Australia Skin cancer check-ups a long time coming as Australia faces huge shortage of dermatologists

06:35  14 june  2021
06:35  14 june  2021 Source:   abc.net.au

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Regional residents facing waiting times of nearly a year to have their skin checked by specialists are warned the queue will continue to grow if funding and training are not increased.

There are only 550 practising dermatologists in Australia and that is predicted to fall to 90 full-time equivalent positions by 2030, according to the national Department of Health.

That is almost 15 per cent less than hwat is required to meet the needs of the Australian population.

It is a gap the Australasian College of Dermatologists (ACD) is trying to help fill.

"As a college, we are acutely aware of the national shortage of dermatologists, particularly in regional and rural areas," the college said in a statement.

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"Addressing this workforce shortage to enable delivery of sustainable, equitable, and timely access to care across the country is a key strategic priority.

"There is insufficient government funding for dermatology trainee and consultant positions in public hospitals, and indeed many hospitals have no state-funded dermatology service.

"All Australians should have timely access to specialist dermatology care when they need it.

"We continue to call on state and territory governments, health departments, and health services to expand public hospital services, incorporating both dermatologists and trainees, and on the federal government to increase the number of dermatology training positions in private and rural practice."

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Vigilance vital

Wodonga mother Catherine Coysh is extra vigilant with skin checks.

Her father was diagnosed with stage five melanoma at the age of 40 after his health concerns were dismissed by a GP.

He lost his battle with skin cancer within 12 months.

Ms Coysh was 15 at the time, but the loss propelled her to continue her advocacy work into her adult life.

But even annual skin checks and her heightened awareness were not enough to stop skin cancer.

This year she sought help from her GP after detecting a sore patch of skin on the tip of her nose that would not heal.

It was a basal cell carcinoma — the most common form of skin cancer and the most frequently occurring form of all cancers.

It took two surgeries for her to be clear from the disease.

"The fact I was so hypervigilant meant I was able to get it before it developed into anything more," Ms Coysh said.

"What I'm finding though is people are asking me where to go and get checked and I'm giving them the details of the local GPs and skin specialists that I know, but there's such a long wait time."

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"It's really worrying.

"We know that early detection is key and if someone can't get in for six to 12 months that's huge in how something can develop over that time."

'Effective gatekeepers'

Medical students are learning more about the skin during their GP training to become "effective gatekeepers" for the nation's skin concerns, as specialists wade through backed up waiting lists, particularly amid the pandemic.

"We feel the role of the GP is very important — GPs have training in skin cancer and skin checks, but we know that in medical school there is an issue of how much dermatology medical students are taught," St Vincent's Hospital dermatologist and University of Melbourne associate professor Chris Baker said.

"We've made an effort to try to increase the amount of dermatology medical students get in their undergraduate curriculum."

The ACD is working with the Australian Medical Association to build up training positions, with a focus on rural services to help support GPs and move specialists to country areas.

There are 120 trainees in positions across the country and that number is expected to increase.

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"It isn't a big number — we do need more," Dr Baker said.

"But also there's no way that dermatologists will be completely able to satisfy the skin cancer needs of the country.

"This is why we come back to the fact that GPs are the primary port of call and why we are emphasising the need for GP training and skilling."

Lifesaving appointments

Jay Allen does not believe he would be alive today if his family GP had not been so quick to treat a mole on his left ankle that he thought was simply a blister in 2007.

The mole had been there all his life, but had become itchy and scabby for six months when he was 32.

It was a melanoma and had already spread into his lymph nodes down his left groin.

"It was certainly on its way to invade my body, " Mr Allen said.

"My GP did the right thing and cut the mole out straight away when I went to him."

Since then, Mr Allen helped lead the Melanoma March fundraisers, which raised more than $1 million for the Melanoma Institute Australia.

He would like to see more GPs play a role in helping tackle the disease.

"A lot of the times I've heard over the years when someone's gone to a GP, and the GP has said, 'It looks a little odd but we'll keep an eye on it', and six months or 12 months down the track they go to the GP again, they cut it out, and it's melanoma.

"Had they cut it out 12 months prior it probably would have been caught in the very, very early stages or might not have been a melanoma at that stage."

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