Fighting for public health

This edition marks my 10th year as CEO of AMA (NSW) and, as such, it is inevitable that such an anniversary gives pause for reflection about the conditions that have changed and those that have stayed the same.

What has stayed the same is the strength of our commitment to advocate for doctors and patients. There is still no other organisation with the reach, political connections and public credibility to speak on behalf of healthcare matters. When the AMA does not do this, the vacuum is obvious, and the impact is profound.

We are still the organisation best able to speak for the entire profession – whether it is GPs, doctors-in-training or other specialists, or even our medical student members. I am constantly told by doctors that the AMA represents everyone but their particular interest. I can assure you that this is not the case. We have strong voices in the AMA for all types of specialties. While it is easy for special interest groups to speak for their members, the reality is that voice is rarely effective; politicians know they do not get a good return when they only consider one doctor interest group. Time and time again, Governments come back to the AMA to find out what the health system as a whole will think about a particular issue.

One thing that some doctors think has changed, is that we now focus on issues that they consider to be outside the direct interests of medical professionals. We have had a few doctors express concern about the AMA’s advocacy on so-called ‘social issues’ and complain that the AMA should just get back to its core focus.

There are many problems with this argument. The first being that doctors, and the AMA, have always been leading advocates on public health issues. Those issues have evolved as evidence of associated harms have been brought to light. Campaigns on smoking, seat belts and drink driving are good examples of this. And, in years to come, I am confident that issues such as marriage equality, climate change and refugee health will also be considered obvious concerns for the AMA to publicly campaign on.

However, doing the right thing and standing up against those things which harm the health and wellbeing of our community is not the only reason we talk about public health. We do it because if the only thing the AMA ever talked about was payment for doctors, people would very quickly stop listening to us. When the community has seen us as a creditable voice on issues they care about, we know that when we need to talk to them about issues which can be seen as impacting on doctors’ incomes, they will listen. This thoughtful, credible voice has become even more important in recent years as we move more of our advocacy to social media. We know that social media gives us an extraordinary platform to communicate directly with patients in a way that we could never have done through just mainstream media alone.

Effective social media drives engagement in the form of ‘likes’, ‘shares’ and ‘views’. If we create content and a user likes or shares it, even if they don’t follow the AMA (NSW) page, they are still more likely to see content from us in the future. While this may sound like strange and magical thinking, it works. Take the recent example of marriage equality. We made a Facebook video that featured former AMA Presidents talking about why they – and the AMA – supported marriage equality as a health issue. The video was viewed more than 35,000 times. Communication through Facebook allows us to reach an audience we would ordinarily struggle to find – younger people. Our largest group of followers on Facebook are women aged 25-34 and 18-24, respectively.

Fast forward to March 2018 and a post by AMA (NSW) Councillor Dr Fred Betros on Bupa goes viral, thanks to a signal boost from AMA (NSW). More than 200,000 people saw Dr Betros’ post over one weekend. We then leveraged this with subsequent posts and found a mechanism to get at Bupa where it matters – younger, healthier consumers.

And continuing to reach people in these demographics is going to become increasingly important going forward, because we know the face of medicine is changing and that more women than men are in medical school.
So, our message is simple: for decades, the AMA has stood up for doctors and patients. Our work makes a difference and without us the profession would be far weaker. We will continue that advocacy for decades to come and we will always stand up for the profession and for patients. To those doctors who support us in that work, thank you. To our non-members, we hope you take the time to think about the future and to join with us in helping to shape what that future will be.