New Proposed Guidelines Include Cooling Off Periods For Australian Patients

June 12, 2015

During May 2015 the Medical Board of Australia who essentially are the “regulatory authority for doctors and surgeons” in Australia proposed new draft guidelines for the Australian cosmetic medical and surgical industry.

Whilst any new Australian guidelines do not directly impact on clients seeking plastic and cosmetic surgery in Thailand, PPSI is closely following developments as we are keen to implement any new standards or practices that improve safety, reduce risk and improve our client’s satisfaction and outcomes.

The Board has sought consultation and feedback from interested parties to increase consumer protection and reduce risk, particularly from those looking for cosmetic medical and surgical procedures performed by Australian medical practitioners.

The reason why the Board is looking into this issue is that In Australia there has been a rapid increase in the number of “non-qualified plastic surgeons” performing plastic surgery procedures in clinics, or offices, which has caused concern to be raised, primarily by the Australian Society of Plastic Surgeons. In essence, the discussion is that on the one hand, only qualified surgeons should perform procedures in suitably qualified and certified environments, such as hospitals or qualified clinics. On the other hand, unqualified providers who perform procedures, in “unsafe” environments should be regulated or restricted. This debate has raged on for many years, with questions such as should a doctor with limited surgical experience and qualification perform breast augmentation? Or is it safe for an anesthetic to be administered in a clinic or office setting? The recent well publicized case of a patient whose heart stopped whilst undergoing a breast augmentation in a well know Sydney clinic, by a non-qualified Plastic Surgeon illustrates the life threatening issues related to the debate. The clinic was unable, because of limited equipment and clinical expertise to manage the event and an ambulance was called to stabilize the patient who was then taken to a hospital for appropriate management and care.

The Board is looking at options to mitigate risk and depending on submission received, is likely to publish guidelines for Australian doctors who provide cosmetic medical or surgical procedures to follow. The proposed guidelines include

• a seven-day cooling off period for all adults before procedures
• a three-month cooling off period before procedures for all under 18s, along with mandatory assessment by a registered psychologist or psychiatrist
• explicit guidance on informed patient consent, including clear information about risks and possible complications
• explicit responsibility for post-operative care by the treating practitioner, including emergency facilities when sedation or analgesia is involved
• mandatory face-to-face consultations before prescribing schedule 4 (prescription only) cosmetic injectables
• detailed written information about costs and
• limits on where cosmetic procedures can be performed, to manage risk to patients.

The results of this inquiry, as well as any implemented guidelines, could have a significant impact on how, when, and where Australian clients choose to have their cosmetic and plastic surgery procedure performed. The most controversial issue appear to be the cooling off period. The Board is suggesting one week. The Australian Society of Plastic Surgeons wants two weeks. This could mean that a client has to wait between one and two weeks between having their consultation and having their surgery in Australia. The new guidelines also have the potential to significantly limit where procedures can be performed. Reading between the lines, it appears to PPSI that the Australian authorities are serious about wanting to reduce the number of plastic surgery procedures, which include the administration of an anesthetic, to hospitals or clinics which are fully accredited to do so. The days where this type of procedure can be performed by a non-qualified doctor, in a facility such as an office or “day care facility” maybe numbered.

Further information on the Boards proposal, submissions and other relevant information can be found here www.medicalboard.gov.au/News/2015-03-17-media-release.aspx

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