fbpx

The Use of Fake Titles Threatens Patient Safety

The Australasian Society of Aesthetic Plastic Surgeons (ASAPS) is concerned that the growing number of medical practitioners who hold themselves out as qualified surgeons by using a fabricated title that implies that they are specialist surgeons is compromising patient safety.

In 2019, under the instruction of the Federal Health Minister, the Hon Greg Hunt MP, the Council of Australian Governments (COAG) Health Ministers have agreed to restrict the use of the title Surgeon as its use by non-specialist surgeons can confuse members of the public. The communique from the November 2019 meeting of COAG stated, ‘the use of the title “surgeon”, including by way of “cosmetic surgeon”, by medical practitioners, non-specialist surgeons or those without other appropriate specific training can cause confusion among members of the public.

This ministerial communique is aligned with the expectation of the Australian consumer.

According to research undertaken on behalf of ASAPS by McNair yellowsquares of 2,000 Australians, 93 per cent agreed that it would be easier for patients to separate the Surgeons from the doctors if medical professionals were only to use their Australian Health Practitioners Regulation Agency (AHPRA) title.

The research also found that 86 per cent of Australians agree it is wrong that doctors without any formal surgical training are allowed to call themselves Surgeons.

This public sentiment puts the spotlight on the current ‘loophole’ where doctors not registered as Surgeons by the AHPRA, Australia’s National Medical Regulatory Agency, go about advertising themselves as such and perform cosmetic surgery.

Don’t elect to put yourself in harm’s way!

The current situation

  • In Australia, it is currently legal for anyone with a basic medical degree to use the term ‘Cosmetic Surgeon’.  This loophole means you could be operated on by someone who has not completed any formal surgical training, and yet, they are allowed to advertise themselves using a misleading title. It is also a title that has no standing in the eyes of the Medical Board of Australia, the AHPRA or Medicare.
  • Specialist recognition by AHPRA confers a title that is protected by law. AHPRA relies on accreditation of training by the Australian Medical Council (AMC).
  • But the law is not explicit about titles that are not recognised by AHPRA – such as ‘Cosmetic Surgeon’.
  • The spirit of the law (Health Practitioner Regulation National Law Act 2009) – i.e. to avoid titles, names, initials, symbols, words or descriptions that might indicate they are a specialist – is being regularly abused by the cosmetic surgery industry.
  • The loophole allows medical practitioners who lie outside the protected title regime to overstate their credentials in a way that is confusing to the public.
  • More resources to police the issue is not enough – the law needs to be explicit about the use of the title ‘Cosmetic Surgeon’.

Don’t elect to put yourself in harm’s way!

 

The response to date

  • 2016: The Medical Board re-issued guidelines for cosmetic surgery. These guidelines cover conflict of interest; patient assessment; provision of services to patients who are under 18 years of age; consent; patient management; provision of patient care by other medical practitioners; prescribing and administering Schedule 4 cosmetic injectables. As well as training and experience; qualifications and titles; advertising and marketing; facilities; and financial arrangements.
  • 2017/2018: State Governments (VictoriaQLD and NSW) have passed legislation restricting the type of facility that can perform cosmetic surgery.
  • 2018: COAG issues consultation paper to review the National Law, including the use of the title ‘Cosmetic Surgeon’.
  • 2019: Under the instruction of the Federal Health Minister, the Hon Greg Hunt MP, the state and territory Health Ministers have agreed to restrict the use of the title Surgeon as its use by non-specialist surgeons can confuse members of the public. The communique from the November meeting of COAG stated, ‘the use of the title “surgeon”, including by way of “cosmetic surgeon”, by medical practitioners, non-specialist surgeons or those without other appropriate specific training can cause confusion among members of the public.

Don’t elect to put yourself in harm’s way!

 

Why does the use of the title ‘Cosmetic Surgeon’ matter?

  • Allowing doctors to continue to abuse this loophole and use the fabricated title of ‘Cosmetic Surgeon’ compromises patient safety, endangers life and consumes significant public resources and tax-payers dollars to fix up ‘botched’ jobs in public hospitals.
  • As NSW Health said in its Report on the Review of the Regulation of Cosmetic Procedures April 2018, p8:

However, in respect of the title ‘Cosmetic Surgeon’, the use of this title can be seen to imply that a medical practitioner has a form of specialist registration and could be seen as misleading to patients.

Don’t elect to put yourself in harm’s way!

 

The Australian consumer expects mandatory use of AHPRA titles to protect patients

According to new research on patient safety in cosmetic surgery* released in December 2019 by the ASAPS:

  • Ninety-three per cent of Australians agree that it would be easier for patients to separate the surgeons from the doctors if medical professionals were to only use their AHPRA title.
  • Ninety-two per cent of Australians agree that a patient’s safety is put at risk when a doctor performs surgery without having completed surgical training.
  • Eighty-six per cent of Australians agree it is wrong that doctors without any surgical training are allowed to call themselves surgeons.
  • Eighty-one per cent of Australians agree that the title cosmetic surgeon implies the doctor has completed surgical training.
  • Seventy-seven per cent of Australians agree banning the term cosmetic surgeon would help patients separate the doctors from the surgeons.

The evidence is mounting for the need to restrict the title of “Surgeon” to doctors registered as specialist surgeons by AHPRA.

Don’t elect to put yourself in harm’s way!

 

The life-threatening and life-altering impact of the use of fake and fabricated titling

  • Cosmetic surgeon, Mikhail Soutorine, will be allowed to continue to work as a doctor under strict conditions and supervision following his medical licence being suspended by the Medical Board of Australia in November 2019. The suspension came after two women allegedly suffered complications from botched tummy tucks performed in a Perth clinic in July and August 2019. According to the Medical Board, Dr Soutorine used unsafe sedation during the surgery without the presence of an anaesthetist or monitoring equipment, breaching Australian regulations.
  • A man has been found guilty of carrying out several procedures that involved injecting patients with cosmetic injectables despite never being a registered nurse.  The Australian Health Practitioner Regulation Agency (AHPRA) who levelled the charges, claimed McLennan was performing the duties of a registered nurse when he worked at the clinic and was in breach of national laws.  The story was reported by 10 Daily on 23 November 2019.
  • The Sydney Morning Herald on 3 November, reported a tribunal has found a Sydney cosmetic surgeon showed a “reckless disregard for patient safety.” The doctor performed stem cell treatments akin to “quack medicine”, banning him from practising for seven years following the death of a patient with severe dementia.
  • com.au reported on 6 September the story of Rachael Archer who had breast surgery to boost her confidence after having kids. The NSW South Coast mum-of-two says she was convinced Dr Blackstock was a qualified and experienced surgeon — but it turns out he was nothing more than a general practitioner, and he was also unlicensed at the time of her surgery.
  • On Channel Nine’s A Current Affairs program (30 July) an investigation into a ‘celebrity’ doctor revealed a wake of patients with poor surgical outcomes and two died.  One of the patients interviewed for the story said she would have never agreed to be operated on by the doctor in question had she known he wasn’t a Plastic Surgeon.
  • July 2019, the public became aware of a beauty salon hidden in the back of a jewellery store in Springvale, Melbourne that had put patients lives at risk of HIV through poor hygiene standards.  According to media reports, the Department of Health officers were shocked to discover cockroaches among medical equipment in the clinic at the back of the jeweller’s when they raided the store in late May.
  • In June 2019, the Herald Sun reported that a woman undergoing a liposuction procedure said her doctor performed the roles of Anaesthetist and Surgeon, for which neither was he accredited.
  • The Guardian’s Melissa Davey, under the headline “Fake Plastic Surgeon, performed breast implant on a woman without anaesthetist” on 4 April 2019, wrote that an NSW district court judge, Leonard Levy SC, found a patient was the victim of unprofessional and incompetent treatment by Dr Blackstock. The patient received damages of $204,607 and Dr Blackstock ward ordered to pay her legal costs.  In his judgment, Levy stated, “I find that if the defendant had told the plaintiff that he was going to provide the described treatment without having suitable qualifications, training and experience, it would have been most improbable that the plaintiff would have submitted herself to any such operation at the hands of the defendant.
  • On 31 March 2019, Channel Seven’s Sunday Night program again brought to our attention the devastating consequences that can happen when doctors are allowed to parade as surgeons, free to title themselves whatever they please.
  • In January 2019, a South Australian man was sentenced to jail for the criminal activity of importing and distributing counterfeit medicines.
  • There would appear to be at least two class actions They involve hundreds of cases of women disfigured, suffering life-threatening infections, and who have been severely financially compromised at the hands of under-qualified medical practitioners performing invasive surgical procedures.
  • The TGA handed down a $25,000 fine to an Australian company caught importing counterfeit products meant for injectable treatments in 2018.
  • In 2018 the ABC’s Four Corners program that aired in August highlighted several instances of catastrophic outcomes for patients at the hands of cosmetic medicine providers who demonstrated an inability to play by the rules.
  • In 2018 there was the first case in Australia of a dermal filler causing blindness n a patient.
  • In August 2017, Beauty Clinic Owner, Jean Huang died at the hands of a foreign national who was not registered to practice medicine in Australia following the injection of “quite high” levels of the painkiller tramadol.
  • Raids on beauty salons in Victoria and NSW found many breaches where counterfeit products were being used.
  • BBLs (Brazilian Butt Lifts) have the highest death rate of any cosmetic surgery procedure: one in three thousand surgeries result in fatalities.
  • A woman died in 2008 in a Sydney Cosmetic Clinic following uncontrolled bleeding following mini liposuction(Coroners Case findings in 2016).
  • Two women suffered cardiac arrests during breast augmentation procedures at The Cosmetic Institute in 2015 (in January and September).

Don’t elect to put yourself in harm’s way!

False and Misleading Titles

  • Many of the medical practitioners implicated in recent cases with death or disastrous surgical outcomes do not have formal accredited specialist training in Australia.
  • Many of these medical practitioners use a fabricated title that is not an actual and accurate reflection of their AHPRA registered title.
  • In many cases, patients were under a false illusion that “their surgeon” was a specialist who was comprehensively regulated by the relevant authorities.
  • The public’s expectation of credible regulatory oversight of practitioners stated titles, and in turn, safe surgical outcomes are not being met.

Don’t elect to put yourself in harm’s way!

 

Our Recommendation

To keep patients safe, we want it made mandatory for a medical practitioner only to use a title that is identical with their AHPRA category of registration. This move would make the misleading and fabricated title ‘Cosmetic Surgeon’ redundant and would provide patients with a clear way to identify who the accredited surgeons are in Australia.

Don’t elect to put yourself in harm’s way!