. These barriers have historically limited access to commercial property investment to large institutions and highly capitalised individuals. However, unlisted property funds provide an alternative avenue for investors seeking exposure to high-quality commercial assets without the complexities of direct ownership.

An unlisted property fund pools capital from multiple investors to acquire and manage a portfolio of commercial properties. Investors benefit from

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professional management, economies of scale and diversification across property types and geographic locations. Access is provided to assets that may otherwise be beyond reach individually, including prime office buildings, industrial warehouses and healthcare facilities.

Getting the mix right Diversification remains a critical consideration for building a resilient investment portfolio. A balanced investment portfolio requires exposure to asset classes that perform differently across market cycles.

Commercial property offers stable, long-term income through quality lease agreements, alongside the potential for capital growth.

Unlike equities and bonds, commercial property often moves independently of broader market volatility, helping to smooth returns and preserve capital. Its income-driven nature and intrinsic asset value also provide an effective hedge against inflation.

Through unlisted property funds, investors can achieve exposure to a broad range of commercial sectors and locations, helping smooth returns and manage risk across varying market conditions.

Superannuation opportunities Unlisted property funds also present an opportunity for investors to access commercial property assets through Self-Managed Super Funds (SMSFs). SMSF trustees are increasingly seeking avenues that offer consistent income, capital preservation and long-term growth potential. Investing through a professionally managed fund allows SMSFs to access institutionalgrade commercial property while benefiting from

FRP’s Brickworks Marketplace Fund

the concessional tax environment afforded to superannuation investments.

For medical professionals managing SMSFs, commercial property exposure through a fund structure can complement existing portfolios, strengthen wealthbuilding strategies and provide a reliable source of income leading into retirement.

Commercial property investment through unlisted funds represents a powerful tool for portfolio diversification and long-term wealth creation. As demand for quality commercial assets continues to rise, carefully selected and professionally managed property funds are well positioned to deliver attractive outcomes for investors at all stages of their investment journey.

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The FRP Capital approach FRP Capital is committed to providing investors with access to premium commercial property opportunities through expertly managed unlisted funds. With a focus on disciplined asset selection and active management, FRP Capital seeks to deliver sustainable income and capital growth outcomes.

Adrian Rivish, director, FRP Capital

AMA SA Member Benefit FRP Capital is an Australian-owned company with decades of experience helping investors grow their wealth through commercial property.

AMA members receive exclusive access to upcoming investment opportunities before they go to market.

Visit ama.com.au/sa/membership-benefits to see more

JOIN AMA SA TO ACCESS BENEFIT

A DV E R TO R I A L

25 YEARS OF URBAN HABITATS Jock Merrigan started Urban Habitats in 1999. What began as a small, construction company is today, 25 years later, an award-winning team of over 25, offering a fully integrated approach to residential design and construction in South Australia.

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Aldinga Beach House This new home captures the spirit of its coastal setting – a relaxed, contemporary ​beach house where architecture, construction, and landscape come together seamlessly under the Urban Habitats philosophy.

The evolution of Urban Habitats is a story of steady growth, a strong design ethos, and meaningful relationships with clients, collaborators, and contractors.

‘We want people to walk into one of our homes and feel that it’s an Urban Habitats home, not because they all look the same, but because there’s a shared language of quality, detailing, and thoughtfulness,’ Mr Semmler says.

Initially focused on renovations and custom builds, the company has matured into a diverse portfolio of new homes, extensions, and transformations.

The company’s growth has been built on long-standing relationships with suppliers, designers, and contractors, many of whom it’s worked with for decades. But at the centre of every project is the client – their lifestyle, their needs, and their vision.

Founding Director Jock Merrigan says all projects have one thing in common – a deep respect for individuality and place.

Mr Merrigan says Urban Habitats takes pride in building genuine relationships and ensuring that each home is a true reflection of the people who live in it.

‘Designing and building a home isn’t just about bricks and mortar, it’s about lifestyle, functionality, and longevity,’ ‘We’re passionate about design and building, but most of Mr Merrigan says. all, we’re passionate about the people we work with,’ Mr At the heart of Urban Habitats is a commitment to Merrigan says. architecturally-led design. The studio includes a ‘Helping clients bring their vision to life is a privilege and team of four internal architects who work closely a responsibility we never take for granted.’ and collaboratively with the broader Urban Habitats construction and project delivery team. This seamless As Urban Habitats reflects on the past 25 years, it’s also integration of design and build allows for a more fluid, looking ahead. With a continued focus on architectural cohesive process – one that balances creativity with excellence, innovation, sustainable design, and personal buildability and ensures the final outcome honours both connection, the team says it’s excited about what’s next the client’s vision and the architectural intent.

– and committed to delivering homes that are built to last Urban Habitats Director Josh Semmler says what makes Urban Habitats distinct is its fully collaborative, end-toend approach. The studio brings together architecture, interior design, construction, and landscaping under one roof to ensure a consistent vision from concept to completion, reducing stress for clients and enhancing design integrity.

and designed to support the way clients live, now and into the future.

Urban Habitats 96 King William Road, Goodwood 08 8373 1731 | urbanhabitats.com.au @urbanhabitats_sa

Malcolm A new build that embodies Urban Habitats’ fully integrated approach to design and construction. The home balances elegance and functionality, and reflects the collaboration, care, and attention to detail.

51 Wattle Residence A thoughtful renovation that breathes new life into an existing home while honouring its original character. By balancing modern design with timeless natural elements, it reflects Urban Habitats’ commitment to creating homes that truly support the way clients live, now and into the future.

A commitment to cutting-edge care 52

Eastwood Private Hospital, on the fringe of the Adelaide Parklands, opened to the public in June. Orthopaedic surgeon Dr James McLean was involved in the concept and design of the facility. Writing for medicSA, he says Eastwood integrates advanced medical technologies with a patient-centric approach.

Innovation and care go hand in hand at Eastwood Private Hospital (Eastwood). The 52-bed facility, located on Greenhill Road near Adelaide’s CBD, is dedicated to ophthalmology, orthopaedic, plastic and general surgeries.

Cutting-edge technologies are integrated into each step of our patients’ management journey.

Eastwood contains six state-of the-art, enlarged operating theatres. AI-powered surgical planning, real-time surgical navigation and robotically-assisted surgical technologies are employed routinely to augment Eastwood surgeons’ minimally-invasive procedures.

These innovations, combined with the latest technologies in laminar airflow systems, positive pressure ventilation and automated plasma and autoclave sterilisation systems, ensure that the highest standards of patient safety and infection control are met.

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The employment of advanced technologies continues at the bedside. Patient management tools such as smart patient-monitoring systems with AI-driven analytics are designed to enhance accurate patient care and safety.

What makes Eastwood special isn’t just the high-tech equipment - it’s how that technology supports every step of the patient journey. It will help us make better decisions, improve outcomes, and make recovery smoother and safer.

The Eastwood on-site community includes 24-hour medical cover, on-site radiology, pathology, orthopaedics, general surgery, medical physicians, podiatry and physiotherapy. From the personalised concierge service to the streamlined admission and discharge processes, every aspect of a patient’s journey has been designed to minimise the stress that can accompany a surgical procedure.

Eastwood’s commitment to achieving the best possible patient outcomes is reflected in its investment in

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research technologies via its links with the Eastwood Research Institute.

Eastwood has partnered with US-based Healthcare Outcomes Performance Company (HOPCo) to develop a customised, smartphone/tablet app, aimed at enhancing patient engagement in their treatment pathway.

This enhanced patient engagement tool covers the pre-operative patient education stage, the in-hospital treatment phase and the post-operative stages.

There is no doubt that partnering with Eastwood Research Institute will give us valuable insights into our patients’ surgical outcomes, which will help drive surgical innovations and improved outcomes.

I am excited to be a part of the research-focused, forward-thinking and dynamic Eastwood team, who share my enthusiasm for achieving optimal results across all aspects of my patients’ care pathway.

Dr McLean says Eastwood Private Hospital has been designed with the patient journey in mind

RESEARCH BRIEFS Study links poor blood flow in the brain to POTS Researchers from the University of Adelaide’s Australian Dysautonomia and Arrhythmia Research Collaborative (ADARC) have used brain scans 54 to identify blood flow problems in people with postural orthostatic tachycardia syndrome (POTS).

POTS is a complex condition affecting the autonomic nervous system, which controls unconscious bodily functions like breathing, blood circulation and digestion.

Symptoms are made worse when standing, often leading to dizziness, brain fog, rapid heart rate, and fatigue.

In collaboration with the South Australian Health and Medical Research Institute (SAHMRI), academics from the ADARC analysed nuclear medicine brain scans (SPECT) from 56 patients with POTS who were experiencing severe issues with brain fog to examine problems with blood flow.

They found 61% of participants had reduced blood flow in key brain areas, even when lying down.

Lead author Dr Marie-Claire Seeley said the findings could help explain brain fog in POTS and similar conditions like long COVID, where many people struggle with fatigue and trouble thinking clearly.

ADARC researchers were the first to show a link between long COVID and POTS, with 79% of those in the study meeting the criteria for POTS. ‘Novel brain SPECT imaging unravels abnormal cerebral perfusion in patients with postural orthostatic tachycardia syndrome and cognitive dysfunction’ (Scientific Reports, January 2025)

Gut microbiome may have role in diabetes Researchers at the University of Queensland have found improving the function of the gut microbiome may delay the onset of type 1 diabetes (T1D).

Professor Emma Hamilton-Williams from the university’s Frazer Institute said 21 individuals with T1D were given an oral biotherapy containing short chain fatty acids (SCFA), which are metabolites usually produced by gut bacteria during the fermentation of dietary fibre.

‘Type 1 diabetes is an autoimmune illness, and we know there is something different about the gut microbiome and gut barrier function that we think changes the immune response in individuals with the disease,’ Prof. Hamilton-Williams said.

‘We’ve learned that it is possible to change the microbiome in individuals with T1D, and when we have done that, we have seen changes in the gut barrier function.

‘When we further tested that microbiome by transferring it into mice, it delayed the onset of diabetes.’

Short chain fatty acids are one of the cornerstone beneficial functions of the gut’s community of microorganisms, which play essential roles in digestion, immunity and overall health. Prof.

Hamilton-Williams said it was the first time in T1D studies that researchers have increased short chain fatty acids in individuals.

Co-senior author Dr Eliana Mariño, from Monash University, said the study uncovered new ways to measure and potentially manipulate the pathways that influence immune function.

‘SCFA biotherapy delays diabetes in humanized gnotobiotic mice by remodelling mucosal homeostasis and metabolome’ (nature communications, March 2025)

Molecular data a key to understanding disease mechanisms An international team of researchers has explored how multi-omics – the integration of molecular data across different biological layers – can enhance our understanding of how genetic and environmental factors interact to influence chronic diseases.

Their review highlights how advancements in multiomics technologies are uncovering the biological mechanisms driving non-communicable diseases (NCDs).

Multi-omics approaches are transforming precision medicine, helping researchers develop more targeted treatments and prevention strategies. NCDs account for more than 74% of global deaths and can include cardiovascular diseases, cancers, diabetes, and chronic respiratory conditions.

The scoping review examines extensive literature in the field to assess how multi-omics techniques are advancing research into these diseases, the challenges in integrating complex datasets and the urgent need for greater diversity in genomic and biomedical research.

‘Non-communicable diseases are driven by a combination of genetic predispositions and environmental exposures, such as diet, pollution, and physical activity; how these factors function together is referred to as gene-environment (GxE) interactions, which plays a significant role in determining disease risk and treatment responses,’ said Dr Robel Alemu, a Visiting Research Fellow at the University of Adelaide Medical School.

‘In some cases, a person’s genetic makeup can alter how environmental exposures impact disease risk.

In other cases, environmental exposures influence which genetic factors contribute to disease risk.’

For example, recent studies have identified specific genes that protect brain cells from damage caused by oxidative stress, a key factor in various neurodegenerative diseases, while in pharmacogenomics, multi-omics research is enabling personalised medicine, such as using BRCA1/2 genetic testing to guide treatment decisions for breast cancer patients who may benefit from targeted therapies.

‘Multi-omics approaches for understanding geneenvironment interactions in noncommunicable diseases: techniques, translation, and equity issues’ (Human Genomics, January 2025)

Biological marker may point to health problems in older adults New research by Flinders University has uncovered a potential marker that could provide valuable insights into the overall health of older adults living in long-term aged care facilities.

The study found that a simple swab from the back of the throat, known as the oropharynx, may offer clues about health challenges faced by aged care residents.

Identifying vulnerable individuals in later life has proven successful through measures of physical robustness, such as grip strength and other 55 physical assessments.

However, this study suggests the inclusion of a biological marker, which may provide additional insight into the risk of poor health outcomes in aged care.

‘As we age, the community of bacteria and other micro-organisms in our throat changes. Factors like taking multiple medications and having more frequent healthcare visits, which are common in later life, can affect this balance,’ says College of Medicine and Public Health PhD candidate Sophie Miller.

‘These changes that occur with age may result in physiological shifts that increase vulnerability to diseases and frailty.’

The research involved the collection of oropharyngeal swabs from 190 residents of aged care facilities across metropolitan South Australia, and followed their health outcomes over 12 months.

One bacterium, Staphylococcus aureus (S. aureus), an organism ordinarily associated with infections - but not in this study context was notably linked to poorer health outcomes. Residents carrying this bacterium were found to be nearly 10 times more likely to die within a year compared to non-carriers.

The presence of S. aureus was found to reflect broader health challenges, rather than being linked to any specific infection.

‘This discovery suggests the usability of the microbiome as an additional marker of identifying residents who may require extra care or monitoring,’ Miller says.

‘Oropharyngeal Staphylococcus aureus is linked to higher mortality in long-term aged care residents’ (Age and Ageing, March 2025)

KEEPING YOU MOVING ORTHOPAEDIC SURGEONS BENJAMIN ALLEN BEN BEAMOND

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WELL Wellbeing

CRAZY 4 SOCKS It’s nine years since Victorian clinician Dr Geoff Toogood founded #CrazySocks4Docs Day to increase awareness of the importance of doctors’ health and wellbeing.

Dr Toogood – now Vice President of AMA Victoria – had worn two socks that didn’t match because his puppy had attacked his sock supply. He says the ‘back chat’ from colleagues suggested that his mental health may be suffering – just because his socks didn’t match.

Almost a decade later, #CrazySocks4Docs has become an annual platform for a wide and open discussion of doctors’ health and wellbeing, encouraging health practitioners and their employers to don their craziest hose on the first Friday in June as a reminder to look after their own health.

In Adelaide, new AMA SA President A/Prof Peter Subramaniam compared his socks with those worn by Health and Wellbeing Minister Chris Picton.

‘Across Australia, we’ve seen real progress in breaking down the stigma around mental health,’ A/Prof Subramaniam said.

‘There’s still considerable work to do, including within the medical community.

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‘#CrazySocks4Docs Day reminds us of all that we’re human.

It’s important to normalise seeking help when needed.

‘At a broader level, the AMA fully supports the “Every Doctor, Every Setting Action Plan”, which calls for the mental health and wellbeing of the medical profession to be a national priority.’

A/Prof Subramaniam and A/Prof William Tam

Health and Wellbeing Minister Chris Picton and AMA SA President A/Prof Peter Subramaniam

A/Prof Subramaniam and SASMOA’s Chief Industrial Officer Bernadette Mulholland

Doctors’ health on the agenda AMA SA staff members Olivia Davey & Elise Thomas

A major Australian conference will examine how the broader health system can improve medical practitioner health, writes Dr Roger Sexton.

The biennial Australasian Doctors’ Health Conference (ADHC25) is being held in Melbourne this year from 27 to 29 November 2025.

This is being hosted by the national Doctors’ Health Alliance and the Victorian Doctors’ Health Program and continues the 25-year tradition of such conferences in Australasia.

AMA SA Vice President Dr Louis Papilion & A/Prof Subramaniam

It is the most significant doctors’ health conference in Australia with a high-quality scientific and social program. Around 300 delegates from across the profession will be attending, including college and hospital leaders, researchers, project and program managers, hospital wellbeing leaders, podcasters, authors, medical indemnity insurers, doctors and other health professionals involved in doctors’ health.

The academic and social vibe of this conference will again be strong and the program allows plenty of opportunity for delegate networking and postconference collaboration.

Dr Papilion and A/Prof Subramaniam with (from left) AMA SA CEO Nicole Sykes, Council Chair Dr Karen Koh and Immediate Past President Dr John Williams

It is a very important solution-focused conference that aims to showcase programs that are improving the health of the profession from three perspectives - the individual, medical workplaces and work practices, and the wider health system. The conference will explore ways in which the wider health system can improve medical practitioner health by embedding better practices within undergraduate, post-graduate and Fellowship pathways and in rural and remote workplaces.

The ADHC25 Scientific Committee is currently assessing abstracts, and you are encouraged to go to the website, submit a paper and register to attend what will be a memorable, informative and truly profession-wide conference.

I hope to see you in Melbourne in November.

Register here: doctorshealthsa.com.au/events/ australasian-doctors-health-conference-2024

AMA SA staff kick up their heels

Explore More Learn More FROM THE START

‘Don’t suffer in silence’ Grappling with health, mental health or addiction issues can be challenging for everyone, including doctors. In this article, the Australian Health Practitioner Regulation Agency (Ahpra) offers guidance about the effects on doctors’ registration.

Begin in Junior Primary Apply now ignatius.sa.edu.au

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Too often, practitioners struggle in silence when they are dealing with a health, mental health or drug and alcohol issue – or even just the day-to-day challenges of being a health practitioner.

The best thing you can do – for yourself, your family, and your patients – is seek help early and actively engage in recommended treatments. Help may come from your own GP, another health practitioner or from one of the many independent practitioner support services available.

There is a common misconception that if you seek help, your treating practitioner will automatically be required to report it to Ahpra and your registration may be affected.

The threshold for when treating practitioners need to make a mandatory notification about health is very high and only necessary when the public is at substantial risk of harm. The need for a mandatory notification to be made is not often met.

If you are managing your health and getting the help you need, you can usually continue to practise. The Board wants you to be healthy and safe to practise, and encourages you to seek help early when you need support.

How will Ahpra manage a notification about my health?

We know that having a notification made about you can be stressful - especially if it’s about your health, mental health or problems with drugs and alcohol use.

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Ahpra manages health-related notifications in a way that aims to make the process clear and relatively easy. You’ll be assigned a case officer from our Health Management Team, who will keep you up to date on the progress of your notification and can advise you about the support services that are available to you.

The four concerns are:

The team is staffed by people who are committed to ensuring that they understand you as an individual and the demands of clinical practice and health care settings.

• sexual misconduct.

The aim, if it is safe to do so, is to keep you engaged in work at a level you choose during the investigation process.

When do I need to make a notification as a treating practitioner?

When treating a practitioner who has a health, mental health, or drug or alcohol issue, you only need to notify Ahpra if you think their health, performance or conduct may be putting the public at substantial risk of harm.

While mandatory notifications are an important part of our regulatory process to keep patients and the public safe, they are not necessary in most cases.

There are four concerns that may trigger a mandatory notification. Depending on the type of concern, you must assess the risk of harm to the public when deciding whether to make a mandatory notification.

• impairment • intoxication while practising • significant departure from accepted professional standards

When it comes to impairment, as long as the practitioner you’re treating won’t pose a substantial risk to the public, is managing their condition, and getting the help they need to practise safely, then you don’t need to make a notification to Ahpra.

Seeking help when they need it is the best thing that a practitioner can do, and you can play an important role in supporting them to continue to practise safely and ensure their patients continue to receive safe care.

Find out more about making a mandatory notification.

If you are struggling with the effects of a notification, you may wish to contact Doctors’ Health SA. Doctors’ Health SA is a not-forprofit, independent and profession-controlled organisation dedicated to improving the health of doctors and medical students.

For more information or to book an appointment go to doctorshealthsa.com.au or phone 08 8232 1250.

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The lasting impact of compassionate care Red Tree Foundation provides free professional grief counselling and bereavement support to South Australian families after the sudden or unexpected loss of a child. Red Tree’s grief and loss counsellor Jodie Gridley explains why doctors should be aware of the Foundation and its important work.

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Pregnancy and child loss are profound and lifealtering experiences. For families navigating the death of a child, whether through miscarriage, stillbirth, genetic termination, neonatal death or accident, the medical system is often their first point of contact in what becomes a lifelong grief journey.

baby. What stayed with her was the quiet sense that her grief didn’t matter.

The experience of Anna and Daniel, a South Australian couple who experienced multiple losses, highlights the lasting impact that trauma-informed, compassionate care can have in the grieving process. While their story is deeply personal, it is not uncommon, and it reflects the invaluable role that both medical professionals and community-based organisations like Red Tree Foundation play in walking alongside families during their most vulnerable moments.

In the months that followed, Anna and Daniel’s grief remained unspoken. They were unsure whether it was something they were even allowed to feel.

Anna and Daniel, already parents to a three-year-old son, never imagined their second pregnancy would end in miscarriage at 10 weeks.

‘I remember sitting in the waiting room, still bleeding, not really knowing what was happening,’ Anna said.

‘It all happened so fast, like it was over before I even understood what I’d lost.’

She recalled being told that it was common and that they could just try again, but she was still grieving this

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‘It was like my baby didn’t matter, so neither did how I felt,’ she said.

Without space or gentle care to process it, the loss remained unacknowledged.

A year later, Anna became pregnant again, and at the 20-week scan, they received devastating news: their baby had a severe genetic condition. After several consultations, they made the harrowing decision to end the pregnancy for medical reasons.

In moments like these, families are often overwhelmed by emotion, medical information and impossible decisions. Many describe struggling to comprehend what’s happening while being asked to make choices no parent expects to face. The emotional impact of their choice can linger long after, with guilt and self-blame among the most common burdens.

For Anna, the pain of this loss was compounded by the unprocessed grief from her earlier miscarriage.

‘I think I carried the weight of both losses into that room,’ she said. ‘The pain was all-consuming.’

Anna also didn’t realise just how much weight she was carrying - the guilt, the selfblame, the quiet questioning - until she heard the words she hadn’t expected from trusted medical staff: ‘I’m so sorry you’re going through this. Please know this isn’t your fault, you’ve done nothing wrong.’

Anna continued counselling through a subsequent pregnancy, where each scan and milestone brought mixed emotions of anxiety, fear, joy and healing.

She delivered a healthy baby girl. Their grief did not disappear with a new pregnancy, instead evolved.

‘Timely referrals When impacted by grief and loss, many walk a parallel path of to services like and loss. When this is met Red Tree Foundation hope with continued empathy from can significantly reduce healthcare providers and timely to services like Red Tree distress, ease isolation referrals For many mothers, the Foundation, it can significantly emotional toll of terminating a reduce distress, ease isolation, and and support more pregnancy is shaped by deep, support more positive emotional positive emotional outcomes unspoken beliefs that their where grief does not body failed, or that they should outcomes’ become complex. It offers patients a have done something differently.

These brief but powerful moments often become the part families remember most. They can ease the weight of guilt, offer clarity amid confusion, and become an anchor of hope that stays with parents long after the moment has passed.

While much of the focus is often on the mother’s experience, many fathers carry their own grief while trying to stay strong. Daniel described feeling unsure of what to do or say, wanting to support Anna while silently managing his own pain.

‘In a moment when everything felt overwhelming, the emotional attunement of the medical staff at the hospital gave us something to hold onto,’ Daniel said.

‘They gave us precious time with our baby, explained everything with such care, gently put in a referral for grief counselling, and most importantly, they gave us choice at a time when so much felt out of our hands.

These were things we didn’t even know we needed, but they made all the difference.’

Within days of their loss, and following the hospital’s referral, Anna and Daniel received a call from Red Tree Foundation. Within a week, they were sitting with a grief counsellor who understood the depth and complexity of child loss.

In the months that followed, they began attending sessions in person, gradually taking steps forward.

They also joined support groups and attended remembrance events, spaces where their babies were spoken of, honoured, and remembered.

The service was free and had no waiting list, a support they deeply valued while both were off work.

Not having to worry about the cost lifted a burden at a time when everything else felt heavy.

path forward, and a reminder that even in the darkest moments, they are not alone.

Reflecting, Anna and Daniel expressed the lasting impact of being supported throughout their entire journey. Daniel shared it wasn’t one conversation, one person, or one service that made the difference, but the way care flowed between hospital and community, with warmth, respect, and humanity.

‘They didn’t try to fix it. They stood beside us. What they did may have felt small to them, but it meant everything to us, and it shaped how we began to heal,’ he said. * For the purposes of protecting the privacy of individuals, names and identifying characteristics have been altered.

Red Tree Foundation also provides affordable counselling for grief and loss in its many and varied forms, including due to a life-changing or life-limiting diagnosis in a patient or a loved one, the death of a loved one, divorce or relationship changes, loss of a job or retirement, or loss of a pet.

If you’d like to find out more about the work of Red Tree Foundation, whether for child loss or for grief and loss in any form, or make a referral, please visit www.redtreefoundation.org.au

Jodie Gridley, Red Tree’s grief & loss counsellor

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Winter warmer It’s no secret that eating fresh produce free from saturated fats, salt, and added sugars helps reduce the risk of chronic diseases such as type 2 diabetes, stroke, heart disease, and certain cancers. With over 70 traders under one roof, the Adelaide Central Market is one of the largest undercover fresh produce markets in the Southern Hemisphere. The Market has provided this winter recipe to keep you warm and well-nourished during the cooler months.

SERVES: 4 COOK TIME: 3 hours DIFFICULTY: Easy

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Chicken, potato and coconut curry

PREP TIME: 25 mins

Ingredients • 1 teaspoon vegetable oil • 1 tablespoon yellow curry paste • 400ml coconut milk • 1 tablespoon light brown sugar • 1 tablespoon fish sauce • 400g baby potatoes, halved • 500g skinless and boneless chicken thighs, cut into bite-sized pieces • ¼ cup coriander leaves, roughly chopped • Juice of a lime

Method • Heat oil in a medium non-stick saucepan over a medium heat. Add curry paste and cook for 2 minutes or until aromatic.

• Add coconut milk, sugar, fish sauce and lime juice, stirring to combine and bring to the boil.

• Add potatoes and chicken, cover and cook for 15 minutes or until potatoes are tender. Add coriander, stirring to combine.

• Serve curry with steamed rice and broccolini.

Adelaide Central Market Open Tuesday to Saturday or book your home delivery order via shop.adelaidecentralmarket.com.au/

Fresh is best Older Australians who regularly consume ultra-processed foods may be putting their mental health at risk.

A new study from Deakin University suggests that older people who eat a diet high in ultraprocessed foods have an increased risk of depression.

The research, which was published in BMC Medicine in May, analysed data from more than 11,000 people aged 70 and over living in the community.

Participants who ate four or more servings of ultra-processed food a day increased their risk of depression by 10%.

Lead researcher Belayneh Mengist Miteku says the findings serve as an important reminder for older people to prioritise freshly prepared, whole foods.

‘Depression in older Australians is a major problem and can lead to poor health outcomes and even premature death,’ Mr Miteku says.

‘Reducing depression risks is an important way to ensure people are living well into their older age.’

Mr Miteku says ultra-processed foods are not just limited to junk foods. They also include massproduced and highly refined products that may be considered relatively healthy, such as diet soft drink, flavoured yoghurts, margarine and many ready-toheat frozen meals.

‘We know that older people might be tempted to look for tasty and convenient meals that don’t require much preparation,’ he says.

‘But pre-prepared and frozen meals often include a lot of ultra-processed ingredients that might be tasty but are not healthy when eaten too often.’

Deakin University’s Associate Professor Mohammadreza Mohebbi says the findings are further evidence of the need for policy change and improvements to dietary guidelines to reduce the growing reliance on ultra-processed food in the Australian diet.

‘We know reducing ultra-processed food has a positive impact on our physical health and this research is further evidence that reducing ultraprocessed food in our diet will contribute to better mental health and quality of life,’ Associate Professor Mohebbi says.

‘These findings will also provide much-needed evidence for healthcare professionals to incorporate dietary recommendations into mental health care for ageing populations.’

The AMA has long supported improved nutrition for older Australians. The organisation’s position statement on nutrition advocates for the development and implementation of national nutrition standards in aged care facilities and encourages healthcare professionals to discuss nutrition with older patients as part of routine care.

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Lifestyle

legacy

Dr Sarabjit Saggu and Dr Hiren Chotaliya at Lake Fuji Kawaguchi with the majestic Mount Fuji in the background

Japan: a journey through time From the haunting legacy of Hiroshima to the serene beauty of Kyoto, AMA SA member Dr Sarabjit Saggu’s holiday to Japan was one of reflection, discovery and wonder.

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Before arriving in Hiroshima, my husband Dr Hiren Chotaliya and I weren’t quite sure what to expect.

The city holds profound global significance as the first military target of a nuclear weapon. On our way there, haunting images of mushroom clouds from school textbooks filled our minds. Would we see a city still marked by devastation? Would the locals harbour resentment towards outsiders because of the horrors they endured during the Second World War? What we found was nothing like what we feared.

Hiroshima welcomed us with openness, peace and beauty. The city itself reminded us of Adelaide – modern, well-organised, not overly crowded, and framed by hills on three sides and the sea on the other.

Even the free city-loop buses felt familiar.

Visiting the Hiroshima Peace Memorial Park and Museum, with the iconic Atomic Bomb Dome at its heart, was deeply moving. Just 160 metres from the centre of the bomb strike, the skeletal remains of the Dome stand as a powerful reminder of destruction and death. Walking through the museum – viewing photos, videos, artefacts, and hearing survivors’ stories – was haunting. Looking up at the sky, we imagined the moment the bomb detonated. That image shook us to our core.

Yet Hiroshima is not a city frozen in its past. It has rebuilt itself into a symbol of resilience, hope and peace. As we wandered through its streets and serene gardens, we

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were reminded of the human spirit’s incredible ability to heal and flourish after unimaginable tragedy. It was deeply moving.

Our whole journey through Japan offered more than just history – it was a rich cultural experience. In the city of Himeji, we explored the magnificent Himeji Castle, Japan’s most spectacular and best-preserved feudal fortress. We marvelled at its elegant architecture and imagined ourselves as royalty defending the throne.

We visited spiritually significant landmarks, too. Kyoto’s Fushimi Inari Shrine, with its endless tunnel of vibrant vermilion Torii gates, was both visually stunning and spiritually profound. The floating Torii of Itsukushima Shrine in Miyajima and the historic Asakusa Shrine in Tokyo offered equally immersive glimpses into the country’s sacred traditions.

Our adventure took an exciting turn at the Samurai and Ninja Museum in Kyoto. We donned authentic armour, learned the basics of katana swordplay, and even practised choreographed combat sequences. In Takayama, the Hankyu Dojo introduced us to the art of Samurai archery, blending ancient martial discipline with modern instruction. These experiences gave us a deeper appreciation for the warrior spirit that once shaped Japanese society.

In contrast to the action, our stay in a traditional ryokan in Fujikawaguchiko offered a peaceful retreat. With tatami mat floors, futon bedding, and low wooden tables, the setting was both simple and elegant. Dressed in casual yukata, we savoured beautifully presented

Dr Chotaliya and Dr Saggu at Himeji Castle

Dr Chotaliya at Hiroshima’s Atomic Bomb Dome

Japanese cuisine and participated in a traditional tea ceremony – all while enjoying breathtaking views of Lake Kawaguchi and the majestic Mount Fuji. It was a moment of stillness and serenity, perfect for quiet strolls and reflection.

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Looking back, this trip was far more than a holiday.

Hiroshima especially reminded us why we travel – not just to see beautiful places, but to understand them. To learn, to feel and to return home changed. Japan is a country that honours its past, celebrates its culture, and embraces the future with grace and openness.

Hiroshima cityscape

Dr Saggu and Dr Chotaliya testing their samurai sword skills

OFF-ROAD GP Dr Robert Menz test driving the Jeep Avenger Summit

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Dr Robert Menz road tests Jeep’s general-purpose EV Who would have thought that Jeep, the manufacturer of the quintessential World War Two military transport vehicle, would now be making a small front-wheel drive (FWD) electric SUV? I guess the answer is just about everybody who follows current trends with manufacturers such as Aston Martin, Maserati and Jaguar making SUVs with varying degrees of electrification.

The Jeep brand name is now owned by Stellantis, which was formed when Fiat Chrysler and the Peugeot group amalgamated. Stellantis also owns brands such as Alpha, Citroen and Lancia. Chrysler, the previous parent company of Jeep, has used the ‘Avenger’ nameplate for two previous vehicles, namely the Dodge Avenger (a North American product on sale between 1994 and 2000, then 2008–2014) and before that on the Hillman Avenger built by Chrysler’s long-defunct European division in the 1970s.

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The origin of the Jeep name is more obscure, it having been a US slang term for new vehicles and could be a slurring of ‘GP’, being an abbreviation for a ‘general purpose’ vehicle. Many of the Second World War Jeeps were made under license by Ford and the early production models were designated ‘GP’ with ‘G’ indicating government and ‘P’ indicating a wheelbase of 80 inches.

So how appropriate a GP should be writing about a GP. The fully electric Avenger was introduced to Australia in late 2024 and is the smallest in the now extensive Jeep lineup.

There is a three-model range starting with the Longitude priced at just under $50,000 retail and climbing to the top of the range Summit, the test vehicle for this edition, which is about $68,000 drive away.

Each model has the same underpinnings, with a single 115 kW electric motor producing 260 Nm giving a claimed driving range slightly under 400 km. The 54 kWh lithium iron battery lies neatly

in the floor as with most electric cars, thereby lowering the centre of gravity.

There are several driving modes including eco, normal and sport. This small FWD SUV also includes the Selec-Terrain modes, found in the FWD and larger Jeeps, although I suspect very few drivers will take their Avenger into sand, mud or snow.

The base model Longitude is very well equipped with comfort and safety features including autonomous emergency braking, adaptive cruise control, lane keep assist, driver attention assist and hill descent control.

The appropriately named Summit test car adds 18-inch wheels, heated front seat with powered adjustment and a massaging function, sunroof, wireless charging for your phone, heated exterior mirrors and a hands-free power liftgate.

relaxed weekend returning via the beautiful Ukaria concert Hall at Mount Barker (ukaria.com) where we enjoyed an excellent performance by Ensemble Q, which is led by the husband and wife team of Paul and Trisha Dean on clarinet and cello respectively.

In summary the Jeep Avenger range is a worthwhile addition to an increasingly crowded small electric SUV section that includes key contenders the Hyundai Kona Electric, Smart #1, MG 4, and Toyota bZ4x.

Vehicle supplied by Jeep Australia.

Dr Robert Menz is a GP and enthusiastic motorist who was lucky enough to drive both a Jeep Grand Cherokee and Jeep Compass on fresh snowy roads in Denver in February (4WD certainly needed).

One of the neat features is that when the boot is being lowered, it beeps to remind you to keep your head out of the way. Another feature of the keyless entry is that the car unlocks itself when you approach within a metre.

The Avenger is quite a small car and although there is plenty of room for a driver and front-seat passenger, anybody sitting in the rear seats needs to have very small legs.

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The boot space is 355 L, which is pretty standard for this sector. However this can be substantially increased with the rear seats lowered.

Driving this small Jeep presented no particular problems or challenges. Being an electric car, the full torque is available from standstill and the claimed 0 to 100 kph time is a leisurely nine seconds.

The high-tech dashboard of the Avenger Summit

The Avenger has a two-mode regenerative braking system that can be activated from the pushbutton gear selection. However the car does not come to a complete halt as some of the more sophisticated electric cars do, meaning the driver is still required to apply the brakes.

The little Jeep felt quite stable at highway speeds and the handling through the twisty bits of the Adelaide Hills was perfectly adequate.

The range was never fully tested although I did note that the battery charge was reduced by about a third with a one-way trip to Victor Harbor.

In addition to the usual city driving for the week, I enjoyed a midweek trip to Victor Harbor and a more

The Avenger Summit boasts a 180-degree rear view camera with a ‘drone view’

From the heart: one doctor’s mission to do good Dr Chukwudiebube Ajaero has worked hard and overcome significant challenges to become a successful Adelaide cardiologist.

But his career wouldn’t have been possible without the enormous sacrifice from his parents, the generosity of a benefactor and some wise advice from his mother. Now, he’s paying it forward.

Dr Chukwudiebube ‘Chuks’ Ajaero grew up in Nigeria’s Enugu State – a part of the country that was at the time recovering from a civil war it had lost.

His father was an Anglican priest, and the family moved frequently from village to village.

They didn’t have much, but Dr Ajaero’s mother, a primary school teacher, had big ambitions for her son.

‘My late mother always taught me, “whatever you’re going to do, you’re going to do it well. If you can’t do it well, don’t do it”,’ Dr Ajaero recalls.

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‘I grew up with that notion and it’s stayed with me throughout my life.’

By any objective standard Dr Ajaero has done very well. He’s a highly qualified clinical cardiologist and electrophysiologist with extensive experience managing cardiac arrhythmias, heart failure and implantable cardiac devices.

But he’s also done a lot of good. Dr Ajaero was instrumental in setting up the African Australian Heart Health Initiative (AAHHI), which aims to improve cardiovascular outcomes for members of African Australian communities.

‘He said, “I want to help. Our village has no doctor and you are the first to gain admission to study medicine.

Our community cannot afford to miss this opportunity”.’

Dr Ajaero excelled in his studies. He toyed with becoming a surgeon, but instead chose to specialise as a physician so he could provide grassroots medical care.

‘The possibility of becoming a surgeon was attractive.

You could make quick money and get dramatic results too,’ he says.

‘But I decided to become a physician so I could focus on my patients’ experiences. Somebody had to look after the elderly and those with chronic conditions.’

In 2005 Dr Ajaero became a fellow of the Nigerian Medical College of Physicians in cardiology.

Two years later, he moved to Australia to pursue further training and faced the significant challenge of requalifying as a doctor in a new country.

‘I had to undertake residency training again, do all the exams again, and go through advanced training again,’ he explains.

He and his wife, Dr Ngozi Ajaero, also established the CANA Foundation to empower underprivileged children in Nigeria through education. The foundation offers student scholarships and vocational educational training as well as basic food supplies and access to solarpowered clean borehole water.

Dr Ajaero’s desire to ‘give back’ is deeply rooted in his family upbringing and the kindness of one man who changed the course of his life significantly.

‘My family was poor; they couldn’t afford to send me to medical school,’ he recalls.

‘When I was admitted to study medicine, a philanthropist from my community, G.O.C. Ubesie, gave me a scholarship.

Dr Ajaero’s CANA Foundation supports underprivileged children in Nigeria

Health Minister Chris Picton, Nigeria’s High Commissioner to Australia H.E. Anderson Madubuike, AAHHI Secretary Pascal Ochi, Dr Ajaero, Multicultural Affairs Minister Zoe Bettison, Labor MP Michael Brown

‘It wasn’t a waste of time. The level of training here is completely different and much, much higher.’

In 2012 Dr Ajaero was awarded the Fellowship of the Royal Australasian College of Physicians in cardiology.

Dr Ajaero’s CANA Foundation is also working in Enugu State to give children in need the education and healthcare they need to thrive.

It’s a deeply personal mission for a man who understands better than most the power and impact of a good The following year he commenced a research doctorate education. study of cardiac resynchronisation therapy in heart ‘(Education) helped me so much to get to the stage I failure with the University of Adelaide and a fellowship am,’ he says. ‘I think it’s just natural to look back and say, in electrophysiology and pacing at Flinders Medical “what can I do to help too”.

Centre.

In his limited spare time, he dedicates himself to the work of the AAHHI, which he established with significant support form AAHHI Secretary Pascal Ochi and the former Nigerian High Commissioner to Australia, H.E Anderson Madubuike.

‘If we make small changes, it can make a big difference.’

The initiative aims to educate both medical professionals and community members about the unique health challenges prevalent among African Australian communities.

‘Africans tend to suffer from cardiovascular diseases more severely,’ Dr Ajaero says.

‘They often wait until things have gotten out of hand before seeking help.

‘We organise seminars for health professionals to create awareness about the specific needs of African patients.

‘We also undertake community events to encourage active lifestyles and proactive health management.’

Dr Ajaero being sworn in as a doctor in 1997

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Dr Rex Pearlman MBBS FFARACS FANZCA 1939 - 2025

Rex Pearlman represented Australia in cricket - at university level, but still an honour for sure.

Along with his older brother Robert, who was also studying medicine, the future Dr Rex Pearlman earned selection for the Australian Combined Universities cricket team in 1959. This Australian team played six matches during a tour of New Zealand. Rex was a toporder batsman, and the team did very well.

He also played A-grade cricket for University in the early 1960s when he scored runs off the bowling of perhaps the game’s greatest all-rounder, the West Indian Sir Garfield Sobers, who was playing for Prospect and South Australia.

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It became one of Rex’s greatest memories.

Another enduring memory was when – as the Glenelg Football Club doctor for many years – he performed CPR on a member of the crowd who suffered a cardiac arrest while watching his team at Glenelg Oval. At the time, CPR was an in-hospital procedure only.

Rex Pearlman’s sporting prowess had become evident at Prince Alfred College, where he had excelled at cricket, athletics and Australian rules football. Later, at university, Rex became a serious weightlifter. But his active sporting pursuits were curtailed in the mid-1960s when he donned the scrubs and the busy, crowded life of a resident medical officer at the Royal Adelaide Hospital (RAH).

He had graduated with a Bachelor of Medicine and Bachelor of Surgery from the University of Adelaide in 1963, along with brother Bob, who by chance completed university at the same time. Rex had achieved his specialist anaesthetist qualification in 1968 when he was awarded Fellowship of the Faculty of Anaesthetists, Royal Australasian College of Surgeons, whereupon he took up a post at the Royal Adelaide Hospital, a position he held until retirement in 2005.

In 1992, Rex was a founding Fellow of the Australian and Zealand College of Anaesthetists when it was formed as a body independent of the College of Surgeons.

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Shortly after Rex gained his specialty qualification, coronary-artery grafting was rapidly expanding. Rex then joined the small team of anaesthetists and maintained this skill throughout his career at the RAH. As a clinician, Dr Pearlman was recognised as having a strong work ethic. He was given all the complex and difficult surgical lists at the RAH and also worked in the intensive care unit when intensive care was an emerging specialty.

He volunteered for many helicopter retrievals and Royal Flying Doctor missions when the delivery of emergency specialist anaesthesia and intensive care to rural South Australians was in its infancy.

Rex was also known for treating all colleagues – no matter their level of training – with respect. His gift to the profession was a long clinical career of sustained anaesthesia excellence while inspiring his co-workers.

He was a fine role model to the many who followed him.

But even more importantly, Rex was known for demonstrating kindness and gentleness with his patients.

His firm, confident, but quiet and professional voice and demeanour reassured his patients as they faced the immediate challenge of major surgery.

Rex leaves a family that misses him: his wife Joan; siblings; Joan’s daughter and son, who she says he ‘shared’; grandchildren and great-grandchildren. His interest in football – specifically Glenelg and the Crows – and cricket never waned. He also loved golf, 20th century history, and surf lifesaving, and played bridge with his beloved Joan.

Dr Rex Pearlman was a gentleman who leaves a wonderful record of devoted and exemplary public service.

• This article is an abbreviated version of the eulogy presented by colleague and friend Dr Rob Singleton at Dr Pearlman’s funeral on 13 March 2025, with contributions by fellow anaesthetist Dr Mervyn Allen.

Dr Kerry Pincombe

MBBS FRANZCP 1957 - 2025

Dr Kerry Pincombe is remembered fondly for her competence, diligence and sense of humour.

Kerry worked as a psychiatrist in Adelaide for about 30 years.

After a senior registrar year at Helen Mayo House, she had entered private practice with Dr Ann Sved Williams and joined the emerging rural and remote telehealth service in the late 1990s. She stayed with the service on a part-time basis until 2020. She enjoyed her teams, led successively by Fiona Hawker, Ken Fielke and Brian McKenny.

Before nominating psychiatry as her specialty as an intern, Kerry was handpicked for the physicians’ training program at the Royal Adelaide Hospital (RAH).

She decided after a couple of years of training not to proceed, as she wanted to delve deeper into lives and minds to help her patients.

She transferred and trained at the then-Hillcrest Hospital. A brilliant neurology presentation for her first clinicals was overlooked by the examiners, a rheumatologist and surgeon, during the leadership of the Examination Committee by Dr John Condon.

To maximise fitness with minimal time off, Kerry took up running and then marathon running – completing two marathons – at about the same time as she ventured into theatre. She performed at the Edinburgh Fringe as a comedienne to rave reviews and solid bookings.

She worked for many years with rural and remote mental services, managing the triage and providing opinions all-round the state, starting with the service when it started and finally leaving after some 25 years in 2020.

Kerry’s private practice gradually moved from perinatal psychiatry to working with military veterans and first responders, in part to honour her grandfather, a colonel in World War II in Borneo who had suffered from his exposure to war.

She was much loved at the Adelaide Clinic where she served on the medical advisory committee for many years. She brought to her Peer Review Group, which she christened ‘the Brains Trust’, intelligence, psychological mindedness and a wicked sense of humour to, at times, overly learned discussions.

As a doctor her patients experienced her kindness, tenacity and patience.

Kerry rode horses for most of her life, including jumping, dressage and cross-country riding. She was deputy president of Black Hill Pony Club for many years, competing and introducing young riders to competitive equestrian events. She was also an accomplished painter and artist.

Kerry was the loved and loving wife of fellow psychiatrist Dr Nick Ford and mother of Hannah – an advanced neurology trainee and Neurology Fellow for 2025 at John Radcliffe Hospital in Oxford – and Tim, a Muay Thai coach and fitness instructor.

•

Dr Nick Ford

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Dr Philip Griffin MBBS FRACS(Plas) 1959 - 2025

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Dr Philip Griffin was surrounded by family when he died at the Laurel Hospice, Flinders Medical Centre, on 27 May. He was 66 years old and will be dearly missed.

teaching initiatives also extended to courses in microsurgery and flap reconstruction, which he ran in his own time pro bono. They attracted attendees from all over Australia, as no other similar courses existed.

Phil received his FRACS in Plastic and Reconstructive Surgery in 1992 and by 1997 had become Head of Unit for Flinders Medical Centre Plastic Surgery, where he served for 17 years. His tireless dedication to patient care and to training registrars, RMOs and junior staff as well as medical students was exceptional.

Phil’s generosity to his colleagues and juniors was truly exceptional and his modesty and integrity were impeccable. He contributed nationally to the Australian Hand Surgery Society and the Australian Society of Plastic Surgeons as well as internationally through trips to Bhutan.

His contribution to hand surgery in South Australia is incomparable. Without fail he gave his regular Thursday morning hand-surgery teaching sessions, which have benefited nearly every current plastic surgeon in South Australia and many beside.

Phil’s commitment at Flinders Medical Centre was unfailing. His default, whenever there were any consultant roster problems, was to put himself on call and he would unfailingly come to the aid of any colleague who asked. He contributed to the Medical Advisory Committee at Flinders and set a culture of excellence and respect that permeated the whole hospital.

He was a surgeon of peerless technical excellence and chose to specialise in hand surgery. Phil’s

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The Unit at Flinders Medical Centre was devastated at Phil’s cancer diagnosis in 2020 which so abruptly cut short his career.

His love of classical music and contribution to the community through playing the viola was another key part of who Phil was.

He is an indelible part of the fabric of the Plastic Surgery Unit at Flinders Medical Centre and was a dear friend and colleague. Vale Philip Griffin.

• Associate Professor Nicola Dean

From the AMA SA History Committee

MEDICO OF MERIT Alfred Austin Lendon MD MRCS

1837-1937

‘Few practitioners have exerted a wider influence on medical science in South Australia’ Upon becoming president of the District Trained Nursing Society, Lendon guided it from near-bankruptcy. He also served for several years as national president of the Australasian Trained Nurses Association and president of the Medical Board of South Australia. Moreover, Lendon He arrived in South Australia in 1883, having served as was honorary secretary and then president of the South ship’s surgeon on the voyage. In Adealide, he joined Australian Branch of the British Medical Association the practice of Dr John Davies Thomas and became a (later the AMA) for two terms a decade apart.

Government Medical Officer, later becoming lecturer Lendon was an author and medical historian. He in Forensic Medicine and then lecturer in Obstetrics and Diseases of Infancy at the University of Adelaide. published two books (Hydatid Disease of the Lung and Nodal Fever) and contributed to many professional For some years Lendon also served as a member journals. of the University Council and Dean of the faculty of Medicine. He was honorary physician at the Adelaide In 1887 Lendon married Lucy Rymill (1865-1929). They went on to have a daughter and two sons, both of Hospital, and consulting surgeon and vice president whom became medical doctors. of the board of the Adelaide Children’s Hospital.

Alfred Austin Lendon was born and educated in England, obtaining an MD(Lond) and MRCS LSA(University College Hospital) before migrating to Australia.

Supporting doctors from crisis to independence “Doctors helping doctors” For over 140 years, the Medical Benevolent Association of SA (MBASA) has been supporting South Australian doctors and their families who are in financial distress.

Our support is highly confidential - which may be why you haven’t heard of us.

We offer financial assistance, advice and support.

MBASA is a registered not-for-profit charity relying solely on donations.

To donate Scan this QR code and it will take you to our donations page where a tax receipt will be issued immediately.

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Preserving AMA SA’s Historical Legacy AMA SA’s decision to downsize to its new, modern office in late 2024 brought with it one significant challenge – what to do with the organisation’s vast collection of historical medical artefacts.

AMA SA History Committee representative Sharyn Kerr explains her role in ensuring these valued pieces will be preserved.

Have you ever moved house? It’s often a chance to reflect on the past while sorting through years of memories, collections, and paperwork. In December 2024, the AMA SA Secretariat relocated to a more modern, albeit significantly smaller, office in Adelaide. This move prompted a muchneeded ‘spring clean’.

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As we delved into storage boxes, cupboards, folders, and files – many untouched for decades – we uncovered a fascinating array of historical items: paintings, photographs, medical kits, and more. The process was both cathartic and captivating. However, faced with limited space, the high cost of long-term management and inadequate storage conditions, we came to a difficult but important realisation: we were no longer the best custodians for these treasured artefacts.

AMA SA’s roots stretch back to 1879 with the formation of the British Medical Association (BMA) in Australia. In 1962, the South Australian branch played a pivotal role in uniting six BMA branches to form the Australian Medical Association (AMA). The AMA SA branch was officially established in 1979. The historical paraphernalia accumulated over this time was extensive.

After thoughtful consideration and collaboration between the AMA SA Council and the AMA SA History Committee, we resolved to find new homes for these significant items – Medical artefacts on display in AMA SA’s offices

medicSA

Lister’s carbolic spray was invented in 1865 by Sir Joseph Lister, who introduced carbolic acid as a steriliser for surgical instruments and wounds

Official seal of the British Medical Association and a notebook of BMA minutes from 1917

places where they would be properly preserved, appreciated and accessible to the public.

We contacted institutions including the Art Gallery of South Australia, the South Australian Museum, the History Trust of SA, the National Portrait Gallery, historical societies, colleges, hospitals, universities, and even families. Although the process was lengthy, the response was heartening.

We successfully placed many artefacts and artworks, safeguarding them from deterioration and loss.

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This initiative preserved our medical heritage and underscored the importance of honouring the past. Many of the paintings, sculptures, medical instruments, books and documents now reside in esteemed repositories such as the CALHN Health Museum at Hampstead Hospital, the University of Adelaide and the Mt Lofty District Historical Society.

A curated selection of items specifically related to the formation of AMA SA remains on display at our new office at Level 7, 431 King William Street, Adelaide – serving as a tangible link to our proud history.

The electrohomeopathy remedy box was made in Italy and owned by Sir Joseph Cooke Verco

AMA SA History Committee representative Sharyn Kerr

The best medicine The Pharmaceutical Society of Australia’s South Australian and Northern Territory (PSA SA/NT branch) presented its 2025 Pharmacist Awards on Friday 28 March at the Playford Adelaide.

AMA SA’s then-President Dr John Williams attended the event, along with other high-profile guests including the Health and Wellbeing Minister Chris Picton.

PSA SA/NT President Dr Manya Angley said the awards recognise outstanding pharmacists who go above and beyond to support their patients, their communities, and the profession.

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Connie Bonaros MLC, PSA SA/NT President Dr Manya Angley, AMA SA Immediate Past President Dr John Williams

Dr Manya Angley, Health Minister Chris Picton

Emeritus Professor Lloyd Sansom and PSA Gold Medal Winner Imogen Bates

Minister Picton, Jessie Wattie, Imogen Bates, Maria Cooper, Simone Rossi, Dr Manya Angley

AMA SA's events to watch out for!

Empower. Inspire. Connect.

Join us for a dynamic series of events, like Speed Mentoring (for junior doctors and students), learn tips on Preparing for Private Practice and Creating Wealth, plus we take you Beyond The Stethoscope to learn smart ways to invest.

Save the Date: AMA SA’s Women in Medicine Breakfast – coming this September!

See more events here

Culture and community The South Australian Indian Medical Association (SAIMA) hosted its Charity Gala Dinner at Adelaide Oval on Saturday 14 June, celebrating cultural heritage, professional achievement, and philanthropic spirit. AMA SA President Associate Professor Peter Subramaniam was one of more than 400 attendees representing all corners of the medical profession.

The event opened with a stirring traditional welcome dance, followed by a mesmerising tabla and sitar performance that paid tribute to classical Indian music. The stage came alive with a soulful set by The Voice Australia finalist Janaki Easwar, followed by high-energy Bollywood choreography that drew the crowd onto the dance floor.

Three prestigious awards were presented to recognise outstanding contributions to healthcare and leadership: • Lifetime Achievement Award – Dr Rakesh Mohindra • President’s Award – Dr Devendra Hiwase • Krishnan Award – Dr Anjani Prasad Nitchingham.

Proceeds supported the Kathryn Browne-Yung Scholarship Fund for Indigenous medical students, with live and ballot auctions generating enthusiastic support.

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AMA SA President Associate Professor Subramaniam with Chief Public Health Officer Professor Nicola Spurrier

Eddie Liew, Jing Lee MLC, Issac Zangre, Multicultural Affairs Minister Zoe Bettison, Shadow Health Minister Ashton Hurn, A/Prof Peter Subramaniam, SAIMA President Dr Jaiveer Krishnan and Vaishali Jaiveer

Ms Hurn presenting the President’s Award to Dr Devendra Hiwase

Minister Bettison presenting the Lifetime Achievement Award to Dr Rakesh Mohindra

2025 SAIMA Committee Members

Meet the team The AMA SA team is here for you. Our mission is to deliver value for our members.

Elise Thomas

Nicole Sykes

Kate Fuss

Alex Brown

Chief Executive Officer

Business Development & Operations Manager

Executive Assistant to CEO & President

Karen Phillips

Membership, Marketing Senior Policy, Media & Communications Advisor & Events Manager

Ben Terry

Olivia Davey

Sophie Duncan

Sharyn Kerr

Media & Communications Advisor

Membership & Content Coordinator

Membership & Events Coordinator

Administration Officer

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Contribute to medicSA AMA SA’s flagship magazine medicSA is produced quarterly. Published in print and digital formats, and strongly supported by social media channels, medicSA ensures your message resonates far beyond its pages.

2025 Advertising Bookings

2025 Editorial Submissions

We take pride in delivering exceptional value to our advertisers, ensuring your brand receives the recognition it deserves.

We invite you to submit your editorial suggestions or your article for consideration by these dates:

Publication: Spring 2025 Booking deadline: 25 July 2025 Artwork deadline: 16 August 2025

Publication: Spring 2025 Pitch deadline: 11 July 2025 Submission deadline: 1 August 2025

For all advertising & editorial enquiries, please contact: medicSA@amasa.org.au

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