What Effective Advocacy Looks Like in Practice

Most people usually only see a final policy announcement, but the advocacy that leads to that moment is often slower than you may think. Some of the most important work happens behind closed doors, in stages, and frequently over long periods of time.

As GPs, we become expert at and comfortable with solving complex medical problems by using time, patience, iterative interventions, patient education and the synthesis of multiple influencing factors that impact patient outcomes. Think diabetes care, any mental health condition, heart failure.

Interestingly, these are the same skills that good advocacy requires: listening to members, understanding different perspectives, gathering evidence, building relationships, staying engaged over time and working through competing priorities.

Effective advocacy requires a sense of curiosity to genuinely understand an issue, the perspectives of each stakeholder and the patience to invest generously in each one’s understanding and commitment to addressing the problem at hand.

Supporting the Next Generation of GPs

Prior to 2023, recruitment of doctors into general practice training was below target. Hospital doctors cited a stark drop in income from their hospital salaries to first-year GP training earnings as the single biggest barrier to choosing general practice as a career. At the time, the Victorian Government was also seeking ways to boost medical workforce, having recognised limitations in available services during the pandemic.

Advocacy to better support GPs in training was not new at that time. It had been a topic of discussion in state and federal arenas for some years. But as the Victorian Government started examining workforce capacity, the opportunity to address the known barriers and collaborate on designing solutions emerged. This opportunity was realised because the conversation had already been started and the concept was not new to government. Familiarity with the situation enabled policy makers to incorporate the GP training issue into the wider suite of solutions for boosting workforce in Victoria at the time.

Those years of conversation prior had developed trust with government that acted as the foundation for collaboration. We had worked together solving myriad other pandemic challenges and a respect for genuine intention to improve the Victorian health system was well established.

We suggested a forty-thousand-dollar grants program to support doctors entering GP training in Victoria: a 30k payment to address the drop in income and 10k to help cover the costs of fellowship exams.

The government agreed and committed to a 2-year program.

We had listened to trainees about their barriers. We had spoken to the government about its workforce needs. We had suggested an intervention that addressed both.

The program was so successful, other states sought to set up similar grants programs to retain and train GPs in their own locations, causing iterative changes to unfold around the country.

With multiple states boosting GP training numbers with the simple yet hugely impactful action that addressed lost trainee income, we then had a compelling, evidence-based and success driven story to take to the federal government to advocate for a permanent first-year trainee payment program.

The federal government, similarly committed to increasing GP workforce agreed, and the result has been more GP trainee applicants than ever before in the history of GP training.

For patients, practices and communities, that outcome matters.

Lessons From Successful Advocacy

Why does this story matter?

It matters because Australia needs more GPs and doctors were unable to enter GP training because of the intense financial pressure the drop in income put them under.

But more than that, it matters because it paints a picture about what is required to do advocacy well.

Advocacy is recognising that change does not happen overnight.

It takes genuine curiosity about an issue and preparedness to do invisible work. It requires relationships and trust. It needs solid, credible evidence and a good deal of persistence. It demands strong representation and a commitment to collaborate.

Finally, it requires an acceptance that you are there to produce practical, tangible results, many of which are obvious to your stakeholders, some of which may remain largely behind the scenes.