AMD eBulletin 18 October 2019
Clinical ethics services
In this month’s post I would like to raise the issue of clinical ethics. It is well recognised that consideration of ethical issues is part of the core activity of all physicians, regardless of their specialties or contexts of work. The ability to respond to ethical challenges is part of the core competency of any medical practitioner and develops through the accumulated knowledge and wisdom gained from experience, conversations with patients, families and peers, as well as through formal educational processes.
In recent decades, largely driven by developments in the United States, attention has turned to the possible benefits of dedicated ethics services designed to provide support for health professionals, their patients and patients’ families. In Australia and New Zealand, various clinical ethics service models have been tried and, although the numbers of such services have been relatively small, moves are presently underway to encourage their more widespread use.
In 2015 the Australian Health Ethics Committee issued a 'consensus statement' calling for a national policy on clinical ethics services and later that same year the National Medical and Health Research Council of Australia published a Clinical Ethics Capacity Building Resource Manual, which provided guidance on some of the questions raised above. Members of the College increasingly encounter settings in which the possibility of the need for clinical ethics support arises.
There are several clusters of issues physicians may need to consider in relation to the establishment and use of a clinical ethics service. The first concerns the range of questions in relation to which clinical ethics support may be helpful. These can range very widely, but typically include: end of life issues; questions of capacity; limits, consequences and goals of treatment; settings in which patients, families and carers encounter difficulties or uncertainties relating to culture, religion or moral frameworks; and any other context in which a blockage of communication may arise in a clinical or caring relationship. In the hospital setting, complex ethical questions are often encountered in relation to critical care and the availability or suitability of treatments. Issues may concern relationships involving patients, doctors, nurses, other health care professionals, and any other person involved directly or indirectly with patient care and wellbeing.
The second set of issues relates to the kinds of approaches that can be employed in providing clinical ethics support. These can vary between informal discussions with colleagues (which is part of ordinary practice), to more structured conversations with physicians or others with professed expertise in ethics, to formal consultation services staffed by 'ethicists' who may or may not have specialised training, to 'clinical ethics committees' which consider questions or problems referred to them and provide guidance about policy or actual clinical decision-making.
Thirdly, there are the objectives of clinical ethics consultations and the kind of assistance they are actually able to offer. These too can vary, according to the approach adopted, from broad advice about how to address a problem, to policy guidelines or guidance about an area of concern, to a specific directive in relation to a difficult decision, to face-to-face facilitation of a complex reflection involving multiple participants in an active clinical setting.
Fourth, there are questions about where a clinical ethics support service should fit in relation to other aspects of clinical practice and governance. Should it be an advisory, facilitatory service or should it be mandated in some circumstances? What should be entered in the patient’s medical record? What might be the ethical or legal implications of an opinion expressed in this manner? Should those who aspire to offer services as ethics practitioners be required to undergo formal training? If so, what kind of training is available – or even possible – to qualify someone for this kind of role?
Finally, there is the question of how to assess the impact and effectiveness of clinical ethics services. How can we determine whether they produce beneficial results? How might their outcomes be measured? Do they, as is sometimes claimed, increase satisfaction, reduce complaints and save money? Is there a chance that they may actually do harm?
The possibilities for clinical ethics support are broad and it may be considered that there is insufficient need for a formal service. The College Ethics Committee is currently considering the kind of assistance the College can offer or should offer in this area. This will respond to the call of the National Health and Medical Research Committee and the Australian Health Ethics Committee for the development of national resources in this area, as well as providing guidance for physicians seeking to establish clinical ethics processes in their areas of work.
As always, feedback on the President's Posts is welcomed. Please send comments to:
Adult Medicine Division
Telephone: +61 (0) 417 55 26 59
Registrations open next week for the 2020 AChSHM Annual Scientific Meeting (ASM), which will be held at Governor Macquarie Tower, Level 19, 1 Farrer Place, Sydney on Saturday, 21 March. The theme for our 2020 ASM is 'Sex, syndemics and special populations', with a focus on:
- syphilis outbreaks in Aboriginal and Torres Strait Islander communities and Māori communities
- the intersection of chemsex and sexual health among men who have sex with men
- sexual health of trans and gender-diverse people.
AChSHM Fellows and trainees will soon receive an email with details of how to register. Register early and save with early bird discounts.
Nominations for the Award for Best Postgraduate Thesis in Sexual Health Medicine close Friday, 1 November 2019. Fellows and trainees who have been awarded a doctoral or masters by research thesis within the last five years are eligible to nominate. AChSHM members can nominate another person or can self-nominate.
The annual Award for Outstanding Contribution to Sexual Health Medicine formally recognises the contributions made by our Fellows to the discipline of sexual health medicine. Nominations for this year’s award close on Monday, 4 November 2019.
The Chapter Committee will next meet face-to-face on Friday, 6 December 2019. If you have any feedback or issues you would like to raise with the Committee, please don’t hesitate to contact us through our secretariat at firstname.lastname@example.org.
Associate Professor Catherine O’Connor
Australasian Chapter of Sexual Health Medicine
On 2 October I attended the Royal Australasian College of Medical Administrators Conferment Ceremony in Adelaide on behalf of RACP President, Associate Professor Mark Lane. It was an enjoyable evening and an excellent opportunity to connect with colleagues from other medical colleges.
Next week I will attend the RACP Convocation Ceremony and I am honoured to be presenting new Fellows in palliative medicine with their Fellowship and also other doctors who have achieved the Clinical Diploma in Palliative Medicine. The RACP Ceremony is one of the great traditions and celebrations of the College and I look forward to celebrating this significant milestone with our new Chapter Fellows and the people who have supported them through this training, their family and friends.
The Training Committee in Palliative Medicine will meet on Friday, 1 November and the Chapter Committee on Friday, 8 November, at the College office in Sydney. If you have any feedback or comments for either of these committees, please do not hesitate to contact us through the Chapter secretariat at PallMed@racp.edu.au.
Professor Greg Crawford
Australasian Chapter of Palliative Medicine
On 2 October immediate past-President of the Chapter, Associate Professor Adrian Reynolds, and I represented the College at the public hearing for the Senate Inquiry into the Social Services Legislation Amendment (Drug Testing Trial) Bill 2019. We reiterated the College's strong opposition to the drug testing trial on the basis that it is not evidence-based, goes against previous expert advice provided to Government on the matter, and is likely to be clinically harmful to people suffering with drug and/or alcohol addiction. We outlined that these reforms will also further marginalise a population that already experiences a greater burden of physical, psychological and social ill health and that the end result is likely to be a worsening of substance use disorder that will have ripple-out effects for the wider community.
Despite the overwhelming lack of support for the Bill from all major medical organisations and other experts, the government appears hell-bent on pushing this legislation through. Last week the committee released its findings, recommending that the Bill be passed, despite there being such resounding opposition. This seems to illustrate perfectly the inherent flaws within the Westminster system.
Following the early release of parts of the International Classification of Diseases 11th Revision (ICD-11), the World Health Organization (WHO) is undertaking field testing of the section on Mental and Behavioural Disorders. The diagnostic categories related to substance use have changed and the WHO is seeking specialist medical practitioners to complete the field-testing survey. The survey is completed online and should take approximately 20 minutes to complete. Interested Fellows can participate in the field-testing survey by emailing AChAM Committee Member, Associate Professor Mike McDonough, via the Chapter secretariat at AddictionMed@racp.edu.au and expressing that they would like to participate.
Finally, I would like to draw your attention to the Asia-Pacific Society on Alcohol and Addiction Research biennial conference which is being held in Kuala Lumpur from Wednesday, 27 to Friday, 29 November 2019. Many AChAM Fellows have been involved in this conference in the past, particularly in 2015 when it was held in Sydney. Interested members can view the program and register on the conference website.
The AChAM Committee will meet face-to-face on Friday, 22 November 2019. If you have any feedback, questions or comments for us, please get in touch via our secretariat at AddictionMed@racp.edu.au.
Dr Martyn Lloyd-Jones
Australasian Chapter of Addiction Medicine
Join your colleagues at RACP Congress 2020, from Monday, 4 to Wednesday, 6 May 2020 at the Melbourne Convention and Exhibition Centre in Melbourne, Australia.
Listen to what Lead Fellow, Professor Don Campbell has to say about RACP Congress 2020: Balancing medical science with humanity.
In this rapidly changing world, RACP Congress 2020 will equip you to deliver healthcare, provide leadership and respond to need. Congress 2020 Lead Fellow, Professor Don Campbell, encourages Fellows, trainees and stakeholders to attend Congress 2020.
“Be a part of something bigger, contribute to the conversation. Congress 2020 will broaden your horizons, challenge your thinking and inform your practise.”
With the theme of ‘Balancing medical science with humanity’, RACP Congress 2020 will look at a range of topics, exploring how the profession is transforming.
Find out more on the program and register
Have your say on the proposed common standards for all 38 Advanced Training curricula.
Find out more
The dates for the Divisional Written Examination and Divisional Clinical Examinations in 2020 are now available on the website.
If you're preparing to sit either exam, or you’re a DPE or supervisor, please check the dates and mark them in your calendar.
Eligible written exam candidates will receive an email closer to the opening date with details of how to apply.
If you have any queries about either exam please contact email@example.com.
The RACP Indigenous Health Scholarship Program aims to support medical graduates and current RACP trainees who identify as Aboriginal, Torres Strait Islander or Māori on their chosen career path to becoming a physician. The scholarships provide a funded pathway through Basic, Advanced, Faculty or Chapter training in Australia and/or New Zealand.
There are several scholarships available for 2020:
Basic, Advanced or Chapter training
- College Indigenous Australian and Māori Health Scholarship
- Aboriginal and Torres Strait Islander Health Scholarship
- Aotearoa New Zealand Māori Health Scholarship
Also offered for Faculty training
- Indigenous Health Scholarship for Occupational & Environmental Medicine
- Indigenous Health Scholarship for Rehabilitation Medicine
- The John McLeod Indigenous Health Scholarship in Public Health Medicine
Applications close Saturday, 30 November 2019.
Learn more and apply today
Registrations are now open for the Tri-nation Alliance International Medical Symposium (IMS), 20 March 2020, Amora Hotel Sydney, Australia.
Now in its ninth year, IMS is an annual event that reinforces the strong historical relationship between medical professions from Canada, New Zealand and Australia. Cementing these ties, a formal agreement between the Royal College of Physicians and Surgeons of Canada, The Royal Australasian College of Physicians, The Royal Australasian College of Surgeons, The Australian and New Zealand College of Anaesthetists and the Royal Australasian College of Psychiatrists created the Tri-Nations Alliance.
The IMS 2020 theme 'Providing care to underserved populations' is relevant to health professionals from all member countries. With a focus on higher medical education, delegates will explore how specialist training can support and enhance access to health care for critical populations experiencing difficulties in accessing healthcare, potentially due to location or isolation, social determinants or other specific issues.
The Medevac Legislation, introduced in February 2019, has improved access to appropriate healthcare for refugees and asylum seekers being held offshore. It allows medical experts to make decisions about healthcare for seriously ill individuals and ensure that they receive the medical treatment that they need in a clinically appropriate timeframe. Previous delays and failures to transfer ill asylum seekers resulted in preventable suffering. The RACP is proud to have been a key part of the campaign to establish Medevac, and we are now continuing this by leading medical college opposition to its repeal.
Last weekend the RACP released an unprecedented statement
with 10 other medical colleges calling on the Australian Parliament to maintain the Medevac legislation and the Independent Health Advice Panel (IHAP) process.
To continue keeping up pressure on the Parliament in the lead up to the Senate voting on this legislation in mid-November, we encourage all doctors to take part in our social media campaign to save Medevac. Show the Parliament that doctors say #SAVEMEDEVAC by retweeting with comment our kick-off campaign tweet
featuring Professor Paul Colditz, RACP President, Paediatrics & Child Health Division
with your own selfie with the sign and #SAVEMEDEVAC.
You can also engage with our existing tweets (tweet #1
, tweet #2
) and Facebook
posts to support momentum for this cause.
Download sign #SAVEMEDEVAC
The RACP were proud conference partners at this year’s Australian Indigenous Doctors' Association Conference held in Darwin from 2 to 4 October 2019. A number of RACP Fellows and trainees were present at the conference, including RACP President Associate Professor Mark Lane, Associate Professor Tamara Mackean, Dr Dennis Bonney and Dr Angie dos Santos. Staff included Director of Education Robyn Burley and Director of Policy and Advocacy Patrick Tobin.
The conference began with a Welcome to Country delivered by Dr Aleeta Fejo, the first locally-trained Northern Territory GP. Keynote speakers included AIDA President Dr Kristopher Rallah-Baker, Northern Land Council CEO Ms Marion Scrymgour, Danila Dilba Health Service CEO Ms Olga Havnen and Australian Medical Association Federal President Dr Anthony Bartone. In her address, Ms Scrymgour emphasised “let's not forget the importance of Aboriginal health practitioners who are the cultural brokers within our communities". Ms Scrymgour also drew attention to leadership and to the role of Treaty as vital to improving the health of Indigenous peoples.
The RACP held a workshop on ‘Community collaboration as a basis for specialist outreach services and innovative change’. Dr Josh Francis facilitated a powerful conversation with Indigenous patients, community leaders, and doctors on the synergistic power of Indigenous community leadership and specialist physician care to tackle Rheumatic Heart Disease in Maningrida, a community of 2,400 people, 500km from Darwin.
RACP President Mark Lane spoke at the ‘Growing our Fellows’ workshop, which was an opportunity for medical students and interns to interact with Indigenous members and leaders of Australia’s specialist medical colleges, ask questions and discuss career pathways through medicine.
A special congratulations to Dr Jaquelyne Hughes FRACP who was awarded Indigenous Doctor of the Year 2019. Dr Hughes is an inspirational leader in the field of kidney health, and advocate for Aboriginal and Torres Strait Islander doctors and patients.
RACP Quarterly is the RACP's member magazine.
Articles in the September/October 2019 edition include:
- New discovery in the fight against Vitamin D deficiency
- In-flight medical emergencies: Is there a doctor on board?
- Obesity: Rising to the challenge
- Medical needs of adolescent refugees resettling in Western Australia
Access previous editions of RACP Quarterly on the RACP website.
The October 2019 issue of the IMJ (Vol 49 Iss 10) is now live on the RACP website and IMJ Wiley page.
Key highlights from the issue include:
- Physical activity for 15 to 45 year olds with chronic cardiorespiratory conditions
- Secondary prevention of ischaemic stroke
- Diagnosis, management and prevention of Candida auris in hospitals
- Socio-economic status and risk of atrial fibrillation
- Universal immunohistochemistry on Lynch syndrome diagnosis
- The evolving role of Instagram in #medicine
The Editor’s Choice for the month is Diagnosis, management and prevention of Candida auris in hospitals: position statement of the ASID.
As evidence and clinical practice advances, Evolve and Choosing Wisely recommendations will reflect these changes. The previous iteration of the Society of Obstetric Medicine of Australia and New Zealand ‘Top-Five’ recommendations included:
Do not perform a D-Dimer test for the exclusion of venous thromboembolism during any trimester of pregnancy.
Recent studies have shown that using a D-Dimer along with a clinical algorithm can increase the reliability of D-Dimer testing in ruling out DVT and PE in pregnancy.
Furthermore, the alternative to D-Dimer tests for these purposes is the use of imaging tests, which have their own set of risks from radiation exposure. Where previous evidence which suggested D-Dimer testing was highly unreliable would have tipped the scales towards discouraging D-Dimer testing, the new evidence suggests the results of D-Dimer testing can be made more reliable. Thus, it is no longer apparent there would be strong benefits from discouraging the use of D-Dimer testing in these settings. Due to this change in evidence and physician support, this recommendation was officially removed in August 2019. A fifth recommendation has not been identified yet.
Find out more
Evolve is a flagship initiative that aims to support physicians to safely and responsibly phase out low-value tests, treatments and procedures where appropriate, provide high-value care to patients based on evidence and expertise, and influence the best use of health resources, reducing wasted expenditure. The RACP Fellows and trainees have recently shaped the next Evolve Strategy for 2019-21.
From 1 to 31 July 2019 the draft strategy was circulated through Divisions, Faculties and Chapters, Specialty Societies and through the Presidents eBulletins. We received 27 responses to the survey, one email response and also undertook a face-to-face consultation with the Paediatrics and Child Health Division.
We received a lot of positive feedback and constructive criticisms. We value all feedback and have made changes to the strategy accordingly and are looking at how we can incorporate it in the implementation of the strategy to ensure Evolve is better meeting the needs of our members. We are pleased to share the updated Evolve Strategy 2019-21 and a summary of the consultation feedback.
Get involved in shaping and implementing Evolve by emailing firstname.lastname@example.org.
In the previous episode we talked about the science of pain, opioid analgesia and dependence. Now we look at the influence of culture, regulation and marketing on opioid prescribing for chronic non-cancer pain. First, we ask which are the prescription opioids most commonly leading to dependence and why are they prescribed? Then we discuss the mixed messages that prescribers are getting from guidelines and pharmaceutical regulation. Ever-relaxing indications for pharmaceutical subsidies can nudge prescribing behaviour in the wrong direction.
Tasmania was for many years the worst performer on measures of opioid use and harm, but this all began to turn around from 2006. Addiction medicine specialist Associate Professor Adrian Reynolds explains how education, regulation and real-time prescription monitoring were brought together in that state.
Finally, an undeniable influencer of prescribing behaviour are the promotional campaigns organised by pharmaceutical companies. Pain medicine specialist Dr Chris Hayes explains that those within the medical profession should not be surprised by this, but should be wary so their professional judgement isn’t compromised. A couple of case studies provide context for the RACP’s Guidelines for ethical relationships between health professionals and industry.
- Dr Christopher Hayes FFPMANZCA (Director Hunter Integrated Pain Service)
- Clinical Associate Professor Adrian Reynolds FAChAM (Clinical Director Alcohol and Drug Service, Tasmania)
Fellows of the RACP can claim CPD credits via MyCPD for listening to this episode.
Subscribe to Pomegranate Health in Apple iTunes, Spotify or any Android podcasting app
The dramatic headlines about the opioid crisis are all-too familiar by now. Australia and New Zealand have followed the lead of the US, and seen a fourfold increase in opioid use over the last thirty years. Most of this prescribing has been for chronic non-cancer pain, but systematic reviews will tell you that that there are no decent trials that would warrant use for this indication.
Learn more about the opioid crisis at the RACP South Australian Annual Scientific Meeting on Saturday, 30 November at the Adelaide Convention Centre. The session will be led by Dr Victoria Cock, the clinical unit head of the Drug and Alcohol Services of South Australia inpatient withdrawal unit.
If you'd like to learn more about opioids before you attend the ASM, check out the Pomegranate podcasts today.
Curated Collections are learning guides based on the contributions and peer review of RACP Fellows and other industry experts. Each guide presents key readings, online courses, webcasts and other tools for physicians’ continuing professional development.
Discover more today
The Department of Health is undertaking a review of antibiotic listings on the Pharmaceutical Benefits Scheme (PBS).
In 2018-19, the Department commenced a review of antibiotic listings on the Pharmaceutical Benefits Scheme (PBS) that currently include a repeat when prescribed. The review is part of the Australian Government’s broader ongoing strategy to support best practice prescribing in Australia, as outlined in Australia’s First National Antimicrobial Resistance Strategy 2015-2019.
The review is being undertaken in stages with the first stage focussing on the top five antibiotics with repeats prescribed (by volume) on the PBS, being:
- Amoxicillin + Clavulanic Acid
The Department’s review proposed changes to some of the PBS listings for antibiotics listed above.
The Pharmaceutical Benefits Advisory Committee (PBAC) considered the proposed changes to the listing of certain antibiotics to encourage antimicrobial stewardship at its August 2019 Intracycle Meeting.
The PBAC recommended the removal of repeat options for a range of listings where no repeats were deemed necessary as per the Therapeutic Guidelines. The PBAC also recommended aligning the listings for specific indications to the Therapeutic Guidelines where increased quantities are clinically indicated. The PBAC considered that the recommended changes, aligned as best possible with the current version of the Therapeutic Guidelines (version 16), would support antimicrobial stewardship and quality use of medicines as well as assist in the reduction of antimicrobial resistance.
An implementation date for the changes has not yet been established. More information on the specific PBS listings considered, changes recommended and implementation timeframes will be provided in the near future.
If you have any questions, please contact the Department at email@example.com.
Earlier in the year the College joined the Obesity Collective, a group of individuals and organisations from across Australia working to take on the obesity challenge together, with empathy and from a whole-of-society perspective.
Since then, the Collective has been active across a range of initiatives, including the launch of the Weight Issues Network (WIN). WIN is a growing organisation that represents the perspectives and needs of people living with overweight and obesity and those who care. The WIN hosted its first workshop at Westmead, where over 40 new members discussed the need for a strong lived experience voice, advocacy priorities and the power of personal stories.
The challenge of obesity is widely discussed in the media, reports and strategic plans. The framing of the challenge influences the public’s perception and weight stigma. It is a goal of the Collective to have a more unified, consistent and balanced narrative around obesity. These key messages and concepts have been developed for Collective members to consider, use and adapt when referring to obesity, including in clinical settings and in discussions with patients. We invite you to review and comment on these messages by sending us an email at firstname.lastname@example.org. You might also be interested in the Collective’s Tiffany Petrie talking to the ABC about the dangers of fat shaming.
Finally, we invite you to fill in a survey from the National Association of Clinical Obesity Services (NACOS). The NACOS represents organisations providing clinical obesity services in Australia. The NACOS is committed to driving improvements to access to clinical obesity services and raising standards in clinical obesity care. The team are working with stakeholders to develop a framework for clinical obesity services and are asking for input from clinicians and people with lived experience of obesity.
To learn more about the Collective and participate in its work, visit the website or contact the organisation.
Are you undertaking Advanced Training to further your career? Consider applying for a $10,000 grant through MIGA’s Doctors in Training Grants Program. There are many eligible training types including post graduate study, specialised fellowships, volunteer placements and more. Applications for the 2019 Program are open until Friday, 1 November 2019.
Find out more and apply
The Department of Health has issued a statement from the Chief Medical Officer and State and Territory Chief Health Officers about e-cigarettes and an emerging link between their use and lung disease.
Read media release
Specialty Society Webinar Series
The Specialty Society Webinar Series is now live. The webinar series is being undertaken by RACP in partnership with its affiliated specialty societies. Please see below for information on upcoming webinars.
- Professor Jacqueline Center – The Bone-Brain-Hormone Connection: Effect of bariatric surgery and weight loss on bone health
Monday, 21 October 2019, 6pm (AEDT)
- Dr Richard Kwiatek – CPD process for case discussions for private practitioners
Tuesday, 22 October 2019, 6pm (AEDT)
- Dr Natasha Smallwood – Managing severe chronic breathlessness and new models of care
Monday, 11 November 2019, 6pm (AEDT)
- Associate Professor Clare Anderson – Biomarkers of fatigue
Tuesday, 12 November 2019, 6pm (AEDT)
New Fellows Forum: Join us to build your career toolkit
Experience a half-day event full of short presentations to inspire you on topics including:
- financial advice
- leadership development
- private practice
- sustainability in our orkplaces
- survival guide for earning a living.
Find out more
Australian Digital Health Agency – My Health Record in Specialist Practice Information and Networking Session
The Australian Digital Health Agency invites you to an information and networking session focussing on how to improve clinical outcomes for patients and streamline business processes.
Tuesday, 12 November 2019, 6pm to 9pm
Rydges World Square Hotel, 389 Pitt Street, Sydney
Wednesday, 13 November 2019
6pm to 9pm
Pullman King George Square, Corner Ann and Roma Street, Brisbane
A significant proportion of healthcare providers across Australia are embracing complementary and evolving digital health technologies to improve care coordination for their patients. The evening will include:
- An overview on My Health Record and its benefits for specialist clinical practice
- Expert panel discussion exploring practical strategies and medico legal advice for embedding its use
- Opportunity to initiate next steps for My Health Record registration
- Networking opportunity with your peers
Go to the events list at any time to see what other events are coming up.
Conjoint Committee for the Recognition of Training in Peripheral Endovascular Therapy
Expressions of interests are sought for one Australia-based Fellow for RACP representation on the Conjoint Committee for the Recognition of Training in Peripheral Endovascular Therapy. The committee is constituted by three parent bodies; RACS, RACP and RANZCR, and will work to formulate training guidelines in Peripheral Endovascular Therapy and to assess the training of persons seeking recognition of their training in this area. If you’re an Australia-based Fellow and interested in applying, visit the Contribute to Peripheral Endovascular Therapy Training in Australia
TGA Consultative Committee representative
Expressions of interest are sought for an RACP representative to join the Therapeutic Goods Advertising Consultative Committee (TGACC). The TGACC provides an opportunity for member organisations to share their views on policy or operational issues relating to therapeutic goods regulation. This consultation mechanism offers the opportunity for continuous improvement of regulatory practices as they impact on the Australian health system. The committee will meet bi-annually in Canberra and will cover member travel and accommodation costs if required.
Find out more and apply
Join RACP's Health Reform Reference Group
Find out more