A nationwide shortage of pathologists has caused a serious bottleneck in medical testing, delaying results for up to three weeks. While many of the delays relate to relatively minor medical conditions, diagnoses of serious conditions are also being held up.
Health experts have warned that a delay in a biopsy picking up something unexpected could have serious consequences.
“It could be the cancer you didn’t suspect,” said Associate Professor Trishe Leong, president of the Royal College of Pathologists of Australasia (RCPA). “There’s always the chance of something unexpected showing up in a biopsy,” she said. “If that is not tended to as soon as possible, it can have an impact on patient care.”
Assoc. Prof. Leong is not the only one to voice concerns about the consequences of the shortages. RCPA chief executive Dr Debra Graves echoed her colleague’s warnings.
“There is a huge shortage of pathologists in Australia,” Dr Graves said. “In fact, it’s an international issue, not just within Australia. It’s a worldwide shortage.”
Australian Pathology CEO Liesel Wett said the shortages were particularly acute in subspecialities such as microbiologists. Also affected are histopathologists, who make cancer diagnoses, chemical pathologists and genetic pathologists.
Where have all the pathologists gone?
There are multiple causes of the pathologist shortage, but Ms Wett has no doubt about at least one contributor. She singled out microbiologists “who have worked 24/7 throughout the COVID pandemic and are exhausted.”
Another possible contributing factor is one that seems to be perennially cited as a ‘feature’ of health industry problems – Medicare. Not that Medicare itself is the problem, rather the lack of its financial maintenance.
According to Ms Wett, the Medicare fees for pathology have been frozen since 1995. This is in sharp contrast to the rest of Medicare which sees regular increases as a result of inflation. “Pathology services are now the only Medicare items that do not receive this sort of CPI increase,” said Ms Wett.
The RCPA says it has thankfully not yet had any complaints about pathologist delays. However, that possibility may not be far off if Royal Australian College of General Practitioners (RACGP) reports are any indication.
National RACGP vice-president Dr Bruce Willett said it was taking more than two weeks for some biopsy results to be sent to him after his patients had been hospitalised. These results, he said, had previously been turned around in a handful of days.
What’s the solution?
Notwithstanding a call for pathology to be brought into line with other Medicare fees, the RCPA is investigating other options. According to Dr Graves, a workforce review in 2018 had brought some positive change and another has been instituted.
But with latest estimates showing a shortage of up to 92 pathologists across Australia by 2030, more is needed. The RCPA is calling for state and federal governments to fund more training positions.
One state government has apparently heeded that call. A Victorian government spokeswoman said it had recruited more than 7000 healthcare workers, including pathologists, as part of its $12 billion pandemic repair plan.
In the short term, though, shortages and delays loom as an ongoing issue.
Have you had a medical test requiring a pathologist recently? Have you noticed any delays? Let us know via the comments section below.
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