Dermatologist shortage leaves regional Queenslanders struggling for care

Samara Watson describes her skin condition as "agonisingly painful".

The Rockhampton mum lives with psoriasis, a chronic skin condition that causes painful scaly rashes, sore joints, nausea, and makes her prone to infections.

Sometimes her flare-ups can produce rashes of up to five centimetres in width.

"It's the worst condition I've ever known. I wouldn't wish this on anybody in the world," she said.

There is no cure, and no dermatologists in town that can treat her.

That is because Rockhampton's sole public dermatologist retired last year, so Ms Watson's options have been limited to seeing a costly private specialist five hours away in Gympie or a longer trip to Brisbane.

She said she has now fallen behind on her medications as a result, leading to more flare-ups.

"We desperately need someone here," the 50-year-old said.

Dermatologist shortage

The Cancer Council's Daniel Lindsay has published research that found a shortage of dermatologists across regional Queensland.

He said it was a worrying finding in a state with the highest rates of skin cancer in the world.

"What we are seeing is that there is then an increased reliance on our general practitioners to do skin cancer work,"

Dr Lindsay, a cancer economist, said dermatology was facing severe issues with an ageing workforce and a lack of incentives for skilled workers to move to regional locations.

"They need to be trying to think about ways that they can lure out young professionals into these areas and then hopefully keep them there as well."

Australian College of Rural and Remote Medicine president Rod Martin said rural generalists were well equipped to deal with common skin cancers through broad training and an online dermatology advice system, "Tele-Derm".

"That is an online service that means the treating doctor in a community can take photos or images, get some patient history, perhaps even biopsy things, send it to pathology," Dr Martin said.

A 600km trip to the specialist

But for patients with complex skin conditions, a face-to-face specialist remains the only option.

Professor Kiarash Khosrotehrani, from the Australasian College of Dermatologists, said patients with dermatology-specific conditions were the most impacted by workforce shortages.

"Skin cancer is an area where we share the load very well with GPs,"

Amanda Sealey, who is also based in Rockhampton, has lupus, an autoimmune disease where she suffers from extreme fatigue, joint pain, and skin rashes.

Sometimes the flare-ups are so bad that she is bedridden for days.

Ms Sealey said her condition was too complex for telehealth and she had no choice but to travel over 600km every six months to see a specialist in Brisbane.

"To do all that in one day, what it puts on my body, it's horrible."

Ms Sealey's condition is chronic, meaning she will need to continue travelling until a dermatologist comes to Rockhampton.

"It's heartbreaking in a way, not just for me but for anyone else who needs it."

Professor Khosrotehrani said the dermatology college was focused on training young professionals with existing connections to regional areas.

"If you take people from central Queensland and then train them in Brisbane in these pivotal years of their life … it makes it very hard for them to move with an entire family back to the region,"

"If their entire training is happening in central Queensland, they're much more likely to stay."

Central Queensland Hospital and Health Service chief executive Lisa Blackler said in a statement that the hospital was working to attract a new dermatologist.

In a statement, Queensland Health said it was not immune to a shortage of skin specialists, but it had many regional hospitals that provided skin care treatments and surgeries.

The statement pointed to existing outreach programs, patient travel subsidies, and telehealth services that alleviate postcode disadvantage.