The APA is the fourth member-based health association I have worked for.

There are similarities among all of them because issues of concern to members share certain commonalities.

All associations and organisations with a large, diverse membership working across the entirety of healthcare face substantial challenges in communicating.

What is highly relevant to some members is junk emails to others.

In-depth, detailed articles and information may be exactly what some members want to receive, while others may prefer short, pithy updates.

One aspect of communication that is, understandably, common to all large member groups is for members to ask, ‘What does this mean for me?’ 

Frustratingly, there is no satisfactory answer to this question. In the field of government relations, explaining an advocacy outcome or win can be difficult.

Not as difficult as being a physio and treating patients, but difficult in the sense that ‘outcomes’ and ‘wins’ mean very different things to a policy adviser than to a practitioner.

When I see my physio, a ‘win’ is greater shoulder movement and reduced pain.

I walk in and 40 minutes later I strut out feeling physically a better person.

‘What did it mean for me?’ is easy to answer—my physiotherapist improved my health and wellbeing and explained what the future holds (an X-ray and ultrasound, then working with me on what these results mean).

I can define and describe a physiotherapy outcome from a patient perspective just as my physio will write up case notes outlining what they did and why. 

Back at the APA office, the ‘wins’ we have cannot be so easily categorised or articulated.

They may seem trite or minor even though they are strategically vital to supporting the APA and advancing the physiotherapy profession. 

"[T]here are always some who want to see more aggression and stronger public advocacy…

"I’ve seen firsthand how governments and ministers react to public attacks as opposed to the way they respond to associations they see as constructive, engaging and understanding of political processes.'

Here’s an example.

Ministers in the Albanese government (and shadow ministers in the Coalition too) are notorious for not meeting with stakeholders.

Some do not even reply to requests to meet, while others reply with one line saying they’re too busy.

So when the APA CEO and National President met Minister for Health and Aged Care Mark Butler in his Adelaide office, this was a significant advocacy outcome.

He talked directly with the APA leadership and heard about our issues, what we want to see changed and how we can work with the government to achieve these outcomes. 

This meeting didn’t necessarily mean anything tangible to members; it didn’t improve your financial viability or change your daily practice.

Yet, when the minister brought up physiotherapy at his Budget briefing and talked about the reforms we put to him, it was a significant advocacy ‘win’.

Recently, after much persistence, we also had a response from another minister’s office and a department calling us for a priority meeting.

Advocacy is often a bit like international diplomacy—there’s a time and place for positioning, a quiet conversation and being ‘onside’ and constructive and another time for posturing and assertiveness.

Within the member organisations I’ve worked for, there are always some who want to see more aggression and stronger public advocacy.

This approach carries enormous risks.

I’ve seen firsthand how governments and ministers react to public attacks as opposed to the way they respond to associations they see as constructive, engaging and understanding of political processes.

The Pharmacy Guild’s approach to the Labor government’s reforms is illustrative. 

Governments and their bureaucracies can be glacial, moving ever so slowly.

More often, reforms are driven by crisis, like the adoption of telehealth during the COVID-19 pandemic.

In the UK, first contact physiotherapy took almost 15 years to be rolled out, even though it too was driven by a GP crisis and supported by the British Medical Association. 

The reforms and advocacy ‘wins’ that the APA wants will likely come about in one of two ways: a government prepared to stare down the strong medical associations and vested interests and to initiate system-wide reforms in primary care and funding or a crisis that necessitates what we call ‘reform at pace’. 

The physio profession is in a much stronger position than it was a decade ago.

We are more respected and have greater engagement with government and funders than ever.

Like winter in the catchphrase from Game of Thrones, reform is coming.

It’s already happening through Strengthening Medicare investments and government initiatives in prescribing and nursing.

We know that allied health and physiotherapy are on their ‘to-do’ list. Just when it will be delivered is still a work in progress. 

How, then, do we communicate these advocacy ‘wins’ if they appear intangible or seemingly have no direct bearing on physiotherapy practices?

I don’t have the answer, but I reckon every similar health association grapples with the same dilemma.

The ‘big picture’ is always harder to paint. But here we are, helping to paint it. 

Head here to find out how the APA is advocating for you and your patients.