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Law needs to recognise ‘vital’ rural GP-Surgeons: RACGP

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Proposed legislation to clamp down on the use of the title ‘surgeon’ requires further clarification, the RACGP has stated.
 
The college has written to Queensland Parliament’s Health and Environment Committee about the Health Practitioner Regulation National Law (Surgeons) Amendment Bill 2023, which aims to protect the use of the title ‘surgeon’.
 
‘The RACGP is currently unable to support the proposed legislation until certain matters have been resolved,’ the college correspondence states.  
 
In particular, the RACGP is seeking clarification on the authority that defines and recognises ‘relevant surgical training’, saying this ‘needs to be reflected in the legislation’.
 
While current National Law protects the use of specialist titles, with a maximum $60,000 penalty fine and/or three years’ imprisonment for their misuse, the title ‘surgeon’ has historically been omitted.
 
That situation has come under the scrutiny following a series of high-profile recent exposes on so-called ‘cosmetic cowboys’, which frequently involved medical practitioners calling themselves ‘cosmetic surgeons’.
 
In its latest submission, the college references its previous responses on the issue, which have included a push for increased public education and regulation surrounding cosmetic surgery and the use of the surgeon title.
 
However, it also reiterates that the clampdown should not undermine the role of some GPs in rural and remote areas.
 
‘The number of GPs who have gained their surgical skills through fellowship with either the RACGP or the Australian College of Rural and Remote Medicine [ACRRM] is small, but their role is often vital to providing essential services in rural communities who do not have access to a full surgical team,’ the correspondence reads.
 
A submission from March 2022 previously set out the principle that the RACGP does not support efforts to diminish the role or skills of GP specialists ‘as a mechanism to regulate unqualified practitioners’.
 
‘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, which needs to be regulated through training,’ that submission stated.
 
The RACGP also contends the current bill contains ‘ambiguities’ in its definition of surgical class, focusing on the following wording:

• ‘a medical practitioner holding specialist registration in another recognised specialty in the medical profession with the word “surgeon” in a specialist title for the specialty.’

According to the college, the phrase ‘recognised specialty’ is clear, but does not include enough clarity on the process for recognising the term surgeon within that specialty.
 
The college has also said the use of the surgeon title should not be limited to those completing training through the Royal Australian College of Surgeons (RACS).
 
‘The use of the title “surgeon” should be dependent on certified completion of approved training and demonstrated required competencies,’ the March 2022 submission stated.
 
‘While this requires legislation, restricting access to this scope of practice only to those who undertake RACS training poses no advantage to patient safety.’
 
According to the college, the term ‘GP-Surgeon’ should be allowed for Fellows of both the RACGP and ACRRM who have completed relevant training.
 
This would include Fellows with the Advanced Rural General Practice (FARGP) qualification who complete the ‘Surgery – Advanced Rural Skills Training’, as well as ACRRM Fellows with the ‘Surgery Advanced Skills Training’.
 
The surgeon title has historically been open to use by any medical practitioner. In 2019 state health ministers agreed to consult the public on restricting its use under National Law.
 
Separately, a wide review of cosmetic surgery practices was published last September after intense public scrutiny of the sector.
 
All 16 recommendations were accepted by AHPRA and the Medical Board. 
 
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AHPRA Cosmetic surgery GP-Surgeons

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