Australia
Medical Board of Australia Issues New Guidelines on Cosmetic Medical and Surgical Procedures
The Medical Board of Australia (MBA) has issued guidelines for medical practitioners who perform cosmetic medical and surgical procedures in an effort to add new protections for patients — particularly minors — undergoing such procedures.
The new guidelines apply to all medical practitioners, including specialist plastic surgeons, cosmetic surgeons and cosmetic physicians, regardless of their qualifications.
The Board consulted widely with physicians, patients and other stakeholders in seeking out opinions about Australia's regulations for cosmetic procedures, and whether there was a need for changes. In 2015, the Board circulated draft guidelines and asked for feedback on other ways to protect patients — including making no changes to existing regulations, providing consumer education, or providing new and different levels of guidance for physicians.
‘THERE WAS VERY CLEAR SUPPORT FROM STAKEHOLDERS FOR CLEAR GUIDANCE IN THIS AREA AND A STRONG MESSAGE THAT OTHER OPTIONS WOULD NOT EFFECTIVELY PROTECT CONSUMERS.’
“There was very clear support from stakeholders for clear guidance in this area and a strong message that other options would not effectively protect consumers,” said MBA Board Chair Joanna Flynn, AM.
Among the changes are the strengthening of mandatory “cooling off” periods, which ensure patients have carefully considered procedures with their physicians before they go forward with them.
The new guidelines, which will take effect on October 1, 2016 to give medical practitioners time to comply, require:
A seven-day cooling off period for all adults before major cosmetic procedures.
A three-month cooling off period before major procedures for all patients under the age of 18 and a mandatory evaluation by a registered psychologist, general practitioner or psychiatrist.
A seven-day cooling off period before minor procedures for all patients under the age of 18, and when clinically indicated, evaluation by a registered psychologist, general practitioner or psychiatrist.
The treating medical practitioner to take explicit responsibility for post-operative patient care and for making sure there are emergency facilities when using sedation, anaesthesia or analgesia.
A mandatory consultation before a medical practitioner prescribes schedule 4 (prescription only) cosmetic injectables, either in person or by video consultation.
Medical practitioners to provide patients with detailed written information about costs.
The guidelines provide explicit guidance on patient assessment and informed consent, and require doctors to provide clear information to consumers about risks and possible complications.
“The Board listened to stakeholder feedback, and responded with a new set of guidelines that will best keep patients safe,” Dr Flynn said.
“The changes prioritize patient safety and reduce some of the regulatory requirements proposed in the previous draft guidelines, when either there was no evidence of improved safety or the costs significantly outweighed the benefits of a proposal,” she said.
Source: Medical Board of Australia news release, May 9, 2016
United Kingdom
UK's General Medical Council Publishes Findings from Early Study of Revalidation
The United Kingdom's General Medical Council (GMC) has published preliminary findings from an independent three-year evaluation of revalidation in the UK — a comprehensive initiative designed to promote lifelong learning among physicians.
With the vast majority of licensed physicians in the UK now required to engage in the revalidation process, the evaluation sought to gauge responses to the new system among physicians, patients and other stakeholders, as well as its effectiveness and impact overall.
A total of 26,171 physicians completed surveys as a part of the evaluation, along with more than 400 members of the public and other stakeholders.
Findings from the surveys show mixed views about the process of “appraisal” for physicians in the UK, during which their skills are evaluated. Responding physicians who had had an appraisal within the twelve months prior to the survey were positive overall about their individual appraisal experiences. However, less than half of respondents (41.8%) agreed that appraisal is an effective way to help improve clinical practice.
FINDINGS FROM THE SURVEYS SHOW MIXED VIEWS ABOUT THE PROCESS OF ‘APPRAISAL’ FOR PHYSICIANS IN THE UK, DURING WHICH THEIR SKILLS ARE EVALUATED.
The evaluation also showed variation in the degree to which physicians were able to collect patient feedback about their skills — a key feature of the revalidation process. Respondents in some specialties, such as pathology and public health, had lower rates of patient feedback submission than general practitioners, for example. Respondents in anesthetics, psychiatry and emergency medicine were also more likely to report some degree of difficulty in collecting patient feedback, according to the evaluation. Some of the responding physicians had concerns about the ability of certain patient groups to give feedback, such as those in intensive care, patients with poor English language skills or where older patients may not be familiar with online feedback tools.
When asked the question of whether engagement in revalidation is promoting medical professionalism by increasing physicians' awareness and adoption of best practices, the majority of responding physicians (57.6%) stated that they had not made any changes to their clinical practice, professional behavior or learning activities as a result of their most recent appraisal, compared to 42.4% who reported having made such changes. According to the evaluation, survey evidence suggests that older physicians may be the least likely to make changes as a result of revalidation, compared to younger physicians.
According to the evaluation, some physicians also expressed “skepticism about whether revalidation has led to improved patient safety, and about whether the process will identify doctors in difficulty at an earlier stage,” and had mixed views about “whether revalidation will improve standards of practice.”
In gauging opinions of patients and public stakeholders about revalidation, the evaluation found that two thirds of patient and public-involvement representatives felt that patients were unaware of revalidation or did not understand its aims and purpose.
In addition, patient and public involvement representatives raised issues of time, anonymity, and perceived negative repercussions as barriers to patient feedback.
To learn more about the evaluation, and about revalidation in the UK, please visit: http://www.gmc-uk.org/about/research/29074.asp.
Source: General Medical Council, Shaping the Future of Medical Revalidation — Interim Report, April 2016
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