Australia’s health regulator has announced a review of patient safety issues in the cosmetic sector, after decades of devastating patient harm at the hands of “cosmetic surgeons”. The review is a long overdue first step, but there is a long way to go before true reform takes place.
The Australian Health Practitioner Regulation Agency already has the power to crack down on cosmetic cowboys, as proven in the case of Dr Daniel Aronov, who has been banned from cosmetic medical and surgical procedures.
The question is, why isn’t AHPRA applying this level of discernment to all practitioners? And why won’t they take a preventative approach, rather than waiting for complaints and media attention to force their hand?
To truly protect Australian patients from harm, AHPRA must provide clear guidance around how it will monitor and regulate practitioners. The regulator mentions it will be updating the codes of conduct and guidance for cosmetic procedures, but there is no reference to how they actually plan on monitoring what practitioners are doing.
One clear solution is banning the use of medical titles that do not directly align with existing AHPRA titles or registration categories, and forcing practitioners to disclose the AHPRA category under which they are registered.
Up until now, AHPRA’s “regulation” has deprived patients of the ability to make fully informed treatment choices, thanks to the continuing deception embedded in the rogue title of “cosmetic surgeon”. It is all too easy for practitioners from non-surgical backgrounds to hide their lack of specialist surgical registration behind deceptive titles and references to academically bankrupt training organisations.
As a result, cosmetic surgery patients – mostly women – are continuously put at risk, leaving them with life-threatening injuries and life-long deformities.
The Four Corners program on cosmetic surgery, a joint venture with The Sydney Morning Herald and The Age that aired in October, shocked the nation. More media reports that followed in quick succession confirmed the scale of the problem.
One woman described yelling “what have you done to me?” at her cosmetic surgeon after her lung was punctured during liposuction. As recently as 2008 and 2013, two patients died at the hands of cosmetic “surgeons”, and one of these doctors is still practising. Not to mention the cosmetic surgeon who removed a 13-year-old girl’s labia.
These are not isolated events. Specialist plastic surgeons see them on a regular basis when patients come to us in need of corrective surgery after their lives have been permanently altered by these non-specialist practitioners.
Despite specialist plastic surgeons reporting these horror stories to AHPRA for years, it sits on its hands. In March, the Australasian Society of Aesthetic Plastic Surgeons made a voluntary notification to AHPRA, urging them to do what they are supposed to do: regulate.
There are key differences between a specialist plastic surgeon and a rogue practitioner. Specialist plastic surgeons have an additional eight to 12 years of training that’s assessed and accredited by the Australian Medical Council. It’s a robust standard of training and care that ensures good patient outcomes and prioritises patient safety by minimising risk.
Specialist surgeons are prepared to decline treatment when they believe it’s not in the patient’s best interest, and only perform major procedures in a hospital setting. They will keep patients in hospital overnight when same-day surgery is deemed unsafe, ensuring patients receive around-the-clock care and comprehensive after-care.
Many cosmetic “surgeons” do not have access to quality overnight hospital care for patients. Instead, the ongoing treatment to correct harm, save lives, and help patients recover is often dumped on the public hospital system at considerable cost to taxpayers.
If someone wants to see a medical professional whose surgical credentials – or lack thereof – are not recognised in Australia, that is their choice. But it must be an informed choice. Australians should be free from harm and deception – that’s what a health regulator and state health departments are there to ensure.
AHPRA’s much-delayed decision to finally review its checks and balances will come too late for some, but for thousands more Australians, change can’t come soon enough. The solution is simple: regulators and governments must compel practitioners to disclose their registration status to patients, and practitioners must tell the truth about their qualifications.
This article was written by Dr Robert Sheen, President of the Australasian Society of Aesthetic Plastic Surgeons