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Review recommends ‘approval model’ for cosmetic surgeons

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Analysis


AHPRA has accepted 16 recommendations from an independent review of the Australian cosmetics industry, with the aim of improving patient safety.

Many patients seek procedures from cosmetic surgeons because their costs are lower than plastic surgeons.


Results of an independent review of the cometic surgery industry have been published, providing 16 recommendations “to improve patient safety”.


The recommendations, all of which have been accepted by AHPRA and the Medical Council, will take 2-3 years to fully implement and track. media regarding “cosmetic cowboys,” which exploded in 2021 and still continue.


Aiming to respond to reports of unhygienic surgical practices, the use of social media and misleading before/after pictures, complications and unsafe surgical procedures, recommendations include:

  • establish an approval model for cosmetic surgeons
  • a public education campaign to help consumers understand a statement
  • help consumers make notifications against cosmetic surgeons, given that there were none between July 2019 and December 2021 compared to other medical fields, which may be impacted by non-disclosure agreements
  • deal with the advertisement, including AHPRA obtain legal advice on the matter and undertake an industry-specific audit.

A $4.5 million cosmetic surgery law enforcement unit will also be created to implement all recommendations.

But while the final report is 132 pages long, it contains few details about how the approval will work and how doctors who perform cosmetic surgery will be affected.

Many patients seek procedures from cosmetic surgeons because their costs are lower than plastic surgeons.

And while most members of the medical profession would agree that anyone with only an MD or MBBS qualification should not perform invasive surgeries, a large cohort of physicians can call themselves cosmetic surgeons.

This may include credentialed ophthalmologists, as well as general, orthopedic, and ENT surgeons.

There are also many general practitioners who practice cosmetic surgery, some who trained as surgeons overseas before specializing in general medicine in Australia and continue to use their skills. Others learned on the job under the guidance of other surgeons.

Meanwhile, the Australian College of Cosmetic Surgery and Medicine (ACCSM), which has been in existence for over 30 years but is not accredited by the Australian Medical Council, also offers a training path for doctors in cosmetic surgery.

The Independent Review specifically named four doctors, including two GPs in their report:

  • Dr. Daniel Lanzer, who has been disqualified since AHPRA and the Medical Board’s response to complaints against him, has specialist designations in dermatology.
  • Dr Ryan Wells, whose registration is currently suspended, and has MBBS training but no other specialist training
  • Dr. Daniel Aronov, who is subject to registration restrictions to prevent him from performing cosmetic surgery, has a specialized training in general medicine. He must be supervised to work as a general practitioner
  • Dr. Mohammad Reza Ahmadi, also banned from practicing cosmetic surgery, specialized as a general practitioner. He must be supervised to work as a general practitioner

Under the current regulatory system, physicians are not currently required to obtain an ACCSM fellowship or take additional training to qualify as a “cosmetic surgeon”.

This is where terminology is important. According to the report, although the title of “surgeon” is part of several protected specialist titles (for example, “specialist plastic surgeon” and “specialist orthopedic surgeon”), there is no stand-alone protected title of “surgeon”. by national law. .

Therefore, ‘cosmetic surgeon’ is not a protected title and it is therefore unlikely that physicians who are not specialist surgeons would infringe provisions for title protection in national law by using this term.

The report also made no recommendations regarding the use of the “cosmetic surgeon”, stating that it is currently under consideration by the Ministerial Council and outside the scope of this review.

Nevertheless, the ACSM welcomed the findings.

“The college has been fighting for 20 years to bring about real reform that will protect patients by ensuring doctors performing cosmetic surgery are properly trained and qualified and we are seeing them now,” said ACSM President Dr. Anoop Rastogi.

“The reforms are practical, sensible and enforceable and, when implemented, have real power to protect patients and prevent the disturbing outcomes we have seen in recent media.

“Any physician or organization concerned with protecting patients will support these reforms.”

newsGP spoke with several cosmetic surgeons who preferred to remain anonymous, but all welcomed the review’s findings, particularly the implementation of endorsement as a way to improve patient safety.

According to the report, the approval will seek to establish “minimum qualifications” for doctors wishing to perform cosmetic surgery.


“This would recognize that this practitioner has an extensive scope of practice and has obtained specific qualifications approved by the medical board,” the report said.


“This would make it easy for consumers to identify if a practitioner is qualified to perform cosmetic surgery, because the approval would be on AHPRA’s public registry.”


There will also likely be a ‘grandfather’ provision for those with many years of experience, similar to what happened to GPs before the Accredited Training Fellowship was implemented.


However, for many plastic surgeons, the reforms do not go far enough.


Dr Robert Sheen, president of the Australian Society of Aesthetic Plastic Surgeons, was critical conclusions of the examination.


“AHPRA has chosen to protect those who call themselves cosmetic surgeons, instead of protecting patients,” he said.


“It’s reckless and irresponsible.


‘The [Federal] The government must step in to enforce the law so that a practitioner who cuts a patient’s body has completed surgical training accredited by the Australian Medical Council.


Cosmetic surgeons who spoke to newsGP fear that this is partly related to a turf war and that plastic surgeons would like all cosmetic procedures to be performed by them, as accredited by the Royal Australian College of Surgeons.


An alternative, less restrictive solution could see AHPRA collaborate with professional organizations such as the RACGP on approval requirements, particularly regarding who is trained and qualified to perform the surgery.


The college has accredited training paths and requirements for general practitioners in cosmetic surgery, and in its submission the review called for the adoption of ‘cosmetician’ for these physicians, as opposed to ‘surgeons’.


But whatever terminology is used, the issue of cosmetic surgery regulation is not specific to Australia’s billion-dollar industry.



Nordic countries, France and the WE have had similar issues, while it is also easy for people to fly to another country with poor regulations to have cosmetic surgery, which still impacts Australian patients.


There is a clear consensus that regulation is needed in cosmetic surgery to prioritize patient safety, as in any other area of ​​medicine.


What is less clear is the effect on patient access if costs become prohibitive, causing them to seek alternatives that could be just as dangerous, or even more dangerous, such as seeking cheap procedures at the stranger.


The stream on the effects of this independent review will continue to be discussed and analyzed in medical circles and the wider media as implementation progresses, but as several cosmetic surgeons have said newsGPthe first thought should be the patients and do no harm.



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