Cameron Stewart is a member of the New South Wales Medical Council, but the views expressed here are his own.
If you are considering a tummy tuck, breast implants, or eyelid surgery, you may need assurance that the doctor you choose is qualified and has the right skills for the job.
Today’s highly anticipated review of how cosmetic surgery is regulated in Australia is part of making that happen.
The review provided sound advice on how to protect consumers after cosmetic surgery allegations surfaced in the media (which prompted the review in the first place).
There is something to be proud of. The review was comprehensive, impartial, realistic and the result of extensive consultations.
He recommends tightening up advertising for cosmetic surgery, simplifying the complaints process when problems arise, and improving complaint handling methods.
However, it is unlikely that these and other recommendations adopted by health regulators will be implemented immediately. Such reforms will take time.
Guidelines for determining who has the appropriate education and skills to perform cosmetic surgery—general practitioners, specialist plastic surgeons, or physicians with other titles, with or without additional surgical qualifications—may take some time to finalize and determine.
This is because programs that identify certain physicians as “accredited” medical practitioners, effectively testing their competency in cosmetic surgery, depend on a medical board to determine and approve what skills and education are required.
Any relevant courses or study programs must also be approved by the Medical Council of Australia (responsible for the education, training and evaluation of physicians).
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Over the past few years, there have been media reports of people undergoing inappropriate or unsafe cosmetic procedures and going to hospitals for reconstructive surgery.
Critics say people are being seduced by deceptive social media ads and trusting “undertrained” plastic surgeons to take care of themselves. But they were never properly warned about these risks.
Faced with what could be a crisis of regulatory confidence, the Australian Regulator of Practitioners, or AHPRA (and its medical board), has an obligation to act. He commissioned an independent review of doctors performing cosmetic surgery in Australia.
This review looks at “cosmetic procedures” that cut through the skin, such as breast implants and tummy tucks (tummy tucks). This does not include injections (such as Botox or dermal fillers) or laser skin treatments.
In the new system, physicians will be “accredited” as AHPRA cosmetic surgeons. This type of “blue check” recognition will only be granted to those who meet a minimum educational standard that has not yet been set.
However, once rolled out, consumers will be trained to look for this recognition in the public register of healthcare professionals.
There are currently several ways to file complaints against cosmetic surgeons, including to the AHPRA itself, to medical boards (within the AHPRA), and to state health care complaint agencies.
The review suggests creating new educational materials to show consumers exactly how and when to complain about plastic surgeons. He also suggested setting up a dedicated consumer hotline to provide more information.
The review recommends tightening existing advertising regulations to strictly control those who promote cosmetic surgery medical services, especially those who may:
Finally, the review recommends strengthening policies on how healthcare professionals obtain informed consent for surgery, the importance of post-operative care, and the expected training and education of cosmetic surgeons.
The review also recommends that AHPRA establish a dedicated cosmetic surgery enforcement unit to regulate physicians who provide these services.
Such a law enforcement unit may refer the appropriate physician to a medical board, which then determines whether immediate disciplinary action is required. This could mean the immediate suspension of their registration (“medical license”).
The Royal Australian College of Surgeons and the Australian Society for Aesthetic Plastic Surgery said the proposed reforms are not enough and could even lead to the recognition of some doctors without proper training.
Another possible reform rejected by the review would be to make the title “surgeon” a protected title. It should only be used by people who have had many years of professional training.
Nowadays, any doctor can call himself a “cosmetic surgeon”. But because “plastic surgeon” is a protected title, only professionally trained people can use it.
Others are skeptical that more regulation of property rights will actually improve safety. After all, ownership does not guarantee security and can have unforeseen consequences, such as the inadvertent creation of market monopolies.
Today’s review is the latest in a long line of reviews of medical practice related to cosmetic surgery over the past 20 years. So far, no reforms have been able to provide long-term improvement in outcomes or reduce complaints.
These recurring scandals and stagnant regulation reflect the divisive nature of the Australian cosmetic surgery industry – a longstanding turf war between plastic surgeons and cosmetic surgeons.
But it is also a multi-million dollar industry that has historically been unable to agree on a set of education and training standards.
Finally, to facilitate this meaningful reform, the next challenge for the AHPRA is to achieve professional consensus on cosmetic surgery standards. With any luck, the approval model may have the desired impact.
This is a huge challenge, but also an important one. Indeed, regulators trying to impose standards from above without the support of professional consensus face an extremely difficult task.
Post time: Nov-03-2022