Dr Naveen Somia, Australasian Society of Aesthetic Plastic Surgeons (ASAPS) President writes the evidence is mounting for urgent action to ban fabricated titles, such as ‘cosmetic surgeon’, so patients can easily spot the fake surgeons.
The Evidence is mounting
A new RealSelf survey conducted online by The Harris Poll¹ reveals 59 per cent of women in the United States do not know there is a difference between a cosmetic surgeon and a Plastic Surgeon. Furthermore, more than eight in 10 women (84 per cent) in the US are unaware that doctors do not have to be Board Certified in Plastic Surgery to perform surgical cosmetic procedures such as Rhinoplasty or Breast Augmentation.
In 2017 a report in Plastic and Reconstructive Surgery found that people were confused between the terms Plastic Surgeon and cosmetic surgeon. Of the surveys 5,135 respondents, 87 per cent believed that surgeons had to have specific credentials and training to perform cosmetic procedures or to advertise themselves as Aesthetic, Cosmetic, or Plastic Surgeons. More than half were unsure what the requirements were to be Board Certified.
Breaches in Patient Safety in Australia
- The Australian Competition and Consumer Commission announced on 8 August 2019 it had launched legal proceedings against HealthEngine, Australia’s biggest online GP booking service. The allegations include engaging in misleading and deceptive conduct, after it was revealed the company refused to publish negative feedback, disregarding around 17,000 reviews and altering approximately 3,000 others to embellish on positives or remove negative aspects before publishing them.
- In 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 when they raided the store.
- 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, on 4 April 2019, under the headline “Fake Plastic Surgeon performed breast implant on a woman without anaesthetist”, wrote about damages awarded to a patient. NSW district court judge, Leonard Levy SC, found the patient was the victim of unprofessional and incompetent treatment by Dr Blackstock and awarded damages of $204,607 and ordered Dr Blackstock 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 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.
- There would appear to be at least two class actions underway. There have been hundreds of cases of women being disfigured, suffering life-threatening infections, and who have been severely financially compromised at the hands of under-qualified medical practitioners performing invasive surgical procedures.
- In 2018 the ABC’s Four Corners program that aired in August highlighted several instances of catastrophic outcomes for patients by doctors who were calling themselves surgeons.
- In 2018 there was the first case in Australia of a dermal filler causing blindness in 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.
- 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).
The Use of the Word’ Surgeon’ Implies Surgical Training Has Been Completed
Hundreds, if not thousands of people are under the false impression that someone using the title cosmetic surgeon has completed accredited training in the field of cosmetic surgery.
However, cosmetic surgery is not recognised as a separate field of medicine. Instead, it’s widely accepted as an integral part of the Plastic and Reconstructive Surgery training program administered by the Royal Australasian College of Surgeons (RACS).
Fellows of this program are entitled to be called Specialist Plastic Surgeons and will have the letters FRACS after their name.
RACS is the only accredited trainer of surgeons in Australia and New Zealand. No other body has been granted the responsibility of training surgeons at the level deemed suitable by the Australian Medical Council (AMC).
It’s easy to see why patients are being misled. Any title that uses the word ‘surgeon’ implies they have completed surgical training. Otherwise, why would someone be using such a word if it’s outside of their qualifications and accreditation? It’s quite simple. Cosmetic surgery is booming, and doctors who place a price tag on a patient’s head are looking to cash in.
Doctors Parading as Surgeons are a Risk to Patient Safety
Urgent action is needed by the Council of Australian Governments (COAG) Health Ministers as part of the review of the National Law to stamp out this practice. By restricting the use of the title surgeon to only those with a Fellowship through RACS, patients will be provided greater transparency when choosing between a doctor and a surgeon.
Doctors should not be allowed to use fake and fabricated titles as this misleads patients and puts them in harm’s way.
Channel Nine’s A Current Affairs program on 30 July 2019 highlighted the negative impact on patients as a result of the use of fake and fabricated titles by a doctor. One of the patients in the story said ‘I would have never agreed to the operation had I known he wasn’t a Plastic Surgeon’ — thus demonstrating that fake and fabricated titles easily mislead patients.
Urgent Action is Needed to Protect Patient Safety
There are so many titles being used by doctors who perform cosmetic surgery to imply qualifications which are not reflective of their legitimate Australian Health Practitioners Regulation Agency (AHPRA) status or the AHPRA titling system.
The (AHPRA), as the national medical regulator, has an official title for all doctors that reflects their training and qualifications. Patients can search the AHPRA database to find out what accreditation their doctor has, and if any reprimands or conditions are currently restricting their practice.
ASAPS is calling on the COAG Australian Health Ministers’ Advisory Council (AHMAC) and the AHPRA to mandate that doctors only use their official AHPRA accredited title as signified by their registration. This will help patients to make an informed decision about who is appropriately accredited to perform their cosmetic surgery.
To do so will be protecting the patients of today, and well into the future.