Have you renewed your membership of NASOG for this year? If not, I want to ask you to seriously consider rejoining the association at this crucial time in the evolution of our specialty.
Obstetrics and gynaecology as we know it, is under threat.
The spectre of managed care has never been a more obvious or prominent threat to Australia’s health system and moves are underway by a number of private health insurers and private hospitals to implement this failed American model in Australia.
The Federal Government has long undervalued the cost of providing specialist women’s health services. The Medicare rebate freeze, as well as longstanding lack of indexation, means that for many women, private medicine is simply becoming too expensive.
Enter the managed care providers with promises of no out of pocket costs to patients and full hospital wards to private hospitals. But delivering only clinical interference, loss of choice for patients and indentured servitude for doctors.
Overseas experience shows that after a grace period, managed care also stops providing cost containment and certainty, leading instead to unsustainable increases in the cost of providing health care.
While this may appear to be an issue initially only affecting private medicine, this scenario can (and will if allowed to continue) impact the public sector as well.
More than 70% of Australian trainees will have to find work in the private sector when they finish their training. If private O&G ceases to become a viable employment model, junior doctors will realise their post training options are limited and stop applying for one of the longest training programs in medicine.
This will eventually lead to community shortages (beyond our current maldistribution with oversupply in urban areas) and increased closure of regional and rural units as GP obstetricians will be unable to attract consultant back up.
The reduction of O&G services in regional areas will mean women travelling long distances to large urban units to receive specialist care.
To date, Government has been reluctant to assist and our role is to help them understand why more needs to be done to protect O&G as a specialty. The provider of women’s healthcare.
NASOG is continuing to lobby on the profession’s behalf to look at alternative funding models to help keep private obstetrics alive as well as providing input into the gynaecology item number debate. Prior to COVID, discussions with the Chief Medical Officer finally reached agreement that unless something substantial was done soon, private obstetrics would go under. Leaving the women of Australia without choice and an already overburdened public sector dangerously stretched.
Another challenge is the ongoing task substitution agenda, with the mistaken thinking that pharmacists, nurses, midwives, paramedics and physiotherapists can diagnose and prescribe without appropriate training. We all know that this solution will only make running a specialist practice less sustainable and more costly, acting as a disincentive to specialist Obstetricians and Gynaecologists and ultimately leave the women of Australia at risk because of less skilled service providers.
The College has safety, standards and training as its central purpose and the AMA looks after issues as they apply to the entire medical profession. Only NASOG can specifically and solely look after the best interests of Obstetricians and Gynaecologists in Australia. NASOG liaises closely with these organisations but remains the main body in the advocacy space for O&G’s and their patients.
There has never been a more important time to be a financial member of NASOG. Your fees give us the resources we need to continue fighting for your rights.
If you have not already done so, please click on the link and rejoin today.
A/Prof Gino Pecoraro