Cosmetic surgery cowboys’ ‘training loophole’

Australia’s prestigious surgical college and peak medical groups have condemned planned reforms to cosmetic surgery as entrenching an ‘unacceptable downgrading in training standards’.

The Australian Health Practitioner Regulation Agency has devised a new ‘endorsement’ training model aimed at establishing minimum qualifications for medical practitioners who perform cosmetic surgery.

Australia’s prestigious surgical college and peak medical groups have condemned planned reforms to cosmetic surgery as entrenching an “unacceptable downgrading in training standards” in which those who are not trained surgeons will be able to continue to perform procedures including breast augmentation and butt lifts.

A new training model formulated by the medical regulator will shortly be put before the nation’s health ministers for approval following a raft of scandals in which patients were injured in cosmetic procedures performed by doctors who were not surgeons.

But, while the reforms ban use of the title “surgeon” by doctors with no accredited training in surgery, the Australian Health Practitioner Regulation Agency has devised a new “endorsement” training model aimed at establishing minimum qualifications for medical practitioners who perform cosmetic surgery. The model recognises that some practitioners who are not RACS-trained surgeons have an extended scope of practice in cosmetic surgery and have obtained a Medical Board-approved qualification in the area.

“Creating an endorsement is the strongest regulatory tool in our kit,” the regulator said in a statement. “We’re introducing it to make patients safer. An endorsement will tell patients who is trained and qualified. Without it, patients will be no better informed than they are now and the opportunity to clean up the cosmetic industry will be lost.”

But several peak medical groups, led by the Royal Australasian College of Surgeons, described the endorsement model as “creating a dangerous system where the benchmark in skills and capabilities required to perform cosmetic surgery will be lower than that required for other forms of surgery”, which may enable cowboy operators to keep performing surgery.

RACS was joined by the Australian Society of Plastic Surgeons, the Australasian Society of Aesthetic Plastic Surgeons, Australian Society of Otolaryngology Head and Neck Society, General Surgeons Australia, Breast Surgeons of Australia and New Zealand, and the Urological Society of Australia and New Zealand in raising the concerns.

“Patients should be undergoing surgery by competently trained surgeons, not general medical practitioners who have done a lesser program of surgical training … but without the extensive high standards that our College in particular requires,” said RACS president Sally Langley.

In response, AHPRA said” “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. We can’t limit surgery to surgeons – that’s 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.”