Westmead Dermatology Dermatology consultation is a valuable inpatient service in hospitals. Adherence rates to consultative advice in international literature range between 67.4% and 93%.
In the second part of our study about inpatient consultations, that has been recently published in the Australasian Journal of Dermatology, we have identified that adherence rates to suggested investigations (61.3%) and management (65%) in our hospital are at the lower end of those reported in the literature.
To improve adherence and patient outcomes we should improve dermatological education and the dermatology team should be proactive charting and performing procedural investigations.
This will require an increase in dermatology workforce in public hospitals.
Unfortunately, the ratio of dermatologists per population is dropping in Australia. According to a study from the Australian Department of Health in 2016, to maintain the ratio from 2016 (already insufficient then) 9 additional dermatology trainees per year from 2018 should have been added to the training program. This has not happened, and there are no clear plans to change this progression.
In our hospital, we stopped booking Category 3 patients 5 years ago (in 2016), almost 2 years ago we ceased Category 2 bookings and now we are struggling to care for Category 1 referrals probably due to the COVID crisis displacing more patients to public services.
Public hospital dermatology needs the help of those with the power to change this trend.
