Cosmetic surgery has become increasingly popular across the world with a significant rise in both surgical and non-surgical procedures over the past few years. According to a global survey conducted by the International Society of Aesthetic Plastic Surgery, the industry saw a 16.7% increase in procedures year on year with the US performing the most procedures worldwide followed by Brazil and Japan. Australia ranks 25th in the world for surgical procedures.
Cosmetic surgery in Australia is a lucrative industry and expected to continue to grow, with the College of Cosmetic Surgery and Medicine, stating that almost seven million Australians (38% of the adult population) are considering a procedure in the next 10 years and almost half want cosmetic surgery to “feel better about themselves”. The strong growth in the cosmetic industry has been enabled through improved access to products, procedures and increased competition driving more affordable price points and further supported by enticing advertising. The continued growth in the sector does come with some risk particularly for patient outcomes but also for medical practitioners, health establishments and their insurers.
Negligence due to lack of qualification or training, poor equipment, inadequate patient screening, poor pre and post operative care and consent issues can lead to claims for compensation. This can include past loss of income for time off work, medical expenses, domestic assistance for pain, distress and loss of enjoyment of life, and for future losses if injuries affect a claimant’s ability to work into the future including ongoing medical and treatment expenses.
With these developments, and in response to concerning reports of patient harm, an independent review of the regulation of medical practitioners who perform cosmetic surgery was commissioned by the Australian Health Practitioner Regulation Agency (Ahpra) and the Medical Board of Australia (the Medical Board). The final report was released on 1 September 2022. It identified that stronger public safeguards are needed because of escalating consumer demand for surgical and non-surgical cosmetic procedures and more practitioners seeking a career path in the cosmetics industry or to supplement existing revenue streams.
Australian Health Ministers agreed to a suite of reforms to the cosmetic surgery sector. The Australian Commission on Safety and Quality in Health Care (the Commission) was tasked with developing the National Safety and Quality Cosmetic Surgery Standards (Cosmetic Surgery Standards). The aim to ensure patients receive safe, high-quality care in facilities where cosmetic surgery is performed.
The Cosmetic Surgery Standards were launched on 14 December, following broad consultation with consumers, clinicians, services, professional and peak bodies, regulators and other representatives of the sector. The intent of the reforms is to drive higher practice standards and new advertising rules for doctors to protect patients.
As of 1 July 2023, the Medical Board have also issued stronger guidance for doctors who conduct and advertise cosmetic surgery. These changes provide greater clarity for medical practitioners conducting cosmetic surgery and will make it easier for patients and consumers to confirm their chosen doctor is appropriately qualified. These guidelines also extend to non-surgical cosmetic procedures performed by medical practitioners, including Botox and dermal fillers (also known as soft tissue fillers),
In particular, the guidelines require;
- GP referral for all cosmetic surgery;
- more thorough screening and psychological evaluation of patients prior to surgery;
- clarity around informed consent (including the need for cooling off periods);
- advertising and marketing conditions
The Ahpra and National Boards are also reforming the regulation of registered health practitioners (including but not limited to nurse practitioners, registered nurses, enrolled nurses, dental practitioners, podiatrists and Chinese medicine practitioners) who work in the non-surgical cosmetics sector in Australia. These reforms will improve practice and standards, public safety and informed consumer choice. The proposed guidelines have been subject to public consultation and approval by National Boards. Consultation occurred between 27 November 2023 to 2 February 2024, and finalisation of the proposed guidelines is likely to be sometime in 2024.
The strengthening in guidelines and standards are ultimately focused on protecting and improving patient outcomes but are also relevant to both medical defence organisations who indemnify medical practitioners as well as general insurers who may insure registered health practitioners and medical establishments. Berkley Re continue to actively monitor the development of regulations and guidelines in this sector and the potential impacts on patient outcomes and claims costs.
