What the regulators have to say?

Recently at the ASCD symposium in Melbourne, we were grateful to attend the session on: What the Regulators have to say: The regulation and ethics of aesthetics. Moderated by, Belinda Walsh and Patrick Mahar.

This is such a pandora’s box. The regulators ultimately are who the health professionals and consumers turn to in the event of something which may seem unjust, unethical or malpractice. This was particularly interesting for Alfie and I, as we are frequently frustrated by poor advertising, the under policed world of social media, the lack of accountability and the patients left behind. I can say Alfie and I have made complaints to AHPRA and it is not an easy process, the outcome is most often less then satisfying and the repercussions for the practitioner are minimal, if any. Having also worked in a clinic which received complaints, we know firsthand the repercussions are not intimidating or threatening in the slightest. It seems to me the exercise is nothing more then a process which is political more than anything.

This was sadly confirmed during the session. We heard from Jamie Orchard, and the question was asked? When does AHPRA enforce advertising breaches and or malpractice? We discovered, much to our dismay, until a criminal conviction is secured, AHPRA do not enforce penalties. If we heard correctly the process is;

    1.A complaint is made

    2.AHPRA determine severity of complaint and act immediately if serious. A less serious complaint will take longer to be acted on. I assume like an emergency triage system.

    3.The practitioner or registered health professional is contacted in relation to the complaint and given the option to either: respond with their defence or remove the breach. What this means is if a patient has complained about an aesthetic outcome or cosmetic treatment, the registered professional can respond and explain how, why and what was done for the patient. In the event the website, social media or an advertisement breaches the guidelines, the health professional is advised to review and take down any breaches.

    4.The case is generally settled because of the response by the registered health professional or the removing of the advertising breach.

The number of health practitioners who have been penalised for breaking the advertising guidelines is extremely low, I believe the number was three. These were extreme cases of the breach. The number of Health Practitioners who have been penalised for malpractice is also extremely low. Although we are looking specifically at plastic surgeons, cosmetic surgeons, dermatologists, and registered Nurses, this low number was across all modalities covered by AHPRA.

We did raise key issues which unfortunately are well known and the Health Practitioners in the room all shared the same frustrations with these issues.

    1.External third-party websites have little to no governance, leaving consumers even more confused. Clinics are held to ransom by patients in regard to google reviews which are free and the clinics have no control over or there are other sites that have ‘all’ good reviews and demand a fee from the practitioner. Either option is not putting the patient first.

    2.Unless a complaint is made – nothing is done or actioned against clinics or practitioners who frequently break the advertising guidelines or practice outside their scope of expertise.

    3.Beauty Therapists using lasers, ultrasound and peels have no minimum standards and cannot be held accountable by AHPRA. However, these treatments are potentially dangerous and can cause serious harm.

    4.The title Therapist is much like cosmetic surgeon vs plastic surgeon, in that you have a Dermal Clinician who is university trained and a Dermal Therapist who is not – both are dermal (hence both cosmetic & plastic are surgeons), yet only one is formally qualified. The Dermal Clinician completes rigorous training and examinations to achieve their degree. Sadly, AHPRA only has jurisdiction over the Dermal Clinician who is a registered health professional. It feels as though the system is set up to penalises those who commit to education, evidence-based practice and patient safety first. Don’t go to university and you can basically do whatever you want.

    5.The register or directory in which you can search a registered practitioner is not user friendly or clear. Mr Orchard acknowledge the directory on AHPRA is not what it could be. Apparently AHPRA frequently receive calls about people who are not listed (but most often they are) the issue is they are not easily found. This could be due to anglicizing their name, using a middle name and trading under a completing different name which can be Pete instead or Peter. We also suggested that a photo be added to clearly identify a health professional. This would be especially helpful for health professionals bearing the same first and last name.

    6.A member of the audience explained how a beauty therapist stole her identity including using her registration number and again AHPRA could not do anything about this as the therapist is not registered. A photo would have been helpful in a case such as this. Despite the fact consumers are left believing the two different treating ‘professionals’ are of equal skill and qualifications. We know this is not the case as we are in the industry, an industry in which credentials are important. Consumers have no reason not to trust claims like: leading, most trusted, most experienced, highly qualified and internationally trained.

    7.There is little to no public awareness around what is AHPRA, how to search a health professional and/or how to complain to APHRA.

    8.No other medical industry requires such accountability on the patient’s behalf, no one is expected to check their GP is a GP, or the physiotherapist is a qualified physiotherapist. Therefore, is it fair to be expecting patients to check AHPRA?

The saddest part of this session was the cold hard reality. In a lucrative industry like aesthetics, there will always be people finding loopholes and putting patients at risk for “easy money”. The finance companies, directory sites, marketers, device companies and practitioners are in a rapidly growing multi-billion-dollar industry. If AHPRA don’t step up their game and either work with the various organisations, such as ASCD and the public, this industry is sure to see more cases of vulnerable patients being victim to an out dated system.