The term “cosmetic surgeon” is a fabricated title, and its use falls outside the scope of normal regulatory control, writes Dr Robert Sheen.
What if I told you that today, in Australia, a weakness in our law has resulted in thousands of patients being systematically put at risk – and up until now, our regulators have been doing little to nothing about it?
In Australia, a group of medical practitioners who are not registered as specialist surgeons knowingly and recklessly use the title “cosmetic surgeon”. The term “cosmetic surgeon” is a fabricated title, and its use falls outside the scope of normal regulatory control.
The title implies to patients that these practitioners are registered specialists, but in most cases, this is not so. As many patients have discovered to their detriment, there is a wide gap between patient expectations and what the practitioner can deliver. At best, patients are forced to pay out of pocket to correct the unfavourable consequences of poorly performed surgery. At worse, patients are experiencing devastating complications with life-threatening health implications.
It all boils down to the use of the title “cosmetic surgeon” by practitioners with no more than a basic medical degree, no specialist surgical training, and no registration as a surgeon. This group of poorly trained medical practitioners regularly use the title “cosmetic surgeon” to create a deception that they are registered surgical specialists.
Australians spend an estimated $1 billion on up to 500,000 separate cosmetic procedures each year and receive more treatments per capita than Americans. The scale of the cosmetic industry opens the door to opportunist practitioners, and the emergence of the “cosmetic surgeon” is a blatant manifestation of this opportunism.
Australian Consumer Law (ACL) is designed to protect consumers from deceptive practice, whereby false advertising or misleading sales methods may lure consumers into making poorly informed and, ultimately, regretful purchasing decisions. Yet the many thousands of patients who have fallen victim to a “cosmetic surgeon” have not been protected at all.
Further, Section 118 of the Health Practitioner Regulation National Law Act 2009 (the National Law) prohibits claims to specialist registration by practitioners who are not registered specialists. Yet this is exactly what the term “cosmetic surgeon” achieves. And the healthcare regulator, AHPRA, continues to tolerate this deceptive behaviour.
Practitioners should only perform procedures for which they have appropriate training, expertise and experience. Practitioners should not make misleading claims about their qualifications or implied registration status. As section 18 of the ACL states, “a person must not, in trade or commerce, engage in conduct that is misleading or deceptive or is likely to mislead or deceive”.
When a practitioner uses the title “cosmetic surgeon”, they are withholding the truth that they have not undergone the necessary education and compliance steps to attain specialist registration. They are wilfully encouraging patients to undergo treatment that is frequently promoted as a lifestyle choice rather than a serious surgical intervention that has the potential for catastrophic consequences.
Consumers pursuing treatment with a “cosmetic surgeon” are likely to spend tens of thousands of dollars for this privilege and are being deceived by inaccurate information and a warped, misleading vision of the final results.
It is not only the title of “cosmetic surgeon” that is misleading. It is the misrepresentation of skills, expertise, training, and professional affiliations that are being made through advertising and self-promotion both online and in person.
Yet, the law is being broken every day by practitioners who call themselves surgeons and who perform surgical procedures without having completed Australian Medical Council (AMC) accredited training – the Australian standard of training in surgery, including cosmetic surgery.
Eclipsing the significant legal and ethical issues, it is important to recognise the significant human cost. This is a human tragedy being played out in the lives of ordinary people. People who may not want to make a fuss. People who may not be able to afford corrective surgery. People who may be so damaged that corrective surgery is no longer possible.
It is too late to say that this needs to be addressed before “something terrible” happens. It has already happened. It is time for the regulator, AHPRA, to exercise the responsibilities given to it under the national law – a law that gives AHPRA the power to prevent patient harm in the first place.
Dr Robert Sheen MBBS MS MBA FRACS is the president of the Australasian Society of Aesthetic Plastic Surgeons (ASAPS).