Your healthcare fieldwork guide to dermatology
Dermatology is the branch of medicine that deals with diseases of the skin, hair and nails. Skin disease is very common, accounting for approximately 15% of all GP consultations in the UK and amounting to around 4,000 dermatological diagnoses every year.
Dermatologists treat a number of disorders including psoriasis, psoriatic arthritis, skin cancer, eczema, acne, atopic dermatitis, juvenile idiopathic arthritis (JIA) and allergies. In addition, they can also specialise in aesthetic procedures such as derma fillers. A large number of dermatologists spend a lot of their time in the private sector, and this needs to be considered when carrying out healthcare fieldwork in terms of sample size and incentives.
Who’s who in dermatology
Dermatology is a huge field, and because skin is an organ, it requires specialist care. As a result, there is a multidisciplinary team (MDT) involved in the treatment of dermatological conditions, which can vary according to the disorder. The core members of this specialist care team includes:
Most dermatologists are skin surgeons as well as physicians – and as an important part of practice, the dermatologists will have at least one theatre list for skin surgery per week. Within the hospital setting, dermatologists are often consulted with regards to patients under the care of other specialists and common procedures/interventions include the excision of cutaneous malignant melanoma, removal of skin lesions such as moles and warts, cautery of birthmarks and diagnostic biopsies.
In addition, aesthetic dermatologists and aesthetic dermatologist GPs are physicians who specialise in diagnosing, treating and preventing any changes to the skin that are aesthetically not pleasing to the patient such as pitting or scarring, aging lines or patients with medical skin problems who also have cosmetic concerns. These types of specialists are open to taking part in market research but there are some things to consider. In comparison to regular GPs or dermatologists who do not have a sub-specialty, incentives will need to be increased because of the large amount of private work they undertake means they will expect a higher hourly rate for honorarium so allow this in your budget from the start. They are fewer of them so consider this when putting quotas or restrictions in place for the number per hospital/surgery.
When it comes to dermatologists they are over-researched and are becoming harder to access, which has resulted in smaller numbers being available for recruitment and higher incentives needed to encourage them to take part. Depending on the specific therapy area and incidence rate, dermatologists can be recruited to take part in both quantitative and qualitative healthcare fieldwork studies, across central locations, telephone interviews and online studies – although it’s worth noting that if recruiting for a central location London is the most feasible location for a full day and for other cities it would be smaller sample sizes.
Dermatology Specialist Nurses
Dermatology nurses help patients through the treatment of wounds, injuries and diseases of the skin, as well as administering skin cancer and post-plastic surgery treatments. In order to become certified, nurses need a degree in nursing and must be registered with the Nursing and Midwifery Council (NMC) as well as choosing either adult, children, mental health or learning disability as a specialism. They must then spend half of their nursing degree on supervised placements in their chosen specialist area.
Dermatology nurses are notoriously hard to recruit for healthcare fieldwork due to the time-pressured nature of their work, which means they often don’t have time to dedicate to research. As a result, when carrying out research in dermatological areas, researchers should be aware that smaller numbers will be recruited and a higher incentive needed than often anticipated. Depending on the therapy area and incidence rate, a feasible sample size would be approximately 30 nurses for quantitative research and 15 for qualitative research. If you are looking to carry out one-to-one interviews, they should be scheduled for early evening after clinic – and you may need to consider travel costs on top of the incentive to offer.
In addition to dermatologists and specialist nurses, depending on the disorder being treated other members of the MDT can also include plastic surgeons, ENT specialists, oncologists and oral and maxillofacial surgery specialists.
Melanoma and skin cancer
When it comes to treating melanoma and other skin cancers, the NICE guidelines Improving Outcomes For People With Skin Tumours Including Melanoma recommends that all cancer networks set up two levels of multidisciplinary teams to decide on the best way to manage a patient’s care. This team can include a number of HCPs such as dermatologists, plastic surgeons, cancer specialists, radiologists, nurses, GPs who specialise in skin cancer, physiotherapists, occupational therapists, cosmetic camouflage advisers and histopathologists. The two levels of MDT for melanoma and skin cancers are the Local Hospital Skin Cancer Multidisciplinary Team (LSMDT) and Specialist Skin Cancer Multidisciplinary Team (SSMDT), with LSMDTs usually located in cancer units or in district general hospitals, whereas SSMDTS are more likely to be found in larger hospitals that have their own cancer centres. Everyone with suspected melanoma is seen by a member of one of these teams.
Melanoma is an area we have vast amounts of experience in and can offer help and advice on targets and sample sizes as well useful information on diagnosis and treatment. Download our Melanoma therapy area guide here to find out more.
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