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More than cosmetic change required

It is a phrase that comes to mind when considering aspects of cosmetic surgery provision, where the ‘consumer’ is entrusted with discerning the competency and skill-level of practitioners advertising under the title of ‘cosmetic surgeon’.  This is a tightrope that consumers — patients — should not have to walk. Much tighter regulations and control are required around the use of titles related to medical practice.

It has been well-reported on these pages over the years that some medical practitioners have been advertising themselves as ‘cosmetic surgeons’ while on the General Division of the Medical Council’s register and not on the Council’s  Specialist Register for Plastic, Reconstructive and Aesthetic Surgery. Quite troublingly, there is no impediment to them doing so.

As outlined on the website of the Irish Association of Plastic Surgeons (IAPS), the term ‘cosmetic surgeon’ is not a qualification used by the Medical Council or by the RCSI. “Unfortunately, there are a number of doctors using the term ‘cosmetic surgeon’ without holding any surgical qualifications,” according to the Association.

The Medical Council has previously pointed out that doctors are required to practise within their competencies, and any contravention of this could result in fitness to practise proceedings.

But this just doesn’t seem good enough.

Potential future ‘credentialling’ of areas of medical practice could be part of the solution. Measures under the Health Information and Patient Safety Bill providing for the extension of HIQA’s remit to private health service providers, including cosmetic surgery clinics, will also be helpful, requiring the Authority to set standards, monitor compliance and undertake investigation.

Yet provisions for the introduction of a more formal programme of regulation to private sector services under the Patient Safety (Licensing of Healthcare Facilities) Bill have been in development for aeons. In a written Dáil response in January, Minister for Health Simon Harris stated that it was his “intention” to “move towards publication” of the licensing bill “later this year”. Not anytime soon, it would seem.  

As reported in these pages, the RCSI would like the term ‘surgeon’ to be restricted to only those medical practitioners registered as surgical specialists. The College has “taken advice from in-house legal counsel and identified an area that would assist the Medical Council in providing protection for the title which would present people’s qualifications more accurately to the public”, according to minutes of a meeting of the RCSI’s Surgery and Postgraduate Faculties Board, seen by the Medical Independent.

It is reassuring to know that the body responsible for surgical training in this country is pursuing the matter.

Meantime, the IAPS website helpfully explains the plastic surgery training journey, from basic to higher level. The site provides a very useful explainer of the ubiquitous ‘letters’ after the names of medical professionals. It is a ready-made resource for the Council, the HSE and Department of Health, and anyone interfacing with patients, should they wish to ‘get the message out there’ more fulsomely.

Patient safety depends on it.

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