AMAQ COVID-19 Urgent Member Updates

31 Mar 2020


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COVID-19 Member Updates aim to provide AMA Queensland members with a regular snapshot on:

What we are hearing from members How we are advocating for you Links to new, updated resources Browse through the accordion below to read all past updates.

AMA Queensland stands ready to assist members with any COVID-19 issues. Email us at covid19@amaq.com.au or call (07) 3872 2222.

Thank you to all our members for your tireless efforts and courage in preparing for and managing the COVID-19 pandemic for Queensland.

Member Update | Restarting of elective surgery and Surgery Connect contracts|Webinar recording available

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If you were unable to attend or simply wish to re-watch our fifth webinar on the latest developments in public/private elective surgery arrangements, we invite you to view the webinar via the link below.

Overview

Queensland Health’s Acting DDG and Chief Clinical Information Officer Dr Keith McNeil and Deputy Director-General Nick Steele attended the webinar to address members’ questions in real time, while senior representatives from the Mater, Ramsay Health, Uniting Health Care, and Cura Day Hospitals provided an update on the current situation and processes at their facilities, as they work towards resuming normal activities. In addition, Anaesthetists Dr Tim Wong and Dr Graham Mapp, and Pathologist Dr Michael Harrison voiced their concerns regarding the public/private arrangements and specialists' fees, and provided an overview of the issues they are currently facing as specialists.

WEBINAR RECORDING:

CLICK HERE

Recorded date: Wednesday 10 June 2020

Please continue to highlight to us any concerns about contracts or any issues in your practice or hospital by emailing covid19@amaq.com.au

Member Update | Restarting of elective surgery and Surgery Connect contracts|Webinar recording available

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With a spirit of cooperation and to continue advocating for a safe, fair return to elective surgery, AMA Queensland hosted its fourth webinar this week with Queensland Health and Queensland’s largest private hospital providers.

The webinar provided members with news of the latest developments in public-private negotiations as well as proposed timelines for the stepped reinstatement of elective surgeries.

Queensland Health’s Acting DDG and Chief Clinical Information Officer Prof Keith McNeil attended the webinar to address members’ questions and concerns in real time, while representatives from the Mater, Ramsay Health, St Vincent’s, Uniting Health Care, and Cura Day Hospitals advised of issues and processes at their facilities as they worked towards resuming normal activities.

WEBINAR RECORDING

Click here
Wednesday 20 May 2020

RESUMPTION OF ELECTIVE SURGERY ACTIVITY

Late Wednesday, Queensland Health Director-General Dr John Wakefield advised by letter that the State Government had determined that private hospitals in Queensland could return to up to 100 per cent of normal elective surgery activity, subject to availability of PPE.

Stage 1 of the resumption would see up to 50 per cent of normal surgical activity levels immediately and up to 75 per cent from June 1. A move to 100 per cent would occur when safe and possible to do so, depending on availability of PPE and other equipment and with the continuing adherence to social distancing measures.

A WIN FOR AMA QUEENSLAND - SURGERY CONNECT RATES

In the letter, the DG advised that, due to the growing waiting list across the State and because “private operators had largely been unable to reach agreements with private specialists on remuneration”, Queensland Health had determined that “Surgery Connect contracts should be used as the vehicle for all referrals of public work to private hospital providers”.

In April, AMA Queensland urged doctors not to sign the contracts and strongly advocated for doctors to be paid above the State Government’s original offer of the Medicare Benefits Schedule fee, indicating that a fee-for-service model, as has been utilised in the Surgery Connect model, was the most appropriate model, rather than the lower offer of fee for time rates.

We welcome Queensland Health’s decision to provide fair and reasonable rates to private doctors whose services will be used to assist the public system in reducing its waiting lists which have increased dramatically since COVID-19 restrictions were imposed.

We recognise that the Surgery Connect model is also not perfect and some conditions and remuneration, especially for anaesthetists and pathologists, are worthy of future discussion when the COVID-19 pandemic has settled further.

CONCERNS

However, as Prof Keith McNeil said during the webinar “the devil is in the details”, and AMA Queensland remains concerned about the lack of clarity on whether there will be a forced allocation of time for public work, as the new contracts with private providers reserve the option for up to 50 per cent of elective surgery capacity to be allocated to public patients. A further concern is the failure of Queensland Health to include a date or process for expiration of the new contracts with doctors. Further clarity is also required on whether idle capacity can be used for private patients, if it’s not used by public patients.

These are very significant issues that must be resolved fairly without disadvantaging doctors and we continue to urge you to read very carefully any contracts you are provided and to seek advice from AMA Queensland, if you have any concerns. It remains imperative that no doctor is shackled to a poor arrangement longer-term and we stand firm to defend the profession against any exploitative behaviour at this difficult time for us all.

With the blow out in both public and private waiting lists over the past two months, AMA Queensland is also calling for an immediate resumption of intermediate lists in the public system.

NEXT STEPS

All private operators will be having urgent meetings with Queensland Health in the coming days to seek clarification regarding the latest announcements.

AMA Queensland will update you again when additional information is to hand.

We are mindful of the need to preserve the real and perceived benefits of private health insurance among patients, to support doctors as they try to rebuild their practices and to always retain the independence of doctors in decision-making and the supremacy of the doctor-patient relationship in all healthcare.

In the meantime, please contact us on covid19@amaq.com.au or call us on (07) 3872 2222, if you have any further concerns regarding the distribution of work in your facility.

Member Update | PPE access for Queensland doctors

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As the Government gradually eases restrictions, we know access to personal protection equipment (PPE) continues to be a critical issue for some of our members.

PPE ACCESS

We are pleased to advise that we have partnered with AMA Western Australia to expedite the PPE availability to all AMA Queensland members.

AMA WA Medical Products has established good supply lines and Queensland doctors will now have access to their stock.

PPE ORDERING PLATFORM & SPECIAL AMAQ MEMBER CODE

A dedicated ordering process for Queensland doctors has been established and, as an added benefit, members will receive a 5 per cent discount on the first order for any products on the PPE page.

AMA Queensland will continue to work with you to enable you to continue delivering high quality care to your patients, as we look to emerge from the effects of COVID-19.

Please contact us for any issues in you practice or hospitals on (07) 3872 2222 or covid19@amaq.com.au

AMAQ Member Update 11 May 2020 - COVID-19 Recovery Phase

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As you are aware the first tranche of elective activity recommencement started on Monday, 27 April 2020.

Since that time, we have had an increasing number of member enquiries regarding how the additional capacity will be distributed, coupled with concerns regarding lack of transparency and equity in the distribution process.

While we acknowledge the important conditions and risks regarding ICU capacity, PPE supplies and infection control, a transparent determination process is critical for you to ensure your patients have equity of access determined by transparent and equitable clinician decision-making, with patient safety at front of mind. Moreover, all doctors must benefit in part from the allowable increased capacity.

The Australian Health Protection Principle Committee (AHPPC) has released a statement on restoration of elective surgery, including principles for re-introduction of hospital activity, risks and suggested approach for elective surgery. You can read the statement HERE.

We are writing to private operators in Queensland seeking their advice on the distribution process in their facility, including criteria, restrictions, methods of prioritising work/equity, decision-maker, clinician involvement in decision-making and transparency of process.

As we receive responses from operators regarding these issues, we will share this information with you.

In the meantime, please contact us on covid19@amaq.com.au or call us on (07) 3872 2222, if you have particular concerns regarding the distribution of work in your facility.

Member Update 28 April 2020 - AMAQ urges doctors not to sign COVID-19 public/private contracts

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AMA QUEENSLAND URGES DOCTORS NOT TO SIGN THE CONTRACT IN ITS CURRENT FORM

AMA Queensland is aware that several private hospitals have issued contracts for doctors to consider for work under the COVID public-private partnership.

ISSUES OF CONCERN

We would like to flag to members several issues of concern regarding these contracts.

A clear imperative for AMA Queensland is for private practicing doctors to be facilitated back into their usual work, setting their own fees, as quickly as possible.

Public work that is done under the new COVID public-private partnerships, we envisage, being a small portion of private practice work going forward. Moreover, forcing work down this pathway which may prioritise public work in the private system, in particular if it displaces a return of usual private practice work for the doctor, is not the stated intent of the public-private arrangements nor is it sanctioned by AMA Queensland.

Further to our ‘principles’ document to help guide doctors in considering the COVID public-private contracts, AMA Queensland has made it very clear that a fee-for-service model that reflects the AMA fee is the appropriate remuneration model. A VMO salary or similar arrangement was only entertained as a very temporary, minority practice for key personnel who might be required to remain on campus for prolonged periods or on-call if the COVID-19 care requirements escalated. This need has not eventuated, therefore AMA Queensland does not envisage a VMO salary-type arrangement as being necessary and urges doctors to consider very carefully the possible negative outcomes that might occur should they sign a salaried contract under any terms with a private hospital.

There is considerable risk for non-GP Private Specialists to be forced into indentured, salaried arrangements with private hospitals and AMA Queensland does not regard this as being in the best interests of patients, hospitals nor individual doctors. Although ‘Surgery Connect’ is suspended while the COVID public-private partnership remains, an appropriate and fair fee-for-service model can still be employed and should be the style of any credible contract doctors are asked to consider, not a time based VMO rate as quoted.

It is crucial doctors protect their future practice and independence by making careful decisions now. It may be that less work and income will be the consequence in the short-term, but this is far preferable than greater intrusion into practice from institutions, funds and Government forevermore into the future.

Should you wish to contact AMA Queensland before you sign any contract or should you have any queries or concerns, please contact us on (07) 3872 2222 or covid19@amaq.com.au.

Be reassured the AMA at both state and federal levels is trying very hard to get an orderly, safe return to normal work as soon as possible to support and restore practices for private sector members.

Member Update - Resumption of elective surgery in Qld | Webinar recording now available

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RESTARTING NON-URGENT ELECTIVE SURGERY

Following the success of the webinar with Queensland Health and Queensland’s private hospital providers on April 8, and to continue our advocacy for members affected by the COVID-19 crisis, AMA Queensland hosted a second online forum on Thursday night.

WATCH THE WEBINAR: If you missed it, you can find the webinar HERE.

More than 135 members dialled in to the webinar to hear the latest developments and ask questions about the reinstatement of some non-urgent elective surgeries, an outcome reached through of extensive negotiations between AMA and the Government.

Queensland Health’s Acting DDG and Chief Clinical Information Officer Dr Keith McNeil and Deputy Director-General Nick Steele provided a brief overview of how the reinstatement of elective surgeries would occur in Queensland and updated participants on the continuing progress of signed agreements between private hospitals and the State Government.

Representatives from the Mater, Ramsay Health, St Vincent’s, Healthscope and Cura Day Hospitals advised how elective surgeries would restart at their hospitals. In addition, representatives from Medical Defence Organisations including MDA National, Avant, MIGA, MIPS and Berkshire Hathaway provided clarity on the issue of indemnity.

KEY ISSUES

Members asked questions of all panellists in real time with the key issues centring on the process for restarting elective surgeries, clarification of the Federal Government’s 25 per cent threshold and the access and availability of Personal Protection Equipment (PPE).

Once again, AMA Queensland collated all unanswered questions and emailed them to Queensland Health for response. Responses will be posted on our dedicated COVID-19 webpage.

RESTARTING NON-URGENT ELECTIVE SURGERIES

  • 25% OF ACTIVITY | The reintroduction of 25 per cent of currently idle capacity will start from April 27. This is defined as the reopening of one in every four currently closed operating sessions for low risk, high value procedures.
  • APPROACH | AMA has been advocating for a fair balance between public and private patients when it comes to restarting elective surgeries. Although Queensland Health has agreed that all patients will be selected on the basis of clinical decision making, it will be seeking to reduce waiting lists in some parts of the state. Hospital and Health Services (HHS) manage the waiting lists and Queensland Health is seeking HHS and private hospitals within their own regions to negotiate on the mix of public /private patients.
  • ALLOCATION | Private hospitals have confirmed they intend to allocate the 25 per cent of idle capacity to clinicians who have regular theatre lists with their facilities. Access will be provided to doctors on an equitable basis.
  • PPE | Private hospitals have responsibility for PPE for clinicians in their facilities. As such, the availability of PPE will determine the number and type of elective surgeries that are able to be reinstated with each facility needing to also continue to be able to respond to COVID-19.
  • SCREENING | Because of extremely low rates of community transmission and the necessity to use PPE, elective surgery patients would be screened rather than tested for COVID-19. Pending Commonwealth Government and Royal College of Surgeons (RACS) guidelines are highly anticipated to clarify what PPE is required for each procedure, PPE remains an area of concern for private doctors and private hospitals.
  • INDEMNITY
    1. MDOs have confirmed they will cover for all public hospital patients where they are not otherwise indemnified.
    2. MDOs recommend all surgeons contact their MDO to clarify indemnity coverage.
    3. Queensland Health has confirmed that where private hospitals do not cover doctors and where doctors are unable to obtain insurance on reasonable terms, the State would provide cover for medical malpractice and professional indemnity risk. In return, Queensland Health will charge private hospitals a premium for the risk.
    4. Private hospitals will be required to maintain their current insurance arrangements, including WorkCover for their normal activity. State insurances will not cover private patients being treated by private VMOs in private facilities.

COVID-19 PRIVATE HOSPITAL ARRANGEMENTS FOR NON-GP SPECIALISTS

  • Agreements are currently being finalised between Queensland Health and private hospital providers in response to the COVID-19 crisis, and Queensland Health has confirmed that the larger providers have signed their agreements to date. The smaller private operators will follow suit.
  • AMA Queensland has developed a set of principles for contracted work undertaken by non-GP Private Specialists under the COVID19 public-private partnership. Read the AMA Queensland principles HERE. All parties agreed that the reinstatement of non-urgent elective surgeries needed to be managed in an orderly and gradual process with fortnightly reviews of COVID case numbers and PPE supplies.

AMA Queensland will continue to work with you to enable you to continue delivering high quality care to your patients, as we look to emerge from the effects of COVID-19.

You can find daily updates and FAQs on our AMA Queensland COVID-19 webpage and engage in discussions with colleagues at Queensland Doctors’ Community.

Please contact us for any issues in you practice or hospitals on (07) 3872 2222 or covid19@amaq.com.au

COVID-19 Member Update – 11 April 2020 | PPE, Hospital arrangements, Recovery Phase

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PPE

Personal protection equipment (PPE) continues to be a critical issue for our profession.

Recently more than 660 of our members responded to our online survey about allocation of PPE in your practices and hospitals. See the AMA Queensland media release with survey’s first findings HERE.

In response to AMA’s ongoing advocacy on the issue, this week Federal Health Minister Greg Hunt announced the allocation of 11 million masks - seven million to hospitals, 2.3 million to the primary health network, including 1.5 million for general practices, 1.7 million for the aged care sector, 160,000 for respiratory clinics, 75,000 for Aboriginal Community Controlled Health Organisations, and 500,000 for pharmacies.

AMA Queensland will continue to call for consistent and clear information about where and when doctors can access the protective equipment required to do their jobs safely.

COVID-19 HOSPITAL ARRANGEMENTS FOR SPECIALISTS

As part of our ongoing advocacy to ensure that reasonable arrangements are made between the private hospital providers and non-GP Private Specialists in response to the COVID-19 crisis, on Wednesday night AMA Queensland hosted a webinar with Queensland Health and Queensland’s main Private Hospital providers.

Over 220 non-GP Private Specialists dialled in to ask questions and hear the latest developments on the pending agreement with private hospitals.

We would like to thank those members who participated in making the online forum informative and productive. For those who missed it, you can watch the webinar HERE.

In summary, Queensland Health’s Chief Clinical Information Officer Dr Keith McNeil and Deputy Director-General Nick Steele provided a brief overview of COVID-19 cases in Queensland to date as well as progress on an agreement to integrate the public sector’s health facilities with 119 Queensland private hospitals.

In addition, representatives from the Mater, Ramsay Health Care, St Vincent’s, Uniting Health Care and Cura Day Hospitals each provided their views on entering into an agreement with Queensland Health.

Members were able to ask questions in real time and the main issues centred on rates for private specialists treating COVID19 public hospital, scope of practice, indemnity and sick pay, PPE supply, as and well as questions on the reintroduction of non-urgent elective surgeries in private settings.

AMA Queensland collated all the unanswered questions and emailed them to Queensland Health for response. We will upload the responses to our dedicated COVID-19 webpage as soon as we receive them.

Following Wednesday’s webinar, Queensland Health provided AMA Queensland with further information in relation to indemnity arrangements in terms of the agreements they are about to sign with private providers across the state.

Queensland Health said they expect to have proposed agreements ready to present to private providers directly after the Easter weekend on Tuesday.

AMA QUEENSLAND GUIDELINES - AMA Queensland has developed a set of principles for contracted work undertaken by non-GP Private Specialists under the COVID19 public-private partnership. Read the AMA Queensland principles HERE.

IMPACT OF COVID-19 ON PRIVATE PRACTICES

We know many GPs and non-GP specialists are feeling the impact of COVID-19 and some practices have already had to consider laying off staff due to the significant changes to their operating environment.

With COVID-19 measures currently successfully flattening the curve, we need to start focussing on how the healthcare system emerges from COVID-19 and on the need to reintroduce activity into the private sector, provided COVID-19 numbers remain low and all medical practitioners have access to appropriate PPE. Plans need to be put in place for a gradual reintroduction of elective surgeries and a public awareness campaign is required to ensure Queenslanders continue to see their doctors for routine check-ups and general health care during the time. Read article HERE.

These are challenging times for doctors and AMA Queensland is committed to continuing to advocate for your professional rights to enable you to continue delivering high quality care to your patients.

Please continue checking our AMA Queensland COVID-19 webpage for daily updates and FAQS, and join the conversations your colleagues are having on Queensland Doctors' Community.

Member Update – 29 March 2020

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It is important to update you on AMA Queensland’s interaction with our members, Government and other key stakeholders, as we tackle the COVID-19 crisis together as valuable health professionals.

Telehealth

This week saw expanded access to telehealth to protect the health of frontline doctors and their patients.

AMA has been working very closely with Health Minister Greg Hunt to deliver better telehealth access via phone and video to all Australians as a matter of urgency in this crisis.

As a direct result of AMA’s strong advocacy, the Government has today announced:

  • extension of telehealth item numbers for all GPs and non-GP Specialists to cover most consultations not requiring a physical examination;
  • doubling of the GP bulk billing incentive for telehealth;
  • removal of the prohibition on private billing for telehealth (where bulk billing does not occur); and
  • an additional GP practice viability payment through the Practice Incentive Payments (PIP) to support business continuity.

These arrangements will be implemented by Services Australia in the coming week. Read the full AMA media release here.

Personal Protective Equipment (PPE)

In response to many concerns received from members in both the public and private sector, this week we continued to call on both the State and Federal Government to be honest and transparent in their communications about the supply and distribution of PPE.

PPE is a critical issue for our profession. While we acknowledge that the COVID-19 crisis has entered our lives very quickly, transparent communication about PPE supply and distribution is essential to instil confidence and reduce anxiety to our essential front line doctors and nurses.

We are continuing to put your general and specific questions to the Department and this week, the Queensland Chief Health Officer repeatedly assured us that there is sufficient PPE and that no health care workers will be put at risk when treating patients with COVID-19. Her recent media interview is here.

In addition, we have been instrumental in calling for sufficient protection of the private sector, both GPs and non-GP Specialists, the latter group being the forgotten group in the distribution.

Public and Private Hospital interface

Over the weekend, we have called on the State Government to utilise private hospitals to free up public hospital capacity to prepare the escalating COVID-19 admissions. Private hospitals are ideally placed to partner with the public sector, so that the emergency and ICU capacity is increased in the public hospitals, as this crisis worsens. Read the AMA media release here.

Junior Doctors

We know that COVID-19 has had a direct impact on education, training and clinical care for junior doctors. AMA is talking to medical colleges and regulatory authorities about how we can work together to support doctors in training and mitigate the impact COVID-19 will have on medical education and training now and over the next 12-18 months. There is also growing concern about GP Registrars, some of whom are facing either termination of their contracts or uncertainty about their training time due to this crisis and for which we will seek some certainty.

See here communiqué that was recently released by Federal Council. Also find here the communiqué developed by all AMA State Councils of Doctors in Training to highlight the important issues for junior doctors.

Financial support for practices

Federal and State government, the Australian Taxation Office, and the banking sector have put out a number of measures to provide financial support to small and medium size businesses at this time. In addition, we have lobbied hard to achieve the support that has been announced by the Prime Minister today; another AMA advocacy win!

We were pleased to see the State Government respond to our call out for a waiver of payroll tax and we are continuing to call for a relaxation of long service leave entitlements. We will provide updates our website and publications.

Free Member Webinar - Coronavirus Stimulus Package Info Session: Our partner, William Buck has provided a webinar for all our members this week to provide an overview and answer questions on the new stimulus package. Due to overwhelming demand for the webinar we are running a further session on Monday, 30 March at 7 pm. Find HERE the link to login to the webinar tomorrow night.

Doctor health and well-being

We are working with the State Government and the Hospital and Health Services (HHSs) to provide well-being support for our doctors.

Additionally, Queensland Doctors Health Program (QDHP) provides an independent, confidential, colleague to colleague support service for Queensland doctors and medical students. You can call the QDHP 24/7 Helpline on (07) 3833 4352.

Primary Care

AMA Queensland was instrumental in bringing together all primary care Colleges and Primary Health Networks for twice weekly teleconferences to discuss the issues faced by General Practice, including how General Practice can assist during the pandemic.

Communication is key

Many of you are talking to your colleagues on our AMA Queensland’s community platform, Queensland Doctors’ Community (QDC) We encourage you to join the many and varied conversations being held.

Log on to QDC with your AMA details (Username: Mcbride). Forgot your password? Click here to reset.

As always, you can also contact us by phone on (07) 3872 2222 or email. For specific COVID-19 issues, we have also set up the following email address covid19@amaq.com.au.

Please continue to check in on our AMA Queensland COVID-19 webpage for updates and FAQs.

We want to assure each and every one of you that we are listening to our members and your suggestions and the support that needs to be provided. In times like this, it is the AMA Queensland that can support you and escalate your issues via our Federal office to the politicians “up the hill”. Please keep in regular contact, look after yourselves, and support your loved ones and colleagues in any way that you are able.

Dr Dilip Dhupelia President, AMA Queensland

Jane Schmitt Chief Executive Officer, AMA Queensland

Member Update – 22 March 2020

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As the global COVID-19 outbreak continues to unfold, we are writing to give you an update on what AMA Queensland has been doing to ensure you are provided with the information and support you need to do your job during these challenging times.

AMA Queensland COVID-19 webpage

We have set up a dedicated COVID-19 page on our website, bringing together all of the latest information and AMA resources and advocacy updates.

Bookmark this link to have the latest information at your fingertips.

Staying connected - Queensland Doctors’ Community

We encourage you to raise concerns and share ideas or advice on how to best support each other and communities during the outbreak on Queensland Doctors' Community (QDC).

Log on to QDC with your AMA details (Username: Mcbride). Forgot your password? Click here to reset.

Advocacy

AMA Queensland has been advocating directly with the Queensland Health Minister, Director-General, Chief Health Officer and Treasurer to address a number of issues affecting our members at the frontline of the COVID-19 threat.

  • AMA Queensland sought a relaxation of the Long Service Leave regulations. Read more here
  • We sought a payroll tax waiver for six months
  • We raised three key issues for doctors, in particular the need for:
    1. Tailored communications at a local level throughout Queensland, particularly across HHSs, the primary care sector and local communities
    2. Transparent and consistent communications regarding personal protective equipment (PPE). In particular we have responded to concerns from members in all specialties and in the primary care sector regarding PPE and the Chief Health Officer has confirmed that this is a key priority for her team and that she will keep us informed of management and supply of PPE. We have again highlighted the need for transparent and consistent communication in this regard.
    3. Transparency of where COVID-19 cases are occurring in the community • AMA Queensland has advised the Government that doctors are concerned about voting polls for the upcoming Council elections being located at schools, while these remain open.
  • The AMA strongly lobbied the Federal Government for telehealth MBS item numbers to safely assess patients. Those items are now in place, with many of you already using them. The AMA is now advocating for the temporary COVID-19 MBS items to be broadened to cover non-COVID consultations as well.

We want your feedback

If you see issues emerging in your practice or at your hospital over the coming days and weeks, please contact us on (07) 3872 2222 or covid19@amaq.com.au

Your continued feedback will be vitally important o to ensure we know the issues you are facing and can advocate on your behalf.

Dr Dilip Dhupelia President, AMA Queensland

Jane Schmitt Chief Executive Officer, AMA Queensland


Published: 31 Mar 2020