Dermatology services in the Gippsland region of Victoria suffer a marked maldistribution in comparison to metropolitan locations. This is the case for multiple speciality areas in rural and remote parts of Australia, where around one third of Australia’s population reside. At present, over 90 per cent of dermatologists working in Australia live and practice in our metropolitan cities, leaving a small cohort of dermatologists providing services in rural areas for the remainder of the population. Workforce demand for dermatologists is expected to increase in future due to a combination of dermatologist undersupply and Australia’s continuing high prevalence of skin cancers.
At present, in the Gippsland region, there is one local dermatologist providing a private part-time service, and a once per month public outpatient dermatology service. Patients requiring inpatient treatment for dermatological conditions are either transferred to a metropolitan hospital, or their management is discussed with consulting metropolitan dermatology teams. Due to this limited outpatient service provision, patients are often travelling long distances to Melbourne to seek dermatologist care. Patients may have a delayed diagnosis with a complex dermatological condition initially seen by the GP, before referral to a metropolitan dermatologist with a long waiting list.
In an effort to consider ways to strengthen this rural health workforce in the Gippsland region, a small group of junior doctors and medical students with an interest in dermatology have initiated a study to audit patients who present to Latrobe Regional Hospital in the Latrobe Valley with a dermatological condition in 2020. The purpose of this rural study is to establish a more detailed understanding of the patients and more specifically the dermatological conditions they present with to this hospital.
The aim is to utilise this information, which is highly specific to our patient population, and apply it to strengthen our rural health education and training to both medical and nursing staff. The information gained in this study could also be used to inform Latrobe Regional Hospital, and possibly other Gippsland hospitals, about resources, training and even workforce opportunities that would benefit patients, such as the potential for visiting dermatologists in a public setting to Gippsland.
During the initial literature review and feasibility assessment of this study we, as the primary researchers, linked with the local dermatologist in our area to establish a combined understanding of the community needs in terms of dermatology services. We discussed these dermatology services provided currently in the outpatient setting, which assisted to guide us on establishing our audit variables to ensure we could define and outline appropriate information to audit in the inpatient setting.
Epidemiological studies such as ours described above, which focus on the documentation of skin disease presentation in this particular regional area, is highly relevant to workforce planning. Different dermatology challenges may be present in different communities and these studies are essential to ensure the appropriate dermatology service provision is considered that fits the community need. As the rural and regional population continues to grow, hospitals will seek to attract more speciality services. It would be pertinent in this situation to have population-specific data which outlines patient needs and resources required to ensure a highly specific service. This is particularly important to dermatology in a rural setting, as it is essential to understand the emergency, inpatient, surgical and outpatient needs of our patient community to ensure appropriate allocation and efficiency of this speciality service.