8 June 2022

College calls for urgent action on workforce shortage

Political Workforce

There are just 590 dermatologists in Australia, and the future looks bleak without intervention.

The Australasian College of Dermatologists has called on the newly minted federal government to commit to increasing dermatology registrar positions as a matter of urgency.

And it also wants the Albanese Government to commit to MBS rebate reforms to “ensure they are adequate, fair and equitable, and reduce financial barriers to access for patients – specifically an increase in the attendance rebate and equity between specialities.”

College president Dr Clare Tait said with melanoma rates continuing to rise – it is estimated that two-thirds of Australians will have skin cancer by age 70 – the need has never been greater.

“In terms of having access to early diagnosis, which we know particularly for melanoma is just vital, having access to good quality, consistent, accessible and affordable health care, I think that’s a big issue for Australians,” she told Dermatology Republic.

“We’re all aware that it is very difficult for our patients to access timely and affordable care.

“We’ve fought for many years now and have been calling on increased funding for registrar positions across our public hospitals in order to have a stronger pipeline of fellows at the other end because it takes four years once you’re on the training program to become a specialist dermatologist.”

The college paints a concerning picture of an already substantial nationwide shortage of dermatologists – just 590. This equates to roughly two dermatologists per 100,000 Australians.

And this shortfall is only set to get worse, according to the college.

“This shortage is not due to a lack of doctors seeking to train as dermatologists but inadequate public investment in dermatology services and in the registrar and consultant supervisory positions needed to grow the workforce,” it said in a statement.

“This limits ACD to graduating just 20 to 25 dermatologists per annum, far short of the number needed to grow the workforce to meet current, let alone future demand.

“Constraints on workforce growth, maldistribution and lack of investment in public dermatology services translate into unacceptable wait times and access barriers. These access barriers are made worse by inadequate Medicare rebates for private dermatology services which increase out of pocket costs.

“These access and equity issues urgently need to be addressed so that vulnerable Australians with skin conditions can access the specialist dermatology care they need.”

The college is asking for a $6 million investment over the next four years to fund additional training positions nationally each year.

Dr Tait said the registrars who work with consultants provide “enormously valuable health care” in the public hospital system both in the outpatient clinics and to inpatients while they’re doing their training.

“We know there have been some improvements over the last 10 to 15 years with the STP [Specialised Training Program], which has looked at funding training positions that also incorporate rural and private training opportunities,” she said.

“I think the college now has about 29 STP-funded training positions so that is helpful but still not enough. We think we need to increase our registrar numbers by probably about 50%.”

Dr Tait said the small investment of $1.5 million a year for the next four years would enable the college to graduate 30 new dermatologists each year from 2027.

“That is a tiny drop in the ocean out of the budget,” she said. “But we feel that that would make a meaningful difference to the number of dermatologists on the ground, who are able to deliver more accessible health care.”

Dr Tait said the college was looking forward to working with the new government.

“There are a number of areas that they have said they’re committed to which we welcome and certainly one of the big things for us is improving access to dermatology care,” she said.

“This new government has made a commitment to improving access to health care, particularly for regional or rural communities. The details on that aren’t absolutely clear at the moment but we very much hope to work with them on solutions to increase the number of training positions in dermatology where there is a national undersupply.”

She said they also welcomed the government’s commitment to strengthening Medicare.

“They have talked about establishing a task force looking at improving access and affordability for patients within the Medicare system and particularly to support better management of ongoing health conditions including chronic conditions,” Dr Tait said.

“This is a great interest to us because to us because dermatology is primarily a chronic disease specialty. We see firsthand the impact that inadequate and inequitable specialist attendance have on our patients’ ability to access ongoing care. We think it’s really critical that financial barriers for patients needing to access this care are considered.”