Health Care Complaints Commission
The old saying goes “if it seems too good to be true, it probably is” rings true in light of claims of improper conduct by The Cosmetic Institute (‘TCI’). A report from the Health Care Complaints Commission (‘HCCC’) has revealed that the largest cosmetic surgery provider in Australia placed certain patients’ health and safety at risk during their procedures.
The HCCC report details over 30 incidents at The Cosmetic Institute where patients were given questionable levels of sedation. Particularly worrying were findings of patients suffering from seizures, heart palpitations and even an incident where a patient’s heart stopped.
These issues have been attributed in part to the use of what is known as conscious sedation as the choice of anaesthetic in order to perform the surgeries. The term conscious sedation refers to a combination of medications which stops a patient from feeling pain, but does not put them to sleep completely (unlike general anaesthetic). Debate is ongoing over the appropriateness of conscious sedation, with some experts contending that it is possible to perform breast augmentation using this technique. The HCCC report outlines occasions where doses of local anaesthetic were given which were in excess of the safe upper limit of the drug. This raises significant issues with regards to patient safety and the HCCC report reflects that the totality of evidence indicates that TCI placed the health and safety of members of the public at risk.
In response, TCI has commented that since the incidents occurred they have taken action to address the issues investigated by the HCCC. Read our previous blog article on ‘Head of Cosmetic Institute Resigns‘.
New guidelines on cosmetic surgery
Incidents such as the ones raised in the HCCC report have led the Medical Board of Australia to release a new set of guidelines on cosmetic surgery, which are designed to better regulate the industry. These will be effective on the 1st of October 2016.
Some of the most significant changes include:
- a seven-day cooling off period for all adults before major procedures
- a three-month cooling off period before major procedures for all under 18s and a mandatory evaluation by a registered psychologist, general practitioner or psychiatrist
- a seven day cooling off period before minor procedures for all under 18s, and when clinically indicated, evaluation by a registered psychologist, general practitioner or psychiatrist
- the treating medical practitioner to take explicit responsibility for post-operative patient care and for making sure there are emergency facilities when they are using sedation, anaesthesia or analgesia
- a mandatory consultation before a medical practitioner prescribes schedule 4 (prescription only) cosmetic injectables, either in person or by video consultation, and
- medical practitioners to provide patients with detailed written information about costs.
Applicable to all medical practitioners
The guidelines will apply to all medical practitioners, including both cosmetic and plastic surgeons and are clearly designed at making cosmetic surgery a safer practice. The regulations should go some way towards reining in the rapid growth of cosmetic surgery in Australia and have been generally welcomed across the medical industry.
However, the Medical Board commented that there are other areas of concern which they do not have jurisdiction to address. These relate to the licensing of private health facilities as well as inconsistencies in drugs and poison legislation across the country. Another point of note is that currently, in Australia, there are no formal qualifications or surgical training required for doctors to label themselves as cosmetic surgeons.
In summation, whilst there is significant appeal to cosmetic surgery, the recent HCCC report and release of new guidelines into cosmetic surgery serve as a timely reminder of the dangers associated with this type of surgery and all patients should take particular care when what is on offer seems “too good to be true.”
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