Independent practice
Independent practice
Feature
• emotional wellbeing ( consideration of affect and mental health impacts of scars ).
Early intervention and outcomes
In order to reduce long waiting lists and increase patient access to high quality scar management , I co-founded a private , therapist-led scar clinic in central London . One of our goals is to keep waiting lists short to enable early assessment and intervention , leading to optimal outcomes ; we offer both virtual and face-to-face appointments to improve accessibility .
As part of our sustainable development goals and mission statement of equity , integrity and transparency , we have established a key partnership with a cancer charity , Yes To Life . The purpose of this is to provide subsidised treatment through supportive grants and concessions , so that patients with scars after cancer surgery can have easy access to scar therapy , without worrying about the cost of treatment .
We also aim to improve our patients ’ survivorship journey , by working towards greater scar satisfaction .
We use patient reported outcomes , including the POSAS ( Patient and Observer Scar Assessment Scale ), to assess a patient ’ s perspective of their scars , and the VSS ( Vancouver Scar Scale ) to support with clinical scar assessment to guide clinical intervention . We also use the JSS ( Japan Scar Scale ) to support with an individual ’ s risk stratification with scars and differentiation between hypertrophic , keloid and atrophic scars .
Setting up in independent practice
I have always had an entrepreneurial mindset , which has supported me to proactively set up my scar clinic from scratch . For any fellow occupational therapists considering opening your own private practice , I would highlight the value of your network of colleagues and friends who can provide encouragement and wisdom .
I also enrolled on business development courses at Birkbeck University to further my knowledge around independent practice and joined RCOT ’ s independent practitioner forums .
Scar management is an important and emerging role for occupational therapists and we aim to support patients to overcome barriers to occupational engagement and performance through individualised assessment and treatment .
Supporting occupational therapists working in the independent sector
The RCOT Specialist Section – Independent Practice supports and promotes occupational therapists working in independent practice – whether considering , new to or established – and including sole traders , companies , not for profit organisations and contractors . The aims are to :
• Support members in the start-up , running and development of their businesses .
• Provide networking and learning opportunities for members .
• Raise the profile of independent occupational therapists and the profession .
• Enable members of the public and other professionals to find an independent occupational therapist .
Find out more about the benefits of membership at https :// bit . ly / 3SwR9pI .
Dastagir K et al ( 2021 ) Non-invasive and surgical modalities for scar management : a clinical algorithm , Journal of Personalised Medicine , 11 ( 12 ): 1259 . DOI : https :// doi . org / 10.3390 / jpm11121259 .
De Decker I et al ( 2022 ) The use of fluid silicone gels in the prevention and treatment of hypertrophic scars : a systematic review and meta-analysis , Burns , 48 ( 3 ): 491 – 509 . DOI : https :// bit . ly / 496oQFO .
Kim EY , Hussain A and Khachemoune A ( 2022 ) Evidence-based management of keloids and hypertrophic scars in dermatology , Archives of Dermatological Research [ Preprint ]. DOI : https :// doi . org / 10.1007 / s00403-022-02509-x .
Obi EE ( 2022 ) Surgical considerations in skin of colour : minimising pathological scars , Clinical and Experimental Dermatology , 47 ( 8 ): 1429 – 1437 . DOI : https :// doi . org / 10.1111 / ced . 15147 .
Yuan B et al ( 2023 ) Vascular and collagen target : a rational approach to hypertrophic scar management , Advances in Wound Care , 12 ( 1 ): 38 – 55 . DOI : https :// doi . org / 10.1089 / wound . 2020.1348 .
Brown BC et al ( 2008 ) The hidden cost of skin scars : quality of life after skin scarring , Journal of Plastic , Reconstructive and Aesthetic Surgery , 61 ( 9 ): 1049 – 1058 . DOI : https :// bit . ly / 3SLbBVl .
Words JOEP FERNANDO , Specialist Hand and Scar Management Occupational Therapist , London Scar Therapy . For information on referrals clinical @ LondonScarTherapy . co . uk or visit the website for more information www . LondonScarTherapy . co . uk
February 2024 OTnews 47