Rosanna Capolingua lives and breathes medicine. Her eldest daughter is a doctor, and the two other children are studying medicine. When she is not seeing patients at her GP clinic in the wealthy Perth suburb of Floreat, she is running the Australian Medical Association, or working at one of the church-connected health organisations that rely on her.

With her double dose of work ethic, some feared the doctors' lobby would be run by a de facto papal delegate, such is the perceived depth of her Catholic faith. But well into the second year of her national presidency, the fear to date is unfounded.

A child of Italian migrants, still grieving the recent loss of her father, the 49-year-old paints a picture of perfectly ordinary family life, lived large between AMA work and other professional commitments. She is divorced and putting her children through medical school. She's up at dawn to help one prepare for an early morning road trip, while her eldest, who is engaged to be married, has just flown the family nest.

Her mother is always on her mind, and dinner often involves the extended Capolingua family, who, in true Sicilian style, conduct their business in the kitchen, fuelled by the love of wholesome, home-cooked food. "They miss me when I am not home; they miss my cooking I think," she says of the kids. "It is a good leveller; this is what normal people do."

But Capolingua takes no prisoners in the politics of health. Her surname, after all, translates as "head language", perhaps even as word of the boss.

A passionate advocate who many predicted would not fit in at the AMA's Canberra head office, she is untroubled by her union's line on the prickly issue of reforming the health workforce, speaking out against plans for nurses and other allied health workers to play a bigger role in treating patients. "First and foremost, we have to ask ourselves: 'what is best for the patient?'," Capolingua says.

Forget the doctor shortage, or that people outside affluent inner-city suburbs cannot get an appointment to see a GP for months. Forget criticism that the current system is not working, or that senior clinical nurses, more extensively trained than ever, are under-utilised. And forget reform that involves re-arranging, albeit incrementally, the roles of doctors, nurses and health-care workers so more people in need can be seen, assessed and treated.

In AMA World, the solution to this problem is clear: a doctor-centred version of the doctor-centred status quo.

As Capolingua stated in her recent National Press Club address on health reform: "The AMA is not in the way; the AMA is the way."

Capolingua has been on one or other committee for the AMA since 1994. By 1998 she had been elected West Australia branch president - its youngest and its first woman leader. In 2005, she became chairwoman of the association's ethics committee - a post she retains today - and has been association treasurer. In 2007 she was elected president.

Briefly a member of the Liberal Party, Capolingua ensured lasting Labor hostility when, before the November election, she strongly supported Coalition health policies, even those aping Labor's. Whether shunned, overlooked or out-preferred, Capolingua was absent from Kevin Rudd's 2020 Summit and the National Health and Hospitals Reform Commission.

Not that the Government's public language emphasises suggestions of snubbing. Says the Health Minister, Nicola Roxon, of the AMA: "They have always been a very influential stakeholder group and an effective lobby group. We are interested in looking at things from the health needs of the community, not a particular profession - they will be an important stakeholder but they are not the only stakeholder."

Of Capolingua, she says: "I think she is very bright and capable and articulate … I think Rosanna is doing her job and feels very strongly about protecting her members; in fact, I have heard someone say she is one of the most effective union leaders of the country."

In a June speech to the National Press Club, Capolingua told of an obese patient attending a clinic and being misdiagnosed by a dietitian as having an obesity-related condition, when the real problem was a syndrome caused by a tumour on the brain. When asked to consider how often such misdiagnoses occur in GP clinics where the doctor churns through a patient every six minutes, she replied: "I am not saying that all medical practitioners are infallible either."

Tony Hobbs is chair of the Australian General Practice Network and is one of the many critics of the AMA's stance on health reform. "We have an ageing population, increasing chronic diseases … with significant inequitable health outcomes according to whether you are indigenous, living outside a major metropolitan centre, or whether you have a mental illness," says Hobbs, a GP based in country NSW.

To find solutions to these problems, Hobbs says, Australia must change the way it uses its health workforce. "My experience in general practice is that when you work as part of a team and you are able to delegate responsibly to a practice nurse or allied health professional, you improve access for your local community and it allows me to look at more complex issues that really do require the skills I have."

Practice nurses already do immunisations, pap smears, chronic disease management and wound management.

"Take the example of a urinary tract infection: the nurse will examine the women, order a urine test, assess the results of that test and prescribe antibiotics appropriately - this is exactly what I do as a doctor."

While disagreeing with Capolingua on what's needed to reform the health system, however, he is full of admiration for the work she does. "Anyone that stands up and says, 'I am willing to put my life on hold for a couple of years and be president of one of the major doctors' organisations in this country', you have to respect that. It is a hard call and I respect her enthusiasm and her energy."

Stephen Leeder, director of the Australian Health Policy Institute at Sydney University's public health and community medicine, says the AMA has always attempted to maintain the status quo for the sole benefit of doctors. "They come to this with a history of fighting any reform anyone has ever attempted to implement," he says.

"The presidential role should at least provide some leadership that articulates a vision about how we are going to confront the big problems." Leeder said resisting examination of better primary care provision was unhelpful when overcoming severe shortages of health workers was a great challenge.

Mukesh Haikerwal was Capolingua's immediate predecessor. Friends with Capolingua for the past 16 years, the two cut their teeth in medico-politics as young doctors on AMA committees, where Haikerwal says he saw her leadership skills emerge early on.

"She has held a strong line and you cannot ask for more than that from the leader," he says. "It's a very difficult job because of the twin roles - one is very much the industrial voice for doctors, the union side as some have described it, and the other is to be an advocate for the health of the public."

The workload is immense, says Haikerwal, and expands year by year, because of the complexity of the problems facing the health system and the ever-increasing demands of 24/7 media.

Haikerwal says it is important for the AMA to be part of the health reform conversation. Often, what looks like a stoush with government is little more than each side muscling up for the media. He has no doubt Capolingua's passion for medicine will guide her through. "She has got three kids in medicine; she is already doing her bit to help the medical workforce."