Australia’s cosmetic industry is growing quickly. This situation makes it very clear that there is an urgent need for stronger rules, better supervision, and stricter enforcement of safety standards.
The cosmetic surgery industry in Australia keeps expanding. It is now thought to be worth around $1.5 billion. The public’s acceptance and normalisation of cosmetic procedures are fueling this demand. Also, there are more and more clinics and practices offering these services.
The Australian Society of Plastic Surgeons (ASPS) and other professional groups have long called for better safety and oversight in the cosmetic surgery industry. This is because when things go wrong in this industry, it can cause serious harm to patients. Some well-known cases in the media led to an independent review of the cosmetic surgery industry. The review was finished and released in August 2022.
The review found that the cosmetic surgery sector, as a health service, is special. It’s a bit of a disruptor in the health market and mostly exists outside the existing health system frameworks. What’s more, the current legislative framework only says what titles practitioners can use, not what they can actually do. So, cosmetic surgery and non-surgical procedures are done by medical practitioners with different backgrounds, skills, and experience levels.
Because of the review and its suggestions, the Medical Board of Australia and Australian Health Practitioner Regulation Agency (Ahpra) updated the guidelines for medical practitioners who do cosmetic surgery and procedures. They also updated the guidelines for those who advertise cosmetic surgery. These guidelines stress that practitioners must use their correct Ahpra-approved title and accurately show their training and experience. But they don’t require a certain level of training or the ability to admit patients to deal with post-operative complications.
A more effective change was the passing of amendments to the Health Practitioner Regulation National Law Act 2009. This restricts the use of the term “surgeon” to those who have specialist registration in one of the recognised specialties like surgery, obstetrics and gynaecology, or ophthalmology. This change means the term “cosmetic surgeon” is no longer valid. Now, patients can better understand the nature and extent of a practitioner’s training and expertise when they think about getting cosmetic surgery.
Now, the media and regulators are focusing on improving the practices and standards of non-surgical cosmetic procedures to protect public safety.
Many of the issues that ASPS has been pushing for in the cosmetic surgery field are also relevant to non-surgical procedures. For example, proper training is important. Strict regulation, even at a basic level, about who can access and administer these medicines and treatments is crucial. Honesty in advertising is necessary. Stricter policies and regulations are useless without proper monitoring and enforcement. And when there are violations, sanctions and penalties should be applied to stop inappropriate practices.
A cosmetic “free market”
The problem for regulators is that many of these procedures are done not only by medical practitioners but also by nurses and other health practitioners. They also overlap with therapies in the beauty and cosmetic industries. However, if these treatments and procedures are done wrongly or by people without the right training, skills, or experience, they can seriously harm patients.
Unlike the traditional medical care model, which has checks and balances through assessment, referral, and return correspondence, the non-surgical cosmetic industry is more like a free market. In this market, patients or consumers drive the demand, and practitioners or providers compete to offer the service. It can also be very profitable, which may influence decision-making.
These factors increase the risk that patients may ask for or get treatments that they don’t need or that are not suitable. They also increase the risk that providers may be tempted to go beyond their normal scope of practice or cut corners in care to make more money. Also, some patients care more about the price than about safety and quality. Recent cases in New South Wales, where people got suspected botulism after being treated by an unqualified practitioner with what seems to be an unregulated supply of botulinum toxin, show many of these problems.
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