Medical groups have accused Ahpra of implying that Australia’s leading surgeons are lying about their motivations for raising concerns about Ahpra’s ‘misguided’ new endorsement system for cosmetic surgery.
The Royal Australasian College of Surgeons (RACS) as well as surgical specialty societies voiced their alarm rover the reforms and Ahpra’s subsequent and ‘deeply troubling comments’ published in The Australian .
Dr Anne Tonkin, the MBA’s Chair, was quoted by Ahpra and The Australian as stating that the reform package prioritised ‘patient safety over vested interest.’
“There is a lot of money at stake in cosmetic surgery reform. Our reform package prioritises patient safety over vested interest. It reflects what is legally possible and what will help keep patients safe,” Dr Tonkin said in the article.
“Patients choosing cosmetic surgery deserve safe care. We have put together and delivered a reform package that raises standards and increases safety measures to stop patients being exploited and reduce the risk of harm.”
In response, medical groups have said that Ahpra’s implication that all the colleges and societies named were acting ‘solely from financial incentives’ was ‘deeply troubling’ and ‘offensive.’
“To claim that any opposition to an endorsement scheme that does not require the standards expected of all other surgeries in Australia is motivated by money, is an offence to the patients who have been maimed and the brave whistle-blowers who have spoken out against cosmetic cowboys,” the groups said in a joint statement.
“RACS and specialist surgical societies have at their hearts the excellence of surgical training and the safety of patients, and to suggest otherwise is also deeply offensive.”
The groups added that plastic surgeons were increasingly seeing patients who needed corrective surgery after being harmed by underqualified practitioners.
“This must stop. These practitioners do not have admitting rights to inpatient services and therefore are often unable and unqualified to look after complications of surgery, and this often results in patients being dumped onto the public hospital system,” they said.
“And in response, we see Ahpra showing disdain for their wellbeing and a desire to further weaken standards. Our concerns are about public safety and quality for all.”
Health ministers have approved the new registration standard for cosmetic surgery endorsement to help patients know who is trained and qualified to perform cosmetic surgery safely, and say it will be clear on the public register if a doctor has met cosmetic surgery standards set by the Australian Medical Council (AMC) and the MBA.
Among other measures targeting advertising, patients seeking cosmetic surgery will also need a referral from their GP, and the reforms apply to doctors practising in two areas:
- cosmetic surgery that involves cutting beneath the skin – including breast augmentation, facelifts, and liposuction
- non-surgical cosmetic procedures, which may pierce the skin but not cut beneath it, such as injectables, thread lifts and laser treatments.
Dr Tonkin noted that while Ahpra acknowledged the expertise of specialist surgeons and endorsed health ministers’ decision to protect the title ‘surgeon,’ the board could not limit surgery to surgeons, citing the example of existing practice in regional hospitals.
“That is not how the law works. Already, every day, hospitals across rural and regional Australia employ doctors who are not specialist surgeons to provide surgery to patients. Changing this would grind surgical services to regional and rural Australians to a halt,” she said.
“Creating an endorsement is the strongest regulatory tool in our kit…Without it, patients will be no better informed than they are now and the opportunity to clean up the cosmetic industry will be lost.”
However, the surgeons contended that Ahpra ‘clearly did not value specialist surgical training’ and were ‘condoning lesser standards.’
“It is true that there are non-surgeon doctors in public hospitals in all parts of Australia performing surgical procedures, but they are within the boundaries of strict training and supervision settings,” they said.
“GPs already practice within their scope of competence in rural hospitals that have appropriate governance in place, but as we have seen with cosmetic surgery, some medical practitioners do not professionally practice within a safe scope of practice based on their competence.
“By undertaking surgery in their own, privately owned, clinics without proper clinical governance, they escape independent scrutiny. A professional audit of outcomes is inaccurate and, in most cases, non-existent.
“This is a matter of patient safety. And in fact, perhaps the underqualified practitioners who are welcoming a lower standard of training, are doing so because they put profits before patients. Ahpra must uphold high standards to put patients before profits.”
For further information:
- Updated: Guidelines for registered medical practitioners who perform cosmetic surgery and procedures
- New: Guidelines for registered medical practitioners who advertise cosmetic surgery
- New: Registration standard: Endorsement of registration of registered medical practitioners for the approved area of cosmetic surgery
- Background: Independent review of the regulation of medical practitioners who perform cosmetic surgery
- Cosmetic surgery hub