Dr Joshua Dally, a Registrar based in Jamestown, South Australia, found his calling in helping others from a young age. Growing up, he was captivated by tales of medical missions, specifically Hudson Taylor's endeavours in the 1800s in China. Inspired by these stories, Joshua embarked on his own medical mission to Mongolia, with plans to return one day. 

Joshua's father, a doctor who received immense satisfaction from helping his patients, also played a significant role in shaping Joshua's career path.  

Services in rural and remote areas 

In rural and remote areas like Jamestown, three hours north of Adelaide, accessing specialist services can be challenging. 

The nearest dermatology service is an hour away in Port Pirie, but there's a time delay for patients to be seen. Similarly, when Joshua worked in rural Queensland, the nearest dermatologist was many hours away with referrals taking more than one month. 

With patient’s needing a faster diagnosis and medical plan, Joshua relied on receiving dermatology information from colleagues, which fluctuated depending on their level of expertise or experience in dermatology. 

Some of the places where Joshua worked had a GP with an interest in dermatology who would do visits, but they would only come around three times a year. As this was a rare occurrence, a lot of the time the patient would have to travel to a dermatologist even if it was only a minor skin concern. 

Dr Joshua Dally explains: “You can see the difficulty with patients having to travel so far. It ends up being something that could have been resolved if they could communicate with someone who had the knowledge, without having to travel.” 

Tele-Derm for rural doctors 

Tele-Derm has proven to be very useful for Dr Dally and many doctors across Australia. It provides access to practical dermatology advice and a wealth of educational resources, including real-life case studies, journal reports, live webinars, and an educational monthly quiz. 

“We don't have anything similar at all at our disposal (Tele-Derm). Within a couple of days, you can have a result. A super contrast in that regard. You get the ability to diagnose and treat patients locally rather than refer them to a dermatologist,” Dr Dally says. 

Free access to Tele-Derm is available for all doctors working in areas MM3 to MM7. All ACRRM members, regardless of where they work, can access Tele-Derm for free. 

Dr Dally has been recommending Tele-Derm to all his colleagues and has found the training sessions very helpful, along with the advice. 

"Why not use it if you don't have access to a dermatologist," he asks. 

“You upload images, upload your questions, put the patient's history, and you can get a response in a couple of days or less. Why would you not want to have access to a dermatologist, which we all have a struggle with regardless of where you live? Even if you live in the city, you still have wait times." 

Memorable case 

One particularly memorable case for Joshua involved an 84-year-old man with a rash that flared up in the heat. 

The patient would experience some relief during winter, but the rash never completely disappeared. It appeared on both flanks and extended to his chest and clavicle area. 

The itchiness and discomfort caused by the rash were significantly bothering him. Despite trying numerous lotions, potions, and tablets, nothing seemed to alleviate his symptoms. 

Joshua was perplexed by the condition, as it neither spread nor improved. Concerned about the patient's persistent discomfort, Joshua sought guidance from Tele-Derm. 

"I was at a bit of a loss. I think he had seen others as well and no diagnosis had been reached. I was looking for help with how to investigate it and what can be done in the interim until we come to a diagnosis." 

Initially, Dr Dally received advice to conduct multiple biopsies to rule out uncommon diagnoses, and potentially reach a definitive diagnosis. 

The multiple biopsies didn't provide him with a clear diagnosis. Subsequently, Tele-Derm specialist Dr Rachael Foster swiftly provided additional differential diagnoses and plans. 

Eventually, the patient's condition improved. 

For Dr Dally and countless other rural doctors, Tele-Derm has not only revolutionized dermatological care but has also become a cornerstone of their practice. 

"I would encourage everyone to think of it as a why would I not want this resource, next day, within 48h response time from a dermatologist resource for my patients,” he says. 

Find out more about Tele-Derm. 

Watch the full conversation Dr Joshua Dally on YouTube.