A Reflection on 2020

As this year draws to a close, I would like to thank you all for your support of NASOG throughout 2020 and acknowledge the challenges we have all faced and dealt with during this unique time.

As demonstrated by the number and content of the “president’s articles this year, NASOG has been tirelessly working to bring attention to the issues that are impacting Obstetric and Gynaecology practice in Australia today. Our aim is to inform both members of the profession, the community and decision makers in government so that where needed, improvements can be made to the service we can offer to our patients and ensure that women have choice in accessing their care

In February, NASOG was an integral part of a body of work with the Federal Department of Health bringing together a wide range of stakeholders to start work on a solution to increase the viability of private obstetrics. While there was a lot of momentum behind this, the project has been slow to progress as a result of COVID-19 but we fully intend to keep the minister and the department’s collective minds focussed on this very important issue.

Our response to the Department’s ‘Future of Private Obstetrics’ discussion paper was widely circulated and supported mid-year forming the basis of submissions from various other groups including some private hospitals and College., demonstrating NASOGs leadership position on issues that relate directly to our members ability to continue in practice.

With an increasing number of private obstetric units closing across the country, in 2021 we will continue to press the Government to reconvene the stakeholder group and make some real strides in supporting private obstetrics. Our discussion paper is available to all members on request.

A key part in bringing patients back is the uptake of private health insurance. I was heartened to read recently that a positive outcome of the COVID-19 pandemic is the increase in new private health insurance policies. This is great news particularly for elective surgery lists across the board and should have a positive impact on workload for gynaecology.

We would hope that the increased number of policies are at Gold level and therefore more women will be looking for private obstetric care. The ability to make their own informed choices around birth is a key factor for many women and something NASOG strongly supports. The moves in New Zealand to require psychiatric consultations before choosing an elective caesarean section are restrictive and, I believe, cruel. NASOG will use all our resources to ensure such an approach never takes hold in Australia.

In the gynaecology area, the MBS Review is complete, and you will now be working with the revised item numbers. Don’t hesitate to contact NASOG if you have any problems so that we can take them up for you.

I have been hearing recently that some private hospitals have been placing increasing compliance demands on O&Gs. This could make it much harder to run your practice as you would like to as your systems must align with the hospital. We would like to know if this is another emerging trend and whether members feel it is another move towards a type of managed care in Australia.

Managed care has been another big topic for work in 2020. With apparent increased pressure from some health insurers and private hospitals to sign tight integrated contracts around remuneration and systems, the AMA has shown more interest in addressing the threat of managed care on our healthcare system and is planning a summit for 2021.

To contribute to the discussion, NASOG surveyed our database on their impressions of remuneration and a managed care structure. We were pleased to find that length of time in practice, percentage of private work and gender made little difference to thoughts around how O&Gs should be remunerated. The vast majority of respondents felt that signing contracts with Private Health Insurers and Hospitals, and allowing these entities to set fees (and rebates) was only marginally better than doctors accepting the established Medicare rebates as full payment for any service that is provided.

We are looking forward to working with our AMA and specialist society colleagues in 2021 to develop a united approach on managed care.

On a more administrative note, we are pleased to have stabilised our financial position this year but we still need to significantly improve our reserves to put in place greater advocacy resources on your behalf and enable a renewed focus on resources and content for trainees who are seeking to find out more about establishing their career in private practice. If you are not a current member of NASOG, I would encourage you to join and support our work through your subscription payment, the more members we have, the more we can achieve on your behalf.

As this unusual year draws to a close, thank you again for your support and I wish you all a Merry and safe, Christmas and Happy New Year.

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