Threat of ‘strong legal action’ for misuse of surgeon title

The detail of the clampdown on rogue, so-called ‘cosmetic cowboys’ is taking shape, with a definition of which medical specialties qualify to use the title ‘surgeon’ now released.
 
According to a summary published from a meeting of state and federal health ministers, only doctors holding specialist registration in surgery, obstetrics and gynaecology, and ophthalmology, will be entitled to use the description.
 
They stated the decision will not impact existing surgical specialists in dentistry and podiatry, and that it will allow action to be taken against those who wrongly use the title.
 
‘The legislation will establish powers to prosecute or take disciplinary action against persons who unlawfully take or use a protected title in relation to surgery or claim that they or another person hold a type of registration or endorsement in cosmetic surgery that they do not,’ the communique states.
 
It follows high-profile scrutiny of the cosmetic surgery industry.
 
Last week, Federal Health and Aged Care Minister Mark Butler said he is ‘delighted’ that health ministers ‘have agreed to take strong legal action to stop people holding themselves out as surgeons unless they have relevant surgical training’.
 
‘Over the last several months … health ministers and the general population have been shocked by the litany of stories of damage being reaped by unregulated cosmetic cowboys,’ Minister Butler said.
 
‘These are people holding themselves out as surgeons without surgical training charging huge amounts of money for cosmetic surgery and in too many cases wreaking often permanent damage [on] unsuspecting patients.’
 
The legislative change protecting the title will be put in place under the National Law.

However, the key definition of ‘relevant training’ for cosmetic surgery – which is to be endorsed as an area of practice under the wide-reaching reforms – is yet to be confirmed.
 
In an update this month, the Medical Board of Australia (MBA) noted ‘a lot of questions about which qualifications will meet the standard for cosmetic surgery endorsement’.
 
It said a ‘rigorous, standards based and consultative’ process is currently underway.
 
‘The outcomes, and the answers to these important questions, will emerge as cosmetic surgery training programs are assessed,’ the MBA update stated.  
 
‘Some programs will meet the standard and its graduates will be eligible for endorsement. Some may not.’
 
Consultation for a registration standard, overseen by the MBA, closed earlier this month, with proposals expected to go before the country’s health ministers in February 2023.
 
The MBA said a public register will clearly show whether a doctor has met cosmetic surgery standards, and allow the public to understand clearly who is trained and qualified.
 
In the meantime, cosmetic surgery accreditation standards are being developed by the Australian Medical Council (AMC).
 
The Council is taking advice from a Project Advisory Group including consumer experts, educators and nominees from the Royal Australasian College of Surgeons, the Australian Society of Plastic Surgeons, and the Australasian College of Cosmetic Surgery and Medicine.
 
According to the group’s terms of reference, a consultation version of the standards was due to be developed by last month.
 
The MBA states that when the registration and accreditation standards are in place, education providers will be able to apply to have their program assessed and accredited.
 
It also promises a ‘simple and quick’ process for eligible doctors to become endorsed.
 
The work is being carried out following a review into the cosmetic surgery industry published in September, which put forward 16 recommendations aimed at improving patient safety.
 
All were accepted by AHPRA and the Medical Board.
 
One of the recommendations, a National Cosmetic Surgery Complaints Hotline, was put in place almost immediately.
 
The health ministers last week also confirmed funding for a public education campaign about the risks of cosmetic surgery and how to identify well qualified providers, as well as the initiation of a review into cosmetic surgery facility standards.
 
They confirmed an earlier decision to ban the use of patient testimonials in health advertising, including for cosmetic surgery.
 
The review was announced last year, with the RACGP’s subsequent submission also suggesting protecting the use of the surgeon title, and limiting it to those who successfully completed approved training and demonstrated required competencies.
 
However, the college also warned over-restricting the title could ‘negatively impact’ GPs such as GP-surgeons, GP-obstetricians and GP-anaesthetists.
 
The cosmetic cowboy issue has been the subject of repeated investigations in recent years.
 
Earlier this year, cases covered in the media included a retired soldier whose surgery for gynecomastia caused his nipple to fall off. He was also sent to a local motel to recover.
 
A 60 Minutes program also highlighted the ‘Brazilian butt lift’ operation of a 24-year-old woman who had to attend intensive care with septic shock.
 
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