Melbourne dermatologist Dr Adriene Lee is the new president of the college and brings with her more than a decade of board experience.
Melbourne dermatologist Dr Adriene Lee has officially taken up the reins of the Australasian College of Dermatology.
She succeeds Perth dermatologist Dr Clare Tait who has completed her two-year term in the role. But Dr Lee is no stranger to the college, having been involved in various committees and roles for more than 15 years.
“I have seen the college evolve and become very progressive, and be more representative of its diverse membership, as well as the community,” she told Dermatology Republic.
“I saw some really positive changes and I wanted to ensure that those changes continue to happen. I also am quite passionate about ensuring that we keep working towards the goals that we have, as part of our strategic plan. And this will be my fifteenth year on the board, so I am across all the issues.”
Dr Lee is also very familiar with Australia. She was born in Darwin, lived in Adelaide for a short period before growing up in Canberra, and then attended university in Sydney.
She finished her dermatology training in Victoria and currently works in private practice as well as attending clinics at St Vincent’s Hospital, Melbourne and the Skin Health Institute.
For the past 16 years she has also participated in an outreach service to the North Western Regional Hospital in Burnie, Tasmania.
Dr Lee said the biggest challenge facing the college was the workforce shortage and maldistribution.
“I acknowledges it’s a challenge with many specialties, but I think acutely we feel it more than most,” she said.
“I was looking at the figures and really 94% of our fellows or our members practice in metropolitan areas. So that’s only 6% who are currently working in regional or rural and remote areas. And if we boil that down further, 50% of the overall workforce is actually over 60 years. So there’s a lot of impending retirement that we also have to factor in too.”
Addressing the issues would require both long-term planning as well as short-term initiatives to ensure existing fellows were supported and new trainees were encouraged to pursue a career in dermatology.
Dr Lee said there also needed to be a strong commitment from government to provide the funding for increased training places, and to help address the workforce shortage in rural and remote parts of the country.
“We know that research shows that if we can attract trainees who have some sort of family or community bond in a rural community, and then train them, then they’re more likely to return back to their community to provide that service,” she said. “There are already some examples of amazing dermatologists working, who’ve been through that process, but we need to do more.
“We have got rural training screen schemes, and we will try and evolve them more and more, especially with the impending retirements of more and more of our senior rural dermatologists.
“And then, of course, longer term, we need to just increase our workforce. And that is through advocating at different government levels to get more funding for training positions.”
The college currently has 29 specialist training program positions.
“We probably at a minimum need to be graduating 10 more dermatologists a year,” Dr Lee said.
We might graduate 20 to 25 a year right now, we need a minimum of 10 more. That will take time to filter out and it’s not easy, but we need to try and get funding for that.”
GPs played a critical role in supporting the work of dermatologists, Dr Lee told DR.
They are often called on to help diagnose and manage basic dermatology problems, especially in areas where there is no ready access to a dermatologist. Dr Lee said creativity was also needed to help dermatologists support GPs.
“That could be with consultations, but it can also be with teledermatology,” she said.
“We’ve managed to evolve that to give support to GPs, but adding to that and evolving it more will help to negate any geographic factors that might come into play for those GPs.
“Shared care model between GPS and specialists exist and certainly there are areas where we can work together for our patients where we can share their care and just contribute when they need it.”
As a visiting specialist to Tasmania, she has seen first-hand the complexities of skin problems – and a large group of patients who have “significant” disease who might miss out on access to the latest treatments without the input of dermatologists.
“Having the ability to work with a GP so that the hurdles that are required before patients see us are all met is invaluable, so that then we can facilitate them on to the most appropriate treatment in a more timely manner,” she said.
Health reform is a “mammoth” issue, but one Dr Lee won’t shy away from during her term as college president.
“To me as a dermatologist working in private practice in metropolitan Melbourne, and having patients call me with simple skin problems, because they can’t get into their GP for three weeks … I think that’s symptomatic of what’s happening with medical care around Australia right now,” she said.
“This is the first time in years where I’ve been addressing a lot more acute problems, because of the GP wait time.”
She believes the system may be close to “breaking point”.
“Obviously, something has to change,” she said.
“I don’t think I have the answers as to whether or not it should be a national or a statewide system. But obviously, there has to be significant changes to ensure that all our patients have equal access to quality health care.
“It shouldn’t matter where you live, who you are, what how much money you have, it should all be equal and equitable. And we’re not there right now.”
The college also welcomed new president-elect Dr Adrian Lim, a Sydney-based dermatologist with a subspecialty interest in phlebology, cosmetic dermatology and lasers.
Dr Lim is a clinical senior lecturer with the University of Sydney and a staff specialist at the Royal North Shore Hospital where he runs the burns scar laser clinic and cutaneous neurofibromatosis clinic. He also runs a private practice with a focus on laser therapy.
Professor Kiarash Khosrotehrani also joined the college board, replacing Dr Ben Carew who had come to the end of his three-year term.
