The Royal Australian College of General Practitioners (RACGP) is calling for greater regulation of the cosmetic surgery industry to improve patient safety and care.
In a submission to Ahpra’s Independent review of the regulation of medical practitioners who perform cosmetic surgery, the RACGP made a number of recommendations to improve patient safety and ensure consumers can make fully informed and thought-out decisions before having a procedure.
Ahpra announced it would review the largely unregulated industry, following a Four Corners exposé of dangerous and disturbing practices in cosmetic surgery clinics. To improve patient safety, the RACGP is recommending:
· a consultation with a GP or other appropriately trained health professional before a significant cosmetic procedure
· specialist adolescent counselling prior to surgery for patients under 18
· measures to ensure all patient consent is considered and informed, including translators to assist people who don’t speak English as their primary language
· 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
· use of terms such as "Cosmetician" and "Dr" for providers of cosmetic surgical services, and not surgeons, and public education so consumers know what different titles mean and the level of training received
· clear guidelines for patients to make a complaint if they are dissatisfied with a service
RACGP President Adj. Professor Karen Price said sensible changes were needed to ensure patient safety.
“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 – clearly greater regulation is needed to ensure patient safety and care,” 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.
“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. 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.
“New and emerging cosmetic procedures such as female genital cosmetic surgery raise even more concerns. 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’.
“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.
“This also highlights why it would be beneficial if patients saw a GP in the first instance when considering cosmetic surgery.
“A GP would be able to discuss the lack of evidence to support a procedure and the potential for injury or complications. Patients should be warned when a medical procedure is not approved, and the benefits are unproven.
“When it comes to female genital cosmetic surgery, patients should be referred to a gynaecologist rather than directly to a cosmetic practitioner, and mental health and body image concerns should be explored, and appropriate counselling arrangements provided.”
The RACGP President said a rigorous review of the marketing, accessibility and costs of procedures was also warranted.
“While the advertising guidelines for cosmetic surgery are appropriate, their implementation is inadequate and requires further action and refinement,” she said.
“The evidence supporting procedures needs to be clearly available to consumers to avoid misleading therapeutic claims.
“And treatments should only be provided if the person performing them has the appropriate training and experience.
“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.
“The RACGP highlighted in a previous submission to the Medical Board of Australia that cosmetic procedures, such as injectable Botox and collagen treatments, are often performed by a beautician or nurse. And it’s 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.
“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.”