Surgeons pan hit on ‘cosmetic cowboys’

Doctors with no recognised surgical training may be able to receive the specific endorsement of the medical regulator and be included on a public register of recognised experts in cosmetic surgery.

AHPRA has moved to set up a Cosmetic Surgery Enforcement Unit to crack down on rogue practitioners in the wake of the review.

Doctors with no recognised surgical training may be able to receive the specific endorsement of the medical regulator and be included on a public register of recognised experts in cosmetic surgery under a plan that has been fiercely criticised by specialised surgeons.

Specialist surgeons say the plan by the national medical regulator to introduce a register of endorsed cosmetic surgery practitioners is not an adequate response to grave risks to public safety posed by rogue doctors.

The Australian Health Practitioner Regulation Agency plans to introduce an “endorsement’ process that would allow cosmetic surgeons who complete minimum qualifications accredited by the Australian Medical Council and the Medical Board of Australia to be recognised as having an extended scope of practice in cosmetic surgery that would allow them to be listed on a public register that could be checked by patients.

The plan is the centrepiece of a six-month review into how to improve consumer safety in the sector that also recommended improvements to complaints and investigation processes and consideration of a ban on advertising cosmetic surgery.

AHPRA has moved to set up a Cosmetic Surgery Enforcement Unit to crack down on rogue practitioners in the wake of the review, which was prompted by revelations that cowboy doctors were botching surgeries and operating in unhygienic and unsafe conditions. It will accept all of the review’s recommendations.

“Clearly change is needed,” AHPRA chief executive Martin Fletcher said. “AHPRA will work with the Medical Board of Australia to use our legal powers in full to better protect consumers who choose cosmetic surgery, and registered practitioners in this industry can expect a relentless focus.”

Despite the planned endorsement model, doctors who have no training in surgery will be able to continue to use the title cosmetic surgeon and carry out operations, albeit not being endorsed on a public register.

And AHPRA would not guarantee that those to be endorsed and included on the public register would have undergone Australian Medical Council-endorsed surgical training, saying the training was yet to be determined but would included “medical and surgical” training.

That could potentially mean that a dermatologist who had undergone AMC-accredited training could become an AHPRA-endorsed cosmetic surgeon on the public register.

Under a planned “grand­fathering” process, those who have practised in cosmetic surgery for many years may be able to obtain endorsement despite not having undertaken a minimum level of training, which peak surgical bodies warned may allow some unscrupulous operators to continue to operate.

The Royal Australasian College of Surgeons is calling on health ministers – who are meeting on Friday – to move to change the law to mandate that only those with surgical training can practise as cosmetic surgeons.

RACS president Sally Langley said it must be made mandatory that surgical procedures were undertaken only by properly qualified surgeons who had Australian Medical Council accreditation if patients were to be protected. The college does not accept the endorsement model.

Surgeons are also extremely concerned that AHPRA appears to be preparing to lift the ban on cosmetic surgery testimonials. “(That) will simply worsen the exploitation of vulnerable people,” Australian Society of Plastic Surgeons president Nicola Dean said. Australasian Society of Aesthetic Plastic Surgeons president Robert Sheen said if AHPRA was to endorse cosmetic surgeons without surgical training on a public register, it risked giving a “veneer of respectability” to rogue operators.