BREAKING SILOS Health and disability unite BIRTH OF AN ADVOCATE Meeting Dr Jessica Teoh
ON THE SHOULDERS OF GIANTS
Honouring our 50-year members
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EDITOR’S
THE RHYTHM OF REFORM
Political lobbying is a waltz, each move deliberate and in rhythm. Dancers must read the room, anticipate shifts and adjust their pace to maintain harmony.
It is a choreography of influence and negotiation, where timing, balance, and mutual understanding are key to achieving shared goals.
And just as in a waltz, missteps can be costly. Inexperience can trip the rhythm, rudeness can sour the tone, and an unwillingness to compromise can bring the entire performance to a halt.
Relationships built over decades can unravel in moments when respect and adaptability are absent. And, as we all know, reputation is currency and once spent carelessly, it’s hard to earn back.
Lobbying for change is a daily occurrence at AMA (NSW) – in ministerial offices, boardrooms, operating theatres and clinics. But sometimes, lobbying behind closed doors isn’t enough.
When voices go unheard, the media can become a powerful amplifier. It can shift public sentiment, apply pressure, and bring urgency to issues that might
otherwise be buried in bureaucracy. Strategic media engagement is not about spectacle - it’s about visibility. When used wisely, it turns a solitary voice into a chorus.
In the past few months, AMA (NSW) has highlighted many issues in the media – from cancer waitlists at Westmead Hospital to the re-categorisation of surgical patients to a lack of vision - and health funding - in this year’s NSW Budget.
We have also spoken out on the ever-harrowing Bureau of Health Information performance results and the ongoing staffing crisis in our mental health system. We push constantly for improved working conditions for doctors and for greater medical leadership in our hospitals.
This has only been possible thanks to members coming forward with their stories, challenges and frontline truths. It can be daunting to step out on the plank and speak up about issues in our public health system, but when we join forces, it can be a much safer course.
Thank you for your support - your voice is helping shape the narrative and driving the funding reforms our communities so urgently need.
Let’s keep the pressure up. Let’s keep talking. Let’s keep doing what AMA (NSW) does best – improving the health system for doctors and patients.
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The NSW Doctor is the quarterly publication of the Australian Medical Association (NSW) Limited.
Views expressed by contributors to The NSW Doctor and advertisements appearing in The NSW Doctor are not necessarily endorsed by the Australian Medical Association (NSW) Limited. No responsibility is accepted by the Australian Medical Association (NSW) Limited, the editors or the printers for the accuracy of the information contained in the text and advertisements in The NSW Doctor. The acceptance of advertising in AMA (NSW) publications, digital, or social channels or sponsorship of AMA (NSW) events does not in any way indicate or imply endorsement by the AMA.
AMA (NSW) BOARD
Dr Kathryn Austin, President
Dr Fred Betros, Vice President
Dr Michael Bonning
Dr Costa Boyages
Dr Brian Fernandes
Dr Amandeep Hansra
Dr Jacqueline Ho
Dr Theresa Ly
Dr David Malouf
Chief Executive Officer, Fiona Davies
Director, Workplace Relations Dominique Egan
Director, Membership Engagement and Commercial Partnerships Gary White
Editor
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PRESIDENT’S WORD
ONCE MORE UNTO THE BREACH
It’s been a busy few months at AMA (NSW) as we continue to fight for our members and their patients. But it has also been a time of wonderful reflection and gratitude as we honoured leaders and mentors across the profession.
What a privilege it was to celebrate our 50 year members in June –half a century of commitment and service to AMA (NSW) and, more importantly, to the cause of better healthcare.
In 1975, it was a different era of medicine. The tools, the treatments, even the expectations were different. We’ve gone from paper charts to digital records; from onesize-fits-all treatments to precision medicine; from silent suffering by some to patient empowerment.
And we have seen 20 health ministers come and go. But the battles in the political arena remain unchanged. And I know I stand on the shoulders of giants each time we prepare to right another wrong; tackle another issue; be the voice for our profession and our patients.
I stand on your shoulders each time we choose to speak out against injustice or when politics takes precedence over patient care.
During my tenure so far as the 131st president of AMA (NSW), we have taken on elective surgery wait lists, birth trauma, public hospital funding, public hospital workforce deficits, VMO determinations, abortion care, indemnity, general practice viability and private hospital viability, to name just a few.
Of course, none of this could be
achieved without the support of our members, our tireless advocates for a better health system.
At our 50-year member luncheon, it was beyond moving to hear Professor Michael Besser talk of his parents’ internment at Auschwitz during the second world war. Their fierce determination to retain their humanity and to continue to think the best of others became his raison d’etre in medicine.
Most of us – fortunately – do not have such a heart-wrenching past, but we all have a North Star. And I was reminded of that the last month when we said goodbye to former AMA (NSW) president and powerhouse Dr Brian Morton.
Brian was a dear friend and incredible mentor to so many. His passion for the profession never wavered; he never backed down from a political stoush and he did
all with small twinkle in his eye that suggested he was loving every minute.
His legacy is our mission statement – to practise with integrity, compassion and excellence, and to take up cudgels when the profession is under siege.
And at AMA (NSW), we are laser focused on doing exactly that. The fight is not over. It will probably never be over. But, by banding together and speaking for the voiceless, we have - and will continue to - achieve greatness. May I end with a quote from William Shakespeare: “Once more unto the breach, dear friends, once more”.
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Dr Kathryn Austin - president AMA (NSW)
CEO’S WORD
WWE STAND TOGETHER FOR THE GREATER GOOD
hen I refer to the AMA, I always refer to it as the AMA family because for me, that is what it is.
It is a connection of people joined together to achieve something better.
While there are very rational and practical reasons to be part of the AMA, it is also an emotion decision, a small investment of money and time into safeguarding the medical profession.
One of the great honours of being part of the AMA family is when members share their stories and passions, the things that are important to them.
Professor Michael Besser gave us that honour in his moving speech to the AMA (NSW) 50 year member lunch. As we detail in this edition, he spoke movingly of his parents and his career. In doing so, he told us so much about the doctor he was and the things that drove him.
In this edition, we are also featuring my own family and the issue closest to our hearts, that is support for Australians living with a disability.
While the AMA is a powerful advocacy organisation, the best advocacy always comes from those with lived experience.
About 1.2 per cent of Australians live with an intellectual disability.
Disability impacts on all walks of life, sometimes it is from birth and at other times it will arise from an accident or illness. We wanted to share our story to highlight the value of the National Disability Insurance Scheme but also the important opportunities that doctors provide to strengthen and improve the NDIS and care for people with a disability.
We wanted to share some of the frustrations we hear from doctors, those with disabilities and their families. As inhabitants in both worlds, we hope we will be well placed to bring what often feels like divided groups together for a common sense of purpose. We know the AMA is excellent at powerful advocacy and has much to contribute in the disability space.
When talking about powerful advocacy, there is no more
obvious example than the Special Commission of Inquiry into Healthcare Funding.
Only AMA (NSW) could have taken an election commitment aimed at attacking doctors and turn the issue to the point where the report could be one of the most influential report into healthcare in decades.
In this edition, the architect of our SCOI strategy, Dominique Egan, has written about the key outcomes. We will update members on how we will hold the government to account to implement its own report.
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Fiona Davies - CEO, AMA (NSW)
BREAKING SILOS: HEALTH AND DISABILITY UNITE
There are boundless opportunities to improve the National Disability Support Scheme, says Stephanie Osfield, but patient need must be at the centre.
When she was hospitalised due to a mystery illness in 2022, Tiahn, then 16, underwent a nine-month diagnostic odyssey.
She was eventually diagnosed with “intestinal dysmotility” following vomiting, weight loss and severe abdominal pain.
Every day for 16 to 18 hours at home, she is hooked up to a food pump providing liquid feed to her intestine via a surgically placed tube which has to be replaced every seven months.
Medical costs are an ongoing pressure for Tiahn and her family. Her nutrition supplies amount to more than $1,000 a month.
There are also bills for wraparound care provided by a dietitian, her GP (consulted weekly or fortnightly, now with no bulk billing), and a physiotherapist she sees twice weekly to prevent deconditioning due to reduced mobility.
Currently not well enough to work, Tiahn counts herself lucky that she receives $300 per week via a disability support pension from Centrelink, but it is not enough to survive on.
“I live with my parents who are stretching to support me but I
worry about the huge financial drain on them so in February of this year, I applied to the National Disability Insurance Scheme for a package just to pay for my nutrition supplies.”
Tiahn spent three exhausting months compiling evidence which included multiple letters from specialists, her surgeon and gastro team, results of medical investigations and several discharge letters confirming months spent in hospital.
“When I was informed via email two months later that I had been rejected by the NDIS, I was in hospital with an infection in my tube and the news was very upsetting,” Tiahn recalls.
She was left feeling she was being viewed as someone trying to sponge off the system.
“In fact, people with disability greatly value their independence and I am driven by the aim to be employed, self-sufficient and give back to my community by training to become a health worker.”
The NDIS in the spotlight
When the NDIS was launched in 2013 and then rolled out from 2016 to 2020, it reflected a watershed moment as its aim was to
empower individuals to choose what went into their individual support packages.
But despite recognition that the NDIS has improved quality of life for some, detractors point to inconsistencies in approvals and issues with access, especially for people in rural and remote regions. Others criticise insufficient regulation and monitoring of service providers, which has enabled poor-quality operators who may be providing substandard options.
The current federal government set up a taskforce to address this and it has made 11 recommendations and 10 implementation actions covering issues such as provider and worker registration and worker screening.
In addition, Mark Butler, the Federal Minister for Health and Ageing, has now been appointed Minister for Disability to address health supports for the 5.5 million Australians living with disability.
NSW Doctor magazine asked him about his future vision.
“The NDIS is a world leading social initiative. I aim to continue to improve it to deliver better, consistent and fair decisions that protect the safety and uphold the rights of Australians with disability, and ensure that people can
continue to live with dignity and exercise control over their future through the scheme.”
Making the NDIS stronger for future generations by providing more opportunities is part of Minister Butler’s big picture.
“I am committed to building on the work of my predecessors to put the NDIS back on a sustainable footing that never strays from placing Australians with disability at the centre of the NDIS.”
He is ensuring implementation of more co-design and consultation in order to amplify the voices of people with disability.
“Working with people living with a disability is at the forefront of the work the government is doing. Since coming into the portfolio, I’ve made it a priority to meet with as many stakeholders as possible to learn about their priorities first-hand. I’ve met consumer peak groups, unions, providers, regulators, advocates and researchers.
“By streamlining the system and focusing on what truly benefits participants, the aim is to make the experience with the scheme smoother, more supportive, and less stressful for everyone involved.”
In the past, Minister Butler has held the ministries of Housing, Homelessness, Social Inclusion, Climate Change, Water and the Environment.
He was also Australia’s first Minister for Mental Health under the Gillard Government. This extensive background had led his recent uptake of the disability portfolio to be well received in some quarters where there is hope he will progress improvements and
FEATURE
ensure greater recognition of those with mental ill health.
“Everyone has a role to play in creating a more inclusive Australia. That includes governments, service providers, the private sector, and each of us as individuals. When people living with a disability are included and supported, our whole society benefits.”
Why we need more GP input in disability care
Though the NDIS provides much of Australia’s disability support, some people need to utilise other options such as care support packages after the age of 65. In addition, people can access a range of different care plans via their GP.
“We’re extremely fortunate to have such an incredible village of medical and allied health practitioners and other support people to provide interventions under these packages,” says Dr Rebekah Hoffman, a GP and
Faculty Chair for NSW and the ACT, for the Royal Australian College of General Practitioners.
“When they work well, these options do empower and improve lives. I have a patient with cerebral palsy and her ability to attend a workplace from nine to five every day has only been possible because of her NDIS package covering a modified car and a modified work environment. It has also enabled her to access some assistance with community transport as needed.”
On the flip-side, Dr Hoffman has supported patients who experienced difficulty qualifying for the NDIS.
“People who are denied assistance may then give up and live on the poverty line or slip below it because they have no-one to help them or advocate for them.”
She also points out that the NDIS has been escalating some
Mark Butler, the Federal Minister for Health and Ageing
healthcare costs, limiting access for some consumers.
“The NDIS sets the fees and if the NDIS sets the initial fee at $1000 or they set the fee for a 15-minute session at $200, that can create astronomical costs. So, there can be reduced access for patients who are not on the NDIS, but are living with a disability.”
Dr Hoffman would like to see greater involvement of GPs in disability schemes, assessments and package choices.
Better systems of communication are also critical to help transform disability support options so that improved access and wraparound care can be provided.
“We need a safe platform for better multi-disciplinary communication between everyone involved in primary care, for example, between the pharmacist and the GP and specialist and allied health professionals. This should have secure messaging and integrated records of communication and would allow us to all communicate about patients in real time and arrange case conferences more quickly and easily.”
Tiahn also agrees that greater GP involvement would be beneficial.
“My GP is absolutely amazing,” she says.
“I see her more regularly than all of my specialists combined. She is an advocate, a keeper of all the information and the main point of communication for my care team.”
FEATURE
STRADDLING TWO WORLDS
An announcement that children with autism will no longer have access to the NDIS has left many families confused, including Brian Owler and Fiona Davies.
Our daughter, Matilda, has a giant personality and an impish sense of humour.
She particularly enjoys shutting down online meetings when working from home by simply announcing the meeting has finished and closing the laptop.
Matilda has been diagnosed with moderate to severe autism (level 3) autism and developmental delay. We were told she would not be able to talk and one of our proudest achievements is that in the last few years, her verbal skills have developed. Hard work has moved many things from the ‘never’ list to the ‘yes’ list – but much remains on the never list for her.
It feels ironic that we championed the NDIS during its implementation, establishing the AMA NDIS Taskforce in 2012.
When it was legislated, we were proud Australia had achieved such a major social reform. Later, as parents, we were grateful for the opportunities it provided.
We have been spending some time digesting the reform proposals announced recently.
Our first reaction was shock as it had initially seemed that all autism would be excluded from the NDIS.
While this has been clarified, the messaging was damaging and reinforced the sense that autism is not a real disability. There is a view, even among advocates for autism, that with hard work it can be resolved.
We have been lucky that hard work has paid off for us, but so many work just as hard and don’t get the gift of speech. That is the heartbreak of autism and it is important that policy makers understand this.
At the time of writing, there is little information available on what the reforms will mean. It is also unclear whether they will be the only changes or whether the system more broadly will receive a well-deserved review.
We appreciate the NDIS was never intended to support children with autism but has, in Minister Butler’s words, provided many parents with the “only port in a storm”.
For so many families, it has given them support they would never have been able to access or afford otherwise.
FEATURE
As the Minister outlined in his National Press Club address, demand on NDIS services has grown substantially – a 12 per cent growth in the past year alone.
We agree that taxpayer dollars are finite and we welcome rigour applied to providers and recipients. Health provides an excellent model for such an approach, with millions of services provided to a generally high standard based on evidencebased processes.
At a major Sydney hospital, a relative was told that it would be October next year before one of the 15 paediatricians would be able to assess their son. We don’t doubt access delays are even worse elsewhere.
The drive to access the NDIS comes from a simple place - the desire to make life better, particularly for our
children. The starting point of an annoucement for reform should have been what have we learned from the NDIS and how can we roll out something better. There should have been advice from experts about whether the drive for a diagnosis is always in the best interests of every child and how services and supports can be accessed more easily.
On paper, the proposed Thriving Kids program has potential, but it does not start rolling out until July 1 next year, with changes to NDIS access taking effect from mid-2027.
In his speech, Minister Butler directed parents to existing playgroups and early childcare centres providing support, but these are of little use to those in rural and regional areas, or for those who may not be health literate.
If parents don’t believe alternative pathways will deliver good care to their children, they will keep fighting to get access to the NDIS.
We would like health and disability groups brought together to build understanding and trust as there is now a clear opportunity for systemic improvements for patients, including those without disabilities, and providers.
And we look forward to this visionary move improving Matilda’s quality of life as she heads toward adulthood.
Brian Owler is a former president of AMA federal and AMA (NSW). He is an adult and paediatric neurosurgeon in Sydney. Fiona Davies is the Chief Executive Officer of AMA (NSW).
Brian Owler, Matilda Owler and Fiona Davies
Bulk Billing Is Changing. Will you change with it?
From 1 November 2025, new rules will reshape how you bill and how you’re paid.
Major changes to Medicare bulk billing are coming. Practices that fully bulk bill all Medicare-eligible patients will be able to access a new set of financial incentives.
If your practice is considering the switch, here’s the questions you need to be asking:
Will the 12.5% rebate loading offset the cost of fully bulk billing all patients?
Is our practice registered with MyMedicare and ready to advertise participation?
How will this affect our cash flow and overall business model?
Find out if bulk billing is right for you.
These changes aim to improve patient access while supporting the long-term sustainability of general practice. Now is the time to assess your eligibility and understand the financial impact on your practice.
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JUST WHAT THE DOCTOR ORDERED
The Special Commission of Inquiry into Healthcare Funding received more than 226 submissions and heard evidence from 220 witnesses over 70 hearing days. Its final report reflects everything AMA (NSW) requested, writes Director of Workplace Relations Dominique Egan
When AMA (NSW) initially met the Commissioner, Justice Richard Beasley, in early October 2023, he assured us the Special Commission of Inquiry into Healthcare Funding would not look backwards for failings and fault.
The terms of reference of the Inquiry were broad but fundamentally related to funding. In April, he delivered a report recognising the strengths of the system, identifying areas for reform and making recommendations for a stronger public health system.
When the Inquiry was announced by the Minns Government, in response to claims by the Health Services Union of waste across the health system - including spending on Visiting Medical Officers, the HSU and the NSW Treasurer advocated for an end to Visiting Medical Officer arrangements.
AMA (NSW) is very pleased to have had the Inquiry recognise the valuable contributions of VMOs and their ongoing role in the provision of services in the NSW public health system.
The Inquiry found that the NSW public health system is well managed, and is well served by
doctors, nurses and other clinicians who are well trained, highly skilled and dedicated, and importantly that additional, ongoing and quarantined funding is required if the system is to implement, embed and sustain the benefits of the recommendations made by the Inquiry.
AMA (NSW) adopted a strategic approach to the Inquiry. We focused on those areas where we have expertise, including, but not limited to, medical workforce, training of the medical workforce, primary care services and the importance of prevention, and with the assistance of Federal AMA, funding.
Careful consideration was given to what we would ask for from the Inquiry, and how we could work with the Inquiry to achieve meaningful and much needed reform.
AMA (NSW)’s asks included a timely and meaningful review of the terms and conditions (including remunerat ion) under which VMOs provide services to retain current VMOs and recruit new VMOs to work in metropolitan hospitals and regional public hospitals. For employed medical staff, we asked for a timely and meaningful review of the terms and conditions (including remuneration) under which employed medical staff
provide services to retain and recruit staff across public hospitals. The fact that Awards and Determinations setting the terms and conditions of employment and engagement for doctors do not reflect contemporary work practices was identified to be a significant issue. This includes, but is not limited to, pay disparity between NSW and other jurisdictions.
The recommendations made by the Commissioner when it comes to reform of industrial instruments reflect AMA (NSW)’s claim for modernisation of the VMO Determinations which is to be arbitrated later this year and early next year: regard be had to the value of the work that is done, the impact of terms and conditions on attraction and retention, and their fiscal and economic impacts.
The Commissioner noted the limitations of bargaining processes, which have to date focussed on remuneration, are unlikely to produce the wholesale reform required, and the forum for modernisation is the Industrial Relations Commission.
AMA (NSW) welcomes the Inquiry’s recommendation that a central workforce planning be established within the Ministry of Health,
WORKPLACE RELATIONS
which collaborates regularly and systematically with local organisations, in circumstances where the Ministry holds much of the data and allocated the funding to local organisations.
In addition to terms and conditions, recommendations were also made, inter alia, regarding Medical Staff Councils and workplace complaint and grievance processes. AMA (NSW)’s evidence before the Inquiry included serious concerns that many medical practitioners feel unable to raise concerns in the hospitals where they provide services and were not involved in decisions about service delivery and resourcing.
The Commissioner has recommended that the Model
By-Laws, which establish Medical Staff Councils and Clinical Councils, should be reviewed and amended to ensure they provide an effective and robust forum for consultation and feedback between clinicians and management. Recommendations were also made regarding the attendance of Chairs of all Councils at Board meetings.
AMA (NSW) has been advocating for the Ministry to take a greater role in workplace investigations to ensure credible and timely advice is available to local organisations regarding the conduct of investigations, and to ensure investigations are undertaken in a timely manner. AMA (NSW) provided a submission and confidential evidence to the Inquiry regarding these important
matters which cause distress to so many over and above the fact of the complaint itself. The Commissioner’s recommendations in relation to workplace complaints and grievances includes a recommendation that the Ministry take this role, and that is also monitor the time taken for the completion of workplace investigation processes.
Additionally, the Commissioner has recommended the establishment of a mechanism of review of workplace actions or decisions external to the local organisation that has taken the action and / or made the decision.
AMA (NSW) welcomes the Inquiry’s recommendation that preventative health should be, and remain
Justice Richard Beasley
WORKPLACE RELATIONS
over the long term, a standing whole of government priority, and recognitions that access to effective primary care must be a priority at all levels of government.
While the work of the Inquiry is complete, AMA (NSW)’s work continues and we will be pressing the NSW Government and the Ministry of Health to accept and implement the recommendations and findings to ensure the work of the Inquiry is realised for the benefit of all medical practitioners, patients and the health system in NSW.
It has been a privilege to lead AMA (NSW)’s response to the Inquiry. I would like to thank AMA (NSW)’s many Board members, councillors and members who gave generously of their time to provide evidence before the Inquiry
which occurred in meetings with Counsel Assisting the Inquiry, in written statements and at public hearings.
AMA (NSW)’s primary objective was to ensure the voices of medical practitioners were heard before the Inquiry and that recommended reforms ensure their voices continue to be heard in the planning and provision of services to the patients of NSW.
We have been successful in this endeavour and will continue to act to ensure this remains the case.
I would also like to thank Scott Chapman and his team at HWL Ebsworth Lawyers for their advice and assistance, as well as the advice of Kate Richardson SC and Kate Holcombe of Counsel.
It has been a privilege to lead AMA (NSW)’s response to the Inquiry.”
AMA (NSW) Director, Workplace Relations, Dominique Egan
The report was handed down in April.
WORKPLACE RELATIONS
WHEN PAID SICK LEAVE RUNS OUT
Managing sick leave can be one of the more challenging of running a practice. Workplace Relations advisor Anastasia Livanova explains how to support staff in these situations.
Every employee will get sick from time to time, but when they exhaust their sick leave entitlements and absences start becoming more frequent, it can become a real challenge.
As an employer, you want to support your staff and show empathy for their health challenges, but you also have a responsibility to ensure that operational needs are met and work continues to be completed. What should you do when an employee’s sick leave runs out? This article explains your options, outlines key legal requirements and offers best practices for managing extended unpaid absences.
How much sick leave are employees entitled to?
In most cases, sick leave and carer’s leave fall under the same entitlement known as personal/ carer’s leave. This leave can be used if an employee is ill or injured or if they need to care for an immediate family or household member who is ill, injured or experiencing an emergency.
Under the National Employment
Standards, full-time employees are entitled to 10 days of paid personal/carer’s leave each year. If an employee works parttime, they receive the pro rata amount based on their hours of work. All employees, including casuals, are entitled to two days of unpaid carer’s leave for each occasion when they need to care for, or support, a member of their immediate family or household.
What can employees do when sick leave runs out?
When an employee exhausts their paid sick leave entitlements but is still unwell, there are several options available, depending on their situation.
One option is to use other types of leave. If the employee has accrued annual leave, they may choose to use this leave to cover their absence. If the employee has no annual leave remaining, they can request to take unpaid leave. While unpaid leave is generally granted at the employer’s discretion, it is often considered unreasonable to refuse such leave when the employee is genuinely unwell and has exhausted their paid sick leave entitlements.
In cases where the illness is ongoing, the employee may request a flexible working arrangement. This could include reducing their hours, working remotely, or adjusting the type of tasks they are responsible for on a temporary basis.
If the employee needs time off to care for a sick family member, they can also take unpaid carer’s leave. What evidence can employers request?
Employers are entitled to request medical evidence, such as a medical certificate or statutory declaration, for any period of sick leave, even if it is only one day and unpaid. To ensure consistency and transparency, it is important for employers to have a clear leave policy in place that outlines what documentation is required and when it should be submitted.
Additionally, when an employee returns from an extended period of absence due to illness, employers may request a fitness-for-work certificate. This helps ensure the employee is fit to resume their usual duties without risk to their health or safety.
WORKPLACE RELATIONS
When can termination be considered?
Determining when an employee’s absence reaches a point where dismissal may be warranted can be a challenging issue to navigate and there is no straightforward answer.
Under the Fair Work Act 2009 (Cth) (the FW Act), an employee is protected from dismissal due to temporary absence from work because of illness or injury. Generally, it is unlawful to dismiss someone solely because of their illness unless they have been absent for more than three consecutive months or for more than three months in total within a 12-month period, and the employee is not on paid personal leave for the duration of the absence.
If the illness is work-related, workers’ compensation laws may prohibit dismissal within a specified protected period. For example, in New South Wales, it is unlawful to dismiss a worker due to a work-related injury within six months from the date they first became unfit for work. Even after the protected period ends, employers must proceed with caution and seek advice before proceeding to termination.
If the illness or injury is not workrelated, workers’ compensation protections generally do not apply. However, employers must still comply with the requirements of the FW Act and any relevant anti-discrimination laws which protect employees from discrimination based on their health condition and disability,
regardless of the duration of their absence.
Employers must consider whether reasonable accommodations can be made to assist the employee and determine if the employee is able to meet the inherent requirements of their role. Termination should only be considered after all these factors have been thoroughly assessed.
How to manage absences when sick leave runs out?
To effectively manage absences of unpaid leave due to illness or injury and reduce the potential for misuse, employers should implement several proactive measures.
Start by maintaining open, empathetic communication, as employees dealing with extended
illness may be under stress. Encouraging regular contact and showing genuine support fosters a positive workplace culture. It is recommended that you have a clear and well-communicated leave policy in place. This policy should explain what evidence is required when taking leave, outline the procedure for applying for leave, whether paid or unpaid and establish expectations around attendance.
Monitoring absence patterns by maintaining accurate records of when leave occurs will help to identify any recurring issues. Also, ensure that you are consistently requesting medical certificates or statutory declarations for any absences due to illness or injury. Applying this requirement consistently across all staff ensures fairness and discourages misuse. If absenteeism impacts
AMA (NSW) Workplace Relations advisor Anastasia Livanova
WORKPLACE RELATIONS
performance, address it early. Meet with the employee to discuss the situation, clarify expectations, and offer support. Be sure to document the conversation and any actions agreed upon.
Lastly, consider making reasonable adjustments for employees recovering from illness or injury. This may involve modifying duties or hours to support a safe return to work.
Key takeaways
Managing sick leave, especially when entitlements are exhausted, requires a thoughtful and consistent
approach that balances the needs of the employee with the operational demands of the practice. By fostering open communication, establishing clear policies, and implementing fair practices, you can effectively manage sick leave while ensuring the smooth operation of your practice.
If you need assistance with managing employees’ sick leave or absenteeism, contact the AMA (NSW) Workplace Relations team for tailored advice. You can contact our team on (02) 9439 8822 or via email workplace@amansw.com.au.
Determining
when absence reaches a point where dismissal may be warranted can be challenging to navigate.”
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WORKPLACE RELATIONS
REDUNDANCY DONE RIGHT: ENSURING COMPLIANCE FOR YOUR PRACTICE
Sometimes, due to changing operational needs or ongoing financial pressures, you may question whether certain roles are essential in your practice. Senior Workplace Relations advisors Joanne Choo and Anastasia Livanova help navigate the process.
In this article, we will take a closer look at whether your redundancy is considered a genuine redundancy under the Fair Work Act 2009 (Cth) (FWA), your consultation obligations under the relevant award, what steps you should avoid and practical tips to help you manage the process efficiently and with minimal legal risk to your practice.
What is a genuine redundancy?
Under the FWA, a redundancy is only considered genuine if the employer can demonstrate that:
• The role is no longer required to be performed by anyone
• The employer has complied with consultation obligations under an applicable modern award or enterprise agreement, and
• It is not reasonable in the circumstances to redeploy the person within the business or an associated entity.
In private medical practices, the consultation obligations apply from the following awards:
• Health Professionals and Support Services Award 2020 (HPSSA) –clause 34
• Nurses Award 2020 – clause 29
These consultation obligations are triggered once a practice makes the decision to implement a major workplace change which includes making a role redundant and it is likely to have a significant effect on affected employees.
The importance of consultation and considering redeployment
Practices must consult with affected employees before any final decision regarding the outcome is made. This includes:
• Notifying affected employees in writing, outlining the nature of the change, the likely impact, and any other relevant information
• Discussing the likely introduction of the change with affected employees, including potential measures to mitigate any adverse effects, and
• Promptly considering any matters raised by the employees during the discussions.
Practices must also assess whether reasonably, in the circumstances, they could have given the employee another job within the practice or an associated entity. Key considerations include:
• The nature of any available position
• The employee’s qualifications, skills and experience
• The location of the role in relation to the employee’s residence
• Comparable pay and conditions
A case example: redundancy considered not genuine
In Maria Bakermans v Hargo Pty Ltd T/A Citywest Gastroenterology [2020] FWC 6238, the Fair Work Commission (FWC) ruled that a medical transcriptionist’s dismissal was not a genuine redundancy, despite evidence the role was no longer required.
The practice failed to comply with consultation requirements under the HPSSA. No written notification was provided, and the practice relied solely on two telephone calls with the employee where she was merely informed that her role would be no longer required due to an economic downturn, with no further discussion, as the basis for claiming that genuine consultation occurred. Through their failure to consult properly, it was also determined they were unable to properly consider
WORKPLACE RELATIONS
redeployment opportunities, despite it being a small practice.
The FWC found that it was not a genuine redundancy and ultimately deemed it an unfair dismissal.
This case highlights the importance of genuine consultation even when the operational justification for redundancy is valid.
What not to do
Avoid raising performance or conduct issues, leave history or any other personal circumstances such as illness during the consultation or in the lead-up. Doing so may cause the employee to speculate as to whether it is a genuine redundancy and may also give risk to either an unfair dismissal claim or general protections claim.
Redundancy entitlements
Redundancy entitlements are governed by the National Employment Standards. For a small business employer (with fewer than 15 employees), no redundancy payment is required.
For a non-small business employer (with 15 or more employees), redundancy payment is owed to part-time and full-time employees with at least 12 months of continuous service, calculated based on length of service.
In addition to standard entitlements such as notice period and annual leave, an employee may also be entitled to a pro-rata long service leave payment if they have between five and 10 years of service.
Key takeaways
Before making a definite decision regarding redundancy, prepare a business case that supports why the role is no longer required, issue written notification of the changes and engage in meaningful consultation with affected staff and genuinely consider redeployment opportunities before finalising redundancy.
By taking a compliant approach, you can ensure redundancies are managed lawfully.
The AMA (NSW) Workplace Relations team is here to guide you through redundancy considerations with tailored advice and consultation letter templates. Please email workplace@amansw. com.au or call (02) 9439 8822.
Employers are entitled to request medical evidence for any sick leave, even if it is only one day and unpaid.”
Dr Louise Woodward Member since 2003
A BUDGET BLIND TO CRISIS: NO PLAN, NO PROGRESS
This year’s NSW Budget, handed done in June, was deeply disappointing for public health staff and their patients, and provides no real vision for the future, writes Isabella Angeli
Staff across the health system have been sounding the alarm for some time. Yet, despite clear and growing evidence of rising demand, stretched services and an exhausted workforce, the 2025/26 NSW Budget failed to deliver any meaningful investment to stabilise and sustain the health system, both now and into the future.
The NSW Government has committed $3.3 billion in the budget to building and upgrading hospitals - but this capital spend is not matched by investment in the workforce needed to operate them.
For frontline doctors, nurses, and allied health professionals, it is a deeply disappointing outcome, one that ignores the people who hold the health system together and instead values bricks and mortar.
The strain the system is under can be seen from recent reports out of western Sydney, with patients waiting up to a year for cancer diagnoses, and newborns being cared for in storerooms due to a lack of space. Meanwhile, some local health districts report being up to $100 million over budget, resulting in recruitment freezes, bed closures, and service suspensions, all while demand continues to rise.
The Bureau of Health Information’s latest report (January-March 2025) lays out the dire state of play in NSW public hospitals.
Elective surgery waiting lists have surged to more than 100,670 people, approaching the record highs seen in the pandemic when elective surgery was cancelled. Of those waiting, over 8,500 patients are waiting longer than clinically recommended, a staggering 151 per cent increase from the previous reporting quarter.
The budget’s one-off $23 million to reduce elective surgery waitlists will barely scratch the surface. Without sustainable, ongoing funding, the backlog will continue to grow, and patient suffering will deepen. Worse still, there was no meaningful investment in preventive health in this state budget, a key strategy proven to reduce long-term demand on the hospital system.
This budget ignores the key findings and clear recommendations from the recent Special Commission of Inquiry into Healthcare Funding (SCOI). Findings from the inquiry:
• There is inadequate or timely access available to primary care, and a failure to embed prevention care into the system.
• The funding available to some parts of the system is insufficient, including that available to local health districts.
• Planning processes have tended to be driven by the needs of capital processes, infrastructure and prioritisation of limited capital funds. This “bricks and mortar’” approach is problematic.
• There are parts of the health workforce suffering from burnout, and most of the awards and other instruments setting the terms and conditions of employment for health workers do not reflect contemporary work practices.
Recommendations from the inquiry:
• Preventative health should be made, and remain over the long term, a standing whole of NSW Government priority.
• With expert guidance, NSW should reformulate the funding model and devise appropriate funding structures to deliver that system and not assume that any historical “base” figure provides a reliable or appropriate starting point.
• There should be an award reform process conducted by the Industrial Relations Commission of NSW.
• NSW Health must be funded
POLICY AND ADVOCACY
adequately to implement, embed, and sustain into the future the recommendations made in this report.
Five-point plan towards success
AMA (NSW) has put forward a fivepoint plan to improve the system for doctors and patients:
1. We need a greater focus on preventive health measures: make a greater, long-term commitment to preventative measures such as a sugar tax.
2. We urgently need more funding for public hospitals: lift Federal Government contribution from 37 per cent to 50 per cent.
3. We need more consultant positions in public hospitals: there are doctors available and keen to work, we need
funding to create more positions.
4. We need service planning with more consultantled surgical services: senior doctors have unique expertise and must be at the forefront of service planning.
• We need modernised industrial arrangements to attract and retain doctors: AMA (NSW) is arbitrating in the IRC this year for modernised working conditions for visiting medical officers.
For frontline doctors, nurses and allied health professionals, it is a deeply disappointing outcome.”
Conclusion
This budget is not the blueprint for a stronger, more resilient health system; it is a missed opportunity.
Investment in the health system doesn’t stop at infrastructure. Patients need timely access to care delivered by wellsupported, properly resourced teams. Investment in workforce, prevention, and effective service design is essential.
The NSW Government cannot build its way out of the crises the health system is facing. We need to see funding priorities adequately address rising demand, stretched services and workforce concerns, or patient outcomes will continue to be jeopardised.
POLICY AND ADVOCACY
UNTANGLING THIS WEED
Isabella Angeli looks at the importance of regulation for medicinal cannabis.
In 2016, the Turnbull government passed historic legislation, legalising access to medicinal cannabis in Australia.
According to the latest data from the Australian Health and Wellness Institute, in 2022-23 around 700,000 people, equating to 3 per cent of Australians, used cannabis for medical purposes within the previous 12 months.
While this product has provided relief to many, health professionals have serious concerns regarding its regulation.
The Australian Medical Association (AMA) is calling for robust oversight of the medicinal cannabis industry to tackle rapidly increasing prescribing patterns.
Loopholes being exploited
Recent media reports have highlighted an explosion in the number of prescriptions being issued, with some allegedly exploiting the Therapeutic Goods Administration’s (TGA) Special Access Scheme (SAS) and Authorised Prescriber Scheme (APS).
These schemes are necessary and allow doctors to provide access to certain specialised unapproved therapeutic goods to patients who are very ill.
Alarmingly, there have been reports of prescribers issuing medicinal cannabis prescriptions at unsustainable rates, in one instance up to one prescription every four minutes.
The AMA views this trend as deeply troubling, especially given that a significant proportion of these scripts involve high-THC (tetrahydrocannabinol) products,
Polestar
Artarmon
POLICY AND ADVOCACY
and suspects that prescribing rates are potentially outweighing likely clinical reasoning.
Online clinics booming
The growth in telehealth companies offering medicinal cannabis scripts has significantly contributed to the rise in prescriptions.
The AMA is concerned that part of this prescribing boom within the medicinal cannabis industry is being operated through online direct-to-consumer models of care, in a way that is not conducive to appropriate healthcare. In many cases individuals complete a quick online form with a potential consultation, before receiving a prescription.
This is not healthcare, this is an abuse of loopholes, coupled with exploitative marketing tactics that in some cases breach TGA advertising guidelines, and prey on vulnerable individuals.
Vertically integrated healthcare
Another area of concern is the rise in vertically integrated business models.
In these arrangements, a company that may own the prescribing software and the online environment stands to make a profit in the distribution of the products that are being prescribed. This is not usual practice in the healthcare, it is a real conflict of interest, and the AMA is concerned about the pressure being placed on practitioners to issue large volumes of scripts out to patients.
AMA is calling for robust reform
As the medicinal cannabis industry evolves, the AMA is calling for robust regulation of the industry to tackle the highly concerning and rapidly increasing prescribing rates.
The AMA has recently made a submission to the TGA’s targeted consultation on proposed measures to enable the sharing of information with other regulating relating to therapeutic goods accessed via the unapproved therapeutic goods framework.
This should make it easier for regulators to address the exploitation of the SAS and APS by vertically integrated, direct to consumer telehealth entities, including the medicinal cannabis industry.
The AMA has also recommended the TGA considers reforms to how unapproved medicinal cannabis
The current regulatory framework is not keeping pace with the commercialisation of medicinal cannabis. There is a concerning rise in prescribing motivated by profit, rather than patient need.”
AMA president Dr Danielle McMullen
products are accessed beginning with a review of the categories of medicinal cannabis products, and the complete removal of category 5 products with a THC content greater than 98 per cent while the review is conducted.
We will continue to update members as this area evolves.
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UNLOCKING AUSTRALIA’S POTENTIAL
Access to innovative medicines in clinical trials is just one part of the equation – we also need to look at timely access to medicines on the Pharmaceutical Benefits Scheme, says Pfizer Australia and New Zealand medical director Dr Krishan Thiru.
Australia, with its robust research infrastructure, streamlined regulatory framework, and supportive government policies, has emerged as a prime destination for conducting cutting-edge cancer clinical trials.
Collectively, these factors have led to a 40 per cent increase in the number of industry-funded clinical studies in Australia between 2008-2019.1
Per capita, Australia leads the world in number of clinical trials and was also among the top five countries in the world to regain the pace of new trial starts following the COVID-19 pandemic.2
Becoming a world leader
Three critical factors contribute to making Australia fertile ground for clinical trials: supportive government policies, streamlined regulatory processes, and worldclass research infrastructure with a skilled workforce.
The Australian government has introduced the National OneStop-Shop for medical research, designed to streamline health and medical research through a single, national approvals and data system for clinical trials. The goal is to reduce duplication in application processes by 50 per cent, cut the Clinical Trials Notification process by 35 per cent, and reduce trial registration timelines by 60 per cent, all of which will be particularly useful for organisations conducting multicentre clinical trials across different Australian states and territories.
REFERENCES:
Secondly, Australia offers targeted initiatives and special processes to expedite early-phase clinical trials with the authorisation process for a Phase 1 study shortened to as little as four to six weeks, compared to months or longer in some other countries. This is facilitated by the Clinical Trial Notification and Clinical Trial Approval schemes, which streamline the approval process for low-risk trials.
Lastly, Australia has world-class research institutions, public hospitals and private centres to run clinical trials.
Taking the next step
But what does this mean for your patients? Australian patients benefit from clinical trials by accessing cutting-edge treatments, receiving highquality healthcare, contributing to medical research, saving costs, experiencing personalised medicine, and gaining enhanced patient education. But what about after the trial concludes?
Faster access to medicine
Access to innovative medicines in clinical trials is just one part of the equation – we need to look at timely access to medicines registered by the Therapeutic Goods Administration.
Providing ongoing access to clinical trial medicines is crucial for patients. Without a supportive system that provides subsidised access to medicines under the Pharmaceutical Benefits Scheme,
patients who have benefited from clinical trial medicines could face disruption to their care.
It takes on average 466 days for a medicine that has been deemed safe and effective by the TGA to be funded on the PBS. That is 100 days slower than the OECD average and 300 days slower than developed markets, such as Japan, Germany and the UK. Medicines Australia is advocating for that time to be reduced to 60 days.
Australia’s PBS pricing of medicines does not fully reflect the value of innovative medicines or fairly contribute to the costs of research and development.
By reforming the system, we can ensure that it keeps pace with the rapid scientific advancements we are seeing, that Australia remains a wave-one launch country, gives patients ongoing access to the best available medicines, and better recognises the full value and wider benefits of innovative medicines, such as productivity gains, tax revenue, and social welfare impacts.
Breakthroughs cannot save lives if they do not get to the people who need them when they need them. At Pfizer Australia, we know that time is life . And for Australian patients waiting for breakthroughs, each and every day counts.
If you’re interested in learning more about the Stronger PBS campaign, please visit www.strongerpbs.com.au.
1. Australian New Zealand Clinical Trials Registry. (2019). Annualreport:2019 . Retrieved from https://www.anzctr.org.au
2. MTPConnect. (2024). Australia’s Clinical Trials Sector . L.E.K. Consulting Australia Pty Ltd. Retrieved from [www.mtpconnect.org.au/clinicaltrials2024] (www.mtpconnect.org.au/clinicaltrials2024)
50 YEAR MEMBERS’ LUNCH
ON THE SHOULDERS OF GIANTS
Professor Michael Besser’s parents, Wolf and Sara, survived Auschwitz.
They had “a grief that would never end” but they never lost their ability to show compassion and empathy.
Their fierce determination to rise above the worst of humanity became Professor Besser’s driving force in medicine, his raison d’etre each and every day.
In June, Professor Besser was one of 137 AMA (NSW) members
honoured at a special luncheon at NSW Parliament House for supporting us for 50 years or more.
In 1975, medicine was vastly different. The tools, the treatments, even the expectations were different.
“We lived and worked in a golden age,” Professor Besser told the audience.
“We had great teachers, they taught us critical thinking and clinical reasoning, but also ethical decision-making, with empathy and
compassion for your patients. This is so important today in a world of social media, fake news and AI.”
We would like to extend our sincere gratitude to all those who attended this year’s celebration.
Your enduring commitment to integrity, excellence and improving the health system has never wavered, and we are grateful for your leadership, mentorship and the example you have set for those coming behind you.
50 YEAR MEMBERS’ LUNCH
MEMBER FOCUS
BIRTH OF AN ADVOCATE
Earlier this year, Sydney registrar Jessica Teoh was named the 2025 NSW Young Woman of the Year for her work as a domestic violence advocate. She talks to Elisha Mistry on her plans to change the system for the better.
While volunteering for the St Vincent de Paul Society in her teenage years, Jessica Teoh saw firsthand the devastating impact of domestic violence.
Later, when someone she knew fell victim, she made a decision to advocate for change.
Now an obstetrics and gynaecology registrar at Royal Prince Alfred Hospital and a volunteer grant writer for Hornsby Ku-ring-gai Women’s Shelter, Dr Teoh has become intimately familiar with the social barriers impacting women’s health and is determined to use this knowledge to implement effective changes in our clinical spaces.
“Domestic violence doesn’t discriminate, it can effect anyone; doctors, colleagues, family members, loved ones,” she says.
“It is the leading cause of homelessness in women, even more than smoking or drinking.”
The non-government organisation DVNSW reports that NSW police receive about 2500
reports of domestic violence every month, but this possibly represents only 40 per cent of actual incidents.
It also reports that women who experience partner violence during pregnancy are three times as likely to experience depression and other physical and psychological harms, and are more likely to experience injury to their trunk than other women.
During her time as a Churchill fellow, which involved travel to six countries, Dr Teoh identified early pregnancy as a particularly vulnerable time for the intensification of domestic violence incidences.
In response, she pioneered the introduction of domestic violence screening to Early Pregnancy Assessment Service clinics in Sydney Local Health District with hopes of expanding the program statewide in the coming years.
“Ideally, if our system is well trained, patients will access that support and feel validated in their experience. Domestic violence screening is short and virtually free, so implementing it is a no brainer.”
When first investing time in women’s healthcare, Dr Teoh noted the duality of biological and social factors in holistic wellbeing and aptly summarised that “being able to provide healthcare is only part of the solution” for socially vulnerable patients.
She settled on obstetrics and gynaecology after two years of residency, hoping the unique skills and scope would allow her to aid women left behind by the system.
“Awareness of domestic violence signs has improved, but programs focusing heavily on identification may underplay the importance of forming safe and supportive environments that persist beyond periods of acute distress.”
Instead, she hopes to see continuity care models involving social workers, nurses, midwives, perinatal mental health clinical nurse consultants and psychologists, recognised for their ability to support the ongoing physiological and social needs of patients.
“That initial disclosure is really important,” Dr Teoh says. “In an ideal world, patients, especially women, feel safe in the healthcare system to freely disclose domestic violence and access support as needed.”
MEMBER FOCUS
2025 NSW Young Woman of the Year and registrar Dr Jessica Teoh
MY PRACTICE
TAILORED ADVICE THAT SAVED THOUSANDS
AMA (NSW) is committed to helping advance our members in private practice, whether they are established or starting out. In this edition, we talk to GP Tom Hilliar about the support he has received thanks to some valuable advice from his father.
Tom Hilliar’s general practice in Kiama Downs had been established for 40 years when he took over the reins in 2016.
His father, also a general practitioner, was a member with AMA (NSW) for 17 years and immediately encouraged him to join.
“My father always said he had a long and productive history with the AMA, where they helped with various workplace relations issues. He said it was just invaluable.”
Dr Hilliar held off initially but now says “I regret not joining AMA in the beginning. I could have saved myself $40,000 to $50,000 in employment battles”.
Soon after purchasing the practice, Dr Hilliar learned he had inherited some “crappy contracts that were not well set up”.
“I followed my father’s advice and reached out to AMA (NSW). At the time, there was some inflexibility from team members, but AMA (NSW) advised me to spell out what I expected in the employment contracts and talked me through difficult discussions with staff about work hours.”
Dr Hilliar says a short phone call
or email with the AMA (NSW) Workplace Relations team gave him the type of guidance he needed.
“And it saved us from spending hours of wasted time. Instead, we nipped the problems in the bud, and it made us a more capable employer. Our practice is now thriving. I have a really happy, upbeat team who are doing so well. I’m super happy and so are they.”
And he has some good advice for colleagues starting out in private practice.
“If you are not set up right from the beginning, and you don’t get your documentation right, everything can go really bad. Sure, you can go to a Fair Work website for advice but it is so dense.
“AMA (NSW) provides tailored advice and narrows down the key points. Essentially, they told me what to focus on, so I wasn’t wasting time on other less crucial matters.”
He recalls that he once had a staff member struggling at work.
“I needed to know how to handle that. If I hadn’t got the right advice, the situation would have been much worse.”
Dr Hilliar also faced a situation where he had determined a staff member needed to be moved on, but after working with the AMA (NSW) Workplace Relations team, the issue was resolved, the staff member stayed on and has done very well.
He believes joining is the first step for independent advice.
“It’s a risky move to be in a medical practice and not have an AMA
MY PRACTICE
membership. It feels mandatory for setting up or taking over a practice and then continuing to run it.
“I have a membership with AMA so that I can use their advice when making key decisions and actions involving any member of my team.
“In medical practice, it’s a fundamental basic block of
running your business and I think people are silly not to do it.”
Dr Hilliar also participates in AMA (NSW) workplace webinars, aimed at giving those in private practice the tools they need to run their business.
“The cover complex topics in general practice that I wouldn’t be aware of otherwise,” he says.
We nipped the problems in the bud and it made us a more capable employer.”
Dr Tom Hillar runs the Kiama Downs Medical Practice, 31 Johnson St, Kiama Downs. He has special interests in paediatrics, child health, adolescent health, pregnancy care, fertility problems, dermatology and mental health. He trained in Sydney (MBBS, UNSW) and has completed a Diploma of Paediatrics (University of Sydney).
He is a Fellow of the Royal Australian College of General Practitioners.
THE CALL OF THE CONFERENCE
It can be challenging to take time away for in says connecting through shared purpose, says Katherine Hutt
As doctors, our relationship with time is complicated. We’re often racing against it - juggling multiple problems within brief consultation slots, squeezing in teaching when we can, and holding onto the faint hope that we might get home on time.
When the workload is relentless, attending a conference can feel unrealistic - even indulgent.
There’s the guilt of leaving colleagues to cover patients, the anxiety of an overflowing inbox, and the temptation to keep going.
The Australasian Doctors’ Health Conference will take place in Melbourne this November. It’s a conference I’ve been looking forward to - not only for the content, but for the communityand it prompted me to reflect on the broader role that conferences play in our medical lives.
Meet in Melbourne for content and community.
DOCTORS’ HEALTH ADVISORY SERVICE
Conferences are often marketed as continuing professional development - ticking the CPD box, collecting hours, staying current. Yet, some of the most valuable experiences happen outside the formal program.
Conversations over coffee, shared insights, and spontaneous connections often matter more than any scheduled session.
The Australasian Doctors’ Health Conference is a great example of this kind of opportunity. Convened by the Doctors’ Health Alliance, it brings together clinicians, researchers, educators, and advocates from across Australia and New Zealand who are working to build a healthier profession.
The 2025 theme, Promoting Great Medical Culture: People, Peers and Places, encourages reflection not only on individual wellbeing, but also on the relationships and
Conversations over coffee, shared insights and spontaneous connections often matter more than any scheduled session.”
environments that shape our working lives.
There are many other conferences that offer the same sense of shared purpose and connection. Being in a room with others who understand the nature of our work can be energising. These moments remind us that we’re not alone.
Not every event will feel like the right fit. Large conferences can be overwhelming, particularly early in a career or when attending alone. Even so, showing up can make a difference. A quiet conversation,
AUSTRALASIAN DOCTORS’ HEALTH CONFERENCE 2025
a meaningful session, or time to reflect can shift our thinking in unexpected ways.
The most rewarding conferences are not competitive or intimidating. They’re welcoming, generous, and kind. They offer places where conversations start easily, where new connections are made, and where people leave feeling supported and part of their professional community.
Maybe this year, that conference could be the Australasian Doctors’ Health Conference.
The Doctors’ Health NSW 24/7 phone line (02) 9437 6552 is here to support all doctors and medical students to prioritise their own health. Whether you need advice on finding the right GP or simply someone to talk to, calling Doctors’ Health NSW can be a first step towards better self-care.
Promoting Great Medical Culture: People, Peers and Places
JOIN US FOR THE ADHC 2025 CONFERENCE
The theme of this year’s Conference is ‘Promoting great medical culture –People, Peers and Places’. For almost 30 years, this has been the biennial gathering of medical leaders, program directors, hospital, private practice and community doctors, health professionals, government
Dates 27, 28 and 29 November 2025
Location 1 Hotel Melbourne, 9 Maritime Place, Docklands VIC 3008
agencies and researchers all involved in improving the health of doctors and medical students across the country.
The conference will be collegial, productive, and guided by the DHA’s vision of enthused and engaged
Registrations Book your ticket now to secure your place by scanning the QR code >
doctors: with safer practice, safer workspaces, and better outcomes for the diverse communities we serve.
MEDICAL BENEVOLENT ASSOCATION
EXPANDING PARTNERSHIPS TO NAVIGATE UNCERTAINTY
In recent years, more doctors have been turning to the Medical Benevolent Association of NSW-ACT for support as they grapple with burnout, regulatory pressures or personal crises, Louise Fallon writes.
Many doctors begin to question their clinical roles or consider career changes when their circumstances force a reassessment of their professional direction.
Now, the Medical Benevolent Association of NSW-ACT has enhanced its existing support counselling services by partnering with Dr Ashe Coxon, a GP and career counsellor.
Dr Coxon also founded Medical Career Planning in 201, which shares similar values with MBA and aims to support healthcare professionals in identifying their core values, strengths, and interests when facing career dissatisfaction or indecision.
Personalised career counselling
Dr Coxon offers personalised career counselling via Zoom, typically in one-hour sessions. These begin with understanding the doctor’s goals and then exploring suitable career paths - whether within clinical practice or in non-clinical roles that better align with long-term wellbeing. Sessions may also include job search advice, CV preparation, or interview coaching.
For doctors in financial hardship, MBA may offer up to three fully funded sessions, with Medical
Many reported renewed clarity, purpose and confidence.”
Career Planning providing these to MBA at a discounted rate.
To further support doctors, MBA has secured lifetime access to two of Medical Career Planning’s most popular self-paced online courses. “Discovery” is designed to help doctors reflect on their values and motivations and develop clarity about their future direction, while “Non-Clinical Non-Medical Careers” provides practical information for those considering roles outside clinical medicine, including retraining pathways and how to present transferable skills.
In 2024, the first year of this partnership, 10 doctors accessed 23 fully funded counselling sessions, with overwhelmingly positive feedback. Many reported renewed clarity, purpose, and confidence in their career choices.
On the road
Dr Coxon also travelled with us to Dubbo and Orange as one of our main presenters for the successful REFLECT AND CONNECT Workshops for regional doctors in September 2024.
MBA’s social workers work alongside Dr Coxon, to ensure doctors feel supported, empowered, and better equipped to make informed, values-aligned decisions about their future professional directions, with their own wellbeing at the forefront.
If you want to access our support services, please call 02 9987 0504 to speak to our experienced social workers. If you would like to donate to MBA NSW-ACT so they we can continue to assist doctors experiencing hardship or adversity, please go to our website mbansw.org.au or scan the QR code.
Dr Ashe Coxon
RURAL DOCTORS’ NETWORK OVERCOMING THE TYRANNY OF DISTANCE
Working rurally can feel isolating when training and networking opportunities seem distant. But now, there is a new app to help, write Theo Clark and Jessica Rostas.
Working as a rural health professional is rich with rewards and country people will tell you that dedicated doctors, nurses and allied health professionals are some of the most valued members in the fabric of a community - and their gratitude shows.
All of this on top of the lifestyle benefits of living in coastal, mountain or country areas of Australia.
Nevertheless, for all this richness, the experience of rural practice can feel isolating and capability can suffer when training and networking opportunities seem distant.
With this in mind, Rural Doctors’ Network (RDN) launched a new social enterprise in 2020 called Rural Health Pro. It seeks to connect, support and inspire health professionals and organisations that care about rural communities.
Through a unique partnership approach, its digital hub and mobile app provide information, resources, and training opportunities, supporting the capabilities of rural health professionals.
The initiative featured in the Australian Digital Health Agency’s National Digital Health Strategy (2023-2028) and new research in the Australian Journal of
Rural Health confirms that it has enhanced the capability of rural health professionals. Titled, Rural Health Pro—A Digital Platform Connecting Rural People, Organisations, and Communities, the study corroborates literature about the role of digital technologies in overcoming geographical barriers and fostering community among health professionals in rural settings.
Enhanced access to multidisciplinary professional learning and upskilling, fostering cross-field collaboration, knowledge sharing, and an
to professional development, fostering a sense of community and contributing to a more capable and resilient rural health workforce.
“Many participants lacked access to face-to-face education, training, and continuing professional development, which they identified as a significant barrier to their capability,” said the report’s author Robyn Ramsden.
“This is significant because the most cited factors that negatively influence health professionals’ retention in rural and remote
Rural Pro presented a viable solution to geographical isolation.”
integrated approach to healthcare education and practice were also identified as benefits of Rural Health Pro.
The research confirmed the role of Rural Health Pro in supporting the mental health and community engagement of rural health professionals, highlighting its pivotal role in reducing professional isolation and enhancing the overall wellbeing of healthcare providers. It found Rural Health Pro presented a viable solution to geographical isolation by enabling access
areas include lack of access to professional development, feelings of professional isolation, and psychosocial and personal factors.”
The success of Rural Health Pro demonstrates how modern innovation can overcome the “tyranny of distance” to make a rural health career even better.
Multidisciplinary rural health practitioners are invited to become members and join the knowledge exchange and support network today.
One of Sydney’s biggest hospitals sounded the alarm on their dysfunctional department. Patients should not be waiting a year for a cancer diagnosis due to an under-funded and under-resourced public health system.
Dr Fred Betros: SMH Front Page June 21st.
Dr Fred Betros: SMH Front Page June 8th
Dr Michael Bonning: ABC News May 30th
IN THE NEWS
Could a combined flu and COVID vaccine lift immunisation rates?
They’ve seen mental health care pushed to breaking point, and are sounding the alarm
Dr Anju Aggarwal: The Daily Telegraph July 2nd
Dr Michael Bonning: ABC News June 30th
Dr Ken McCroary: ABC News June 27th
Dr James Lawler: Four Corners June 2nd
Dr Karen Austin: ABC News Top Story June 26th
Health district CEO steps down in lead up to vote of no confidence by Westmead Hospital doctors
Dr Fred Betros: SMH Front Page July 5th
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LETTER TO THE EDITOR
BORN HERE, WORKING HEREBUT STILL LEFT OUT
In our new Letter to the Editor column, Albury GP Elizabeth Farrell speaks out about HELP debt.
I’m a GP living and working in Albury, where I was born and raised.
After graduating from Albury High in 2003 and working as a nurse, I studied medicine as a domestic full fee paying student, accruing a $155,000 HELP debt.
Despite repaying $85,000 over 10 years, I still owe $117,000 due to indexation.
I returned to Albury in 2022 to serve my community - but because the town is classified as MMM2, I’m excluded from rural workforce incentives like HELP debt reduction.
This policy gap undermines efforts to recruit and retain doctors in regional centres like Albury.
We face critical GP shortages, yet
we’re not “rural enough” for support.
My father has been a GP here for over 40 years. We now work side by side at Gardens Medical Centre, built on the site of the old hospital where I was born.
My family has lived in this region for nearly 200 years, arriving in Australia as ship’s doctors.
Medicine is in my blood, and this land is home. If a home-grown country doctor doesn’t qualify for rural return incentives, who does?
We need a system that values lived rural experience - or we risk losing doctors.
~ Dr Elizabeth Farrell FRACGP, MBBS, BNurs | Albury, NSW
Dr Elizabeth Farrell
If you would to air your views, please send a short email (200 words or less) with your contact details to news@amansw.com.au.
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