For some time now I, along with colleagues across the cosmetic surgery industry, have called for new standards from the General Medical Council. Unethical practice by unscrupulous providers and a lack of regulation around training has done little to help an industry which is, by and large, run by highly professional and caring surgeons. Unfortunately, a ‘few bad apples’, as the saying goes, reflects badly on the rest of us, and we’ve lobbied the GMC to take action.
Now, I’m delighted to report that the GMC has finally issued what it describes as ‘tough new standards for doctors carrying out cosmetic procedures’. The new regulations came into force last month, and have been broadly welcomed within our profession.
The GMC’s document is some 14 pages long though critically the guidance says doctors who provide cosmetic procedures must:
- Advertise and market services responsibly – any advertising must be clear, factual and not use promotional tactics, such as ‘two-for-one’ offers to encourage patients to make ill-considered decisions. It also includes a ban on offering procedures as prizes. This issue alone will do much to clean up questionable marketing tactics and protect patients from making ill-judged decisions. In addition, the guidance says doctors must not allow others to misrepresent their services so service providers must take care that support staff are working ethically.
- Give patients time for reflection – make sure they have the time and information about risks, to decide whether to go ahead with a procedure. Patients should not feel rushed or pressured. This is one of the reasons we place so much emphasis on the initial consultation period – it’s important that we understand your motivations for surgery and your desired outcomes, and that you understand what’s involved and are able to judge whether surgery is right for you.
- Seek a patient’s constent themselves – the doctor carrying out a cosmetic procedure is responsible for discussing it with the patient, providing them with the information and support they need, and for obtaining their consent. This responsibility must not be delegated.
- Provide continuity of care – the doctor must make sure patients know who to contact and how their care will be managed if they experience any complications, and that they have full details of any medicines or implants.
- Support patient safety – making full and accurate records of consultations, using systems to identify and act on any patient safety concerns, and contributing to programmes to monitor quality and outcomes, including registers for devices such as breast implants.
The need for the new regulations was highlighted three years ago at the time of the PIP implant scandal.
PIP breast implants were withdrawn from the UK in 2010 when it was found that a French manufacturer had used industrial-grade, rather than medical-grade, silicone and that they were more prone to rupture.
Some 47,000 British women had had PIP breast implants fitted (PIP breast implants have never been used at our cosmetic surgery practice). In the aftermath of the PIP implant scandal, Sir Bruce Keogh, NHS National Medical Director for England, was asked to review the cosmetic surgery industry.
Many of the recommendations from his subsequent report have been covered in the new guidance issued by the GMC.
At the time of the new guidance being issued in April, Sir Bruce was quoted in a press statement as saying:
“The GMC’s new guidance will play a pivotal role in raising standards and protecting people who choose to have a cosmetic procedure. The independent review I chaired, following the PIP breast implant scandal, highlighted major problems with unsafe practices in the cosmetic sector, including poor follow-up care and record keeping, and misleading and inappropriate advertising and marketing techniques.
“This addresses these issues and will drive safer care, more ethical practice and, overall, a better experience for people undergoing cosmetic procedures. It will also help ensure doctors are seen to be open and honest, that they work within their competence and seek appropriate training and advice where necessary. This marks an important step forward for patient protection across a wide range of cosmetic and lifestyle procedures, including areas such as laser eye surgery.”
It’s interesting to note that the Royal College of Surgeons (RCS) has also published its own set of professional standards, specifically for cosmetic surgery, which will supplement the GMC’s guidance. Later this year the RCS will also launch a new certification scheme, allowing patients to more easily search for a surgeon who has the necessary skill and experience to perform the procedure they are considering.
Details of all UK doctors, including any specialisms they have, are published on the GMC’s online List of Registered Medical Practitioners. The GMC is continuing to explore how additional information about doctors and their qualifications, in areas such as cosmetic practice, can be made available to patients via the register. This may require legislative change, and was the subject of a public consultation by the GMC in 2015.
In addition, the GMC is currently developing a guide for patients considering cosmetic procedures which will give advice and information on things to consider and the questions they should ask their doctor. Regular readers of this blog will find lots of helpful information on this topic, including a new checklist highlighting important research you can do before your initial consultation.
For many people who are just starting out on their cosmetic surgery journey, it may come as a surprise that this sort of guidance and protection isn’t already in place. The rise in popularity of cosmetic surgery, and the increasing use of non-invasive cosmetic treatments such as Botox, has compounded the problem of inappropriate selling of services and lack of training.
It will be interesting to see how the guidance is policed by the GMC and how the guidance develops over the next few years as cosmetic surgery procedures – and patient expectations – continue to evolve.
To download a copy of the GMC’s guidance document, please visit the GMC website.
This article was originally published on our main website – http://www.jamesvmurphy.com/tough-new-standards-for-doctors-carrying-out-cosmetic-procedures-from-general-medical-council/
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