RACGP continues push for overhaul of cosmetic surgery industry

Morgan Liotta

22/04/2022 2:20:52 PM

An ongoing review into the industry’s regulations is critical to ensuring that patient safety ‘comes first’, the college says.

Person having face injection
A number of practitioners have been banned from performing cosmetic surgery following complications and injury to patients.

Late last year, the Australian Health Practitioner Regulation Agency (AHPRA) and the Medical Board of Australia launched an independent review of the regulation of health practitioners in the cosmetic surgery industry.

The review was announced in response to the uncovering of dangerous and unregulated practices that the health regulator said raises ‘significant patient safety concerns’.

Since announcing its review in November 2021, AHPRA has received hundreds of submissions from doctors, patients and medical bodies, including the RACGP, while a number of practitioners have already been banned from performing cosmetic surgery.

RACGP President Adjunct Professor Karen Price says enhanced regulation is ‘clearly’ needed to ensure patient safety and care, as is greater consultation with GPs.

‘The recent reports of patients who’ve suffered due to poor quality practices in the cosmetic surgery industry have been disturbing to say the least,’ she said.

‘It’s important to note that in many instances GPs don’t have the opportunity to have a conversation with people considering cosmetic medical or surgical procedures, because consumers often bypass their usual GP and go directly to cosmetic practitioners.

‘Making changes here to ensure consumers do consult with their GP, or an appropriately trained health professional, could make a real difference.’

Overall, the college is calling for:

  • consultation with a GP or other appropriately trained health professional before a significant cosmetic procedure
  • specialist counselling prior to surgery for patients under 18
  • measures to ensure all patient consent is considered and informed, including translators to assist people from culturally and linguistically diverse backgrounds
  • stricter controls of advertising and marketing of cosmetic procedures, including on social media
  • accreditation of clinics to ensure high-quality infection, prevention, and control standards for patient safety
  • clear guidelines for patients to make a complaint if they are dissatisfied with a service.

The use of terms such as ‘cosmetician’ and ‘doctor’ for providers of cosmetic surgery procedures is also recommended as an important safety measure, with the college recently warning of inappropriate use of the ‘surgeon’ title.

In addition, the RACGP is calling for improved public education so patients know the meaning of each title and the level of training received.

‘Treatments should only be provided if the person performing them has the appropriate training and experience,’ Professor Price said.

‘The potential harms associated with cosmetic surgery are related to the degree to which the competencies held by the practitioner match the scope of practice.’

Professor Price also says pre-surgery consultations with a GP would go a long way towards improving informed decision making.

‘A GP would be able to assess the patient for appropriateness of the procedure, and to screen for underlying physical and mental health issues that may need to be considered,’ she said.

‘GPs should also have access to resources to support patients in these situations, including questions to ask a provider before a procedure, and advice on a cooling off period before committing to surgery.’

She also stressed that GPs are able to discuss the lack of evidence to support a procedure and the potential for any complications or injury, and advise patients when a medical procedure is unapproved and comes with unproven benefits.

Meanwhile, in a 2015 submission to the Medical Board of Australia, the RACGP warned that as cosmetic procedures, such as injectable Botox and collagen treatments, are often performed by a beautician or nurse, it is ‘likely there are instances’ when a treating doctor is not supervising.

‘This is why we believe it’s important that clinical groups agree on a delineation of cosmetic surgery services according to the complexity of the procedures – and ensure that the person performing the procedure has the appropriate training, expertise and experience,’ Professor Price said.

‘A person performing any procedure should be able to deal with all routine aspects of care and any likely complications.

‘Patient safety and care must come first.’

Professor Price says new and emerging cosmetic procedures such as female genital cosmetic surgery are of particular concern.

These procedures are not medically indicated and they’re advertised with commercial labels which can be misleading, such as “designer laser vaginoplasty”, “revirgination” and “G-shot”,’ she said.

‘These are invasive procedures, but there are no evidence-based guidelines for them, and no formal training is required, meaning anyone with a medical degree can perform them.’

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Dr Kate Frances Douglas   1/05/2022 11:27:54 AM

Sounds good in theory, but I have no idea what is involved in most cosmetic procedures so how would I be able to pre-counsel a patient about risks?