Doctors without specialist surgical training can keep offering procedures like facelifts, tummy tucks, breast implants and Brazilian butt lifts while the medical regulator works on a multi-year plan to create new accreditation standards.
The Australian Health Practitioner Regulation Agency (AHPRA) will on Thursday release the report of an external review of the troubled industry and promise a new $4.5 million cosmetic surgery enforcement unit and a social media crackdown.
But the new accreditation pathway will not take effect for two to three years and experts warn it may allow currently practising cosmetic surgeons to have their questionable training and experience recognised through “grandfathering”.
Australasian Society of Aesthetic Plastic Surgeons president Dr Robert Sheen slammed the plan as a “reckless, irresponsible proposal” that would “flood Australia with a new breed of endorsed cosmetic cowboys” seeking to make their fortunes in the $1.4 billion-a-year industry.
Royal Australasian College of Surgeons president Dr Sally Langley said authorities should instead ensure surgical procedures “are only undertaken by properly qualified surgeons”, who undertake at least eight years of study on top of a medical degree, and ongoing training and professional development.
Many cosmetic surgeons have only completed a general medical degree and a short weekend course.
The external review, sparked by The Sydney Morning Herald and The Age’s joint investigations and led by former Queensland Health ombudsman Andrew Brown, found minimum standards for education, training and qualifications were “non-existent” in cosmetic surgery.
“It is possible for any medical practitioner to offer and perform invasive cosmetic surgical procedures without having undertaken appropriate training,” the report said.
Brown recommended the regulator “establish an area of practice endorsement for cosmetic surgery … setting a clear minimum standard of training”, saying that program of study “could be existing or newly developed”.
Two weeks after receiving the Brown report, AHPRA chief executive Martin Fletcher and Medical Board of Australia chair Anne Tonkin fronted the media on Wednesday in an online briefing where they defended their performance.
Fletcher, who is facing calls to resign, said “things needed to be done better” but his powers were limited.
“We are owning our part of this … but some of the gaps that have been identified require action by others,” he said.
“Issues like hygiene, infection control, credentialing, what facilities are acceptable for what procedures to occur are all things that we don’t control. They are what’s involved in the licensing of premises [by state governments].”
Fletcher said changes being considered to the Health Practitioner Regulation National Law, if passed by the Queensland parliament and implemented by all states and territories, would give AHPRA new powers to issue public warnings about practitioners posing a public risk.
Medical Board of Australia chair Anne Tonkin revealed the plan to create a new endorsement process setting minimum qualifications for cosmetic surgery was likely “two to three years away”.
“It is complex [and] it does require ministerial council approval [after] consulting with a lot of stakeholders,” she said.
Tonkin, who has also been urged to step down, said she was “being a responsive regulator” and had been unaware of the extent of the problem.
“I was shocked by what I saw at the end of last year in the media reporting because we had not heard about any of those really serious issues … anytime before those reports were broadcast,” Tonkin said. “I was personally shocked and appalled.”
She said the Medical Board wanted to “minimise” grandfathering and only allow cosmetic surgeons with “the appropriate level of training” to continue to practice, but the details would “need to be worked out”.
AHPRA promised a searchable register of cosmetic surgeons accredited under the new pathway and vowed to enforce a ban on testimonials “that mislead and deceive consumers and trivialise risk”, using new technologies to audit social media posts.
The regulator will also “target the misuse of non-disclosure agreements” to silence victims and launch a public information campaign and confidential hotline.
Health Minister Mark Butler has vowed to take urgent action to clean up the cosmetic surgery industry and clamp down on practitioners without proper surgical training and will discuss the matter with state and territory counterparts at a meeting on Friday.
Health ministers are considering whether to restrict the use of the title “surgeon” to doctors who have completed Australian Medical Council accredited surgical training.
The review of the title “surgeon” was established by former health minister Greg Hunt in November 2021 after an investigation into the practices of the country’s biggest cosmetic surgery clinics run by Dr Daniel Lanzer, who has since retired.