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Exploring Dermatology, Rheumatology and Musculoskeletal – Insights from the 2023 PCRMM Conference

At Novus Health, we believe in exploring the interrelation of healthcare fields to ensure we treat the whole person. That’s why our very own Kevin Farley and Jack Owen attended the “Where Dermatology Meets Rheumatology & Musculoskeletal” conference in London. An exclusive dual speciality conference hosted by the Primary Care Dermatology Society (PCDS) and the Primary Care Rheumatology and Musculoskeletal Medicine Society (PCRMM). 

This event provided an opportunity to deepen our understanding of the overlaps between these disciplines, particularly relevant to our specialist services at Novus. 

In this article, Kev shares their key takeaways from the conference, highlighting the importance of comprehensive, multi-disciplinary patient care. Read on to learn how these insights shape our approach to delivering compassionate and informed healthcare.

Jack Owen and I attended the PCRMM “Where Dermatology Meets Rheumatology & Musculoskeletal” conference at the Cavendish Centre in central London, to see and hear what colleagues in other disciplines, in this case namely Rheumatology and Dermatology, are doing in clinical practice to address patient needs and more relevant to us here at Novus Health, where and how an MsK service overlaps Rheumatology and Dermatology with regards to patient care and management.

The conference, which started just after registration and coffee at 0930, was very much targeted (rightly, I suppose) towards GPs, specialist physiotherapists and other AHPs working in Rheumatology, or closely attached to Dermatology departments, but was nonetheless beneficial for those of us in MsK Services who also attended. 

GPs actually made up over 84% of attendees, physiotherapists 11%, with the remaining 5% coming from AHPs and other Physician roles.

The speakers came from many different fields of the respective disciplines, and topics covered included Psoriasis & Psoriatic Arthritis, Spondyloarthropathies, Gout, Scleroderma, Cutaneous Vasculitis, Ehlers Danlos & Joint Hypermobility Syndromes, Skin Cancer Lupus and Dermatomyositis. Jack and I both felt a speaker from a musculoskeletal field, or an orthopaedic background could possibly have been added to the list of speakers to discuss further any associated problems they encounter with patients who present with both MsK/Orthopaedic pathologies and a combined rheumatology or dermatological presentation? 

Though one of the speakers was a physiotherapist, she was a specialist in Rheumatology Physio (&FCP), and whilst her talk, as good as it was, focused mainly on the Rheumatology aspect of her role, she did report on the importance of physiotherapeutic input when it came to treating and managing patients with axial-spondyloarthropathies.

All speakers discussed, in appropriate detail, their specific roles relating to their presentations and patients, along with various assessment techniques, radiography/investigations, patient PMH, DH and resulting diagnoses & treatment plans.

It was, however, interesting to note that the predominant and primary interventions for all conditions discussed were pharmacologically based. Every treatment plan seemed to veer towards prescription medicine as a first response.

This, while being a perfectly medically sound approach and evidently in conjunction with NICE guidelines, takes precedence when managing rheumatology and dermatology conditions and no doubt appropriately so in some cases. 

There was, however, very little mentioned with regard to taking a holistic approach to some of the presenting diseases discussed and mentioned above. We both felt that mental health issues, lifestyle, diet, sleep hygiene, patient education and exercise in general, could and should have been part of the larger conversation and, indeed, included as part of any patient management plan, as would normally be addressed by the whole MDT collective.

Likewise, any discussion of onward referral to a nurse specialist, dietetic, podiatry, social worker, mental health practitioner (psychiatry and psychology), physiotherapy and occupational therapy input, was hardly mentioned. 

Some speaker colleagues did advocate for physiotherapy, but as much as an “aside” and an adjunct (which they may well be) to the pharmacological interventions already implemented, over any initial introduction and referral to any of the alternative, aforementioned clinical groups and modalities.

Some discussion around the importance of psychiatry and psychology input was mentioned. Still, all too briefly in both our opinions, and whilst the prohibitive time constraints may explain for this, it would have been nice to have heard from someone in either of these disciplines, describe their roles in the patient care pathway, though understandably, the day was about dermatology, rheumatology and MsK, the point still stands I believe.

Whilst the syllabus and topics were generally well thought out and undoubtedly of interest to the participants, another minor criticism was that some speakers were given more time than others. Indeed for some of the guest speakers, condensing their professional speciality with case studies, assessment techniques and management plans into a 15-minute presentation, was challenging, to say the least. A time limit which subsequently some of them failed to keep to and therefore had to race through their remaining slides to complete the respective presentations. 

Notwithstanding the above observations, which I’m sure the organisers were aware of, the day itself was very enjoyable and equally as educational. The ambience was relaxed and inclusive, and participant interaction was encouraged and likewise reciprocated. 

Jack and I agreed that we were introduced to some new, invaluable clinical knowledge and information, particularly in relation to Dermatology patients. More importantly, that physiotherapeutic and musculoskeletal input is definitively indicated in the treatment and management of patients presenting with both dermatology and rheumatology pathologies, as part of a wider MDT approach, which we at Novus Health adhere to, as professionally and compassionately as able.

All in all, a good day all around was had; many thanks to the organisers and speakers for arranging and contributing accordingly and to our Novus Health management colleagues for encouraging and funding the trip.

 

Kev and Jack Where Dermatology Meets Rheumatology & Musculoskeletal (1)

Kev Farley
Novus Health MsK Clinical Lead

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