Australian Health Practitioner Regulation Agency - Information for practitioners
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What’s new 

Public consultation happening now

Ahpra and National Boards are consulting now on the proposed new practice and advertising guidelines. Consultation is open until 2 February 2024.

Ahpra and relevant National Boards are proposing to develop the following new guidelines for registered health practitioners who perform and/or advertise non-surgical cosmetic procedures:

  • Guidelines for nurses who perform non-surgical cosmetic procedures (nurses practice guidelines)
  • Guidelines for registered health practitioners who perform non-surgical cosmetic procedures (shared practice guidelines)
  • Guidelines for registered health practitioners who advertise non-surgical cosmetic procedures (advertising guidelines) (for all relevant practitioners, including nurses and medical practitioners)

Information on how you can provide feedback can be found on the Ahpra Consultations page.

New cosmetic surgery standard and guidelines 

As of 1 July 2023, updated cosmetic surgery practice guidelines and new advertising guidelines apply to medical practitioners. 

Read more in the news item and FAQs. The consultation on this work is on the past consultations page

We need practitioners to report unsafe practice

We need your help to make cosmetic surgery safer for patients. Tell us if you see unsafe practice or patient harm.

You can make reports to the Cosmetic Surgery Hotline – 1300 361 041. You can also lodge a notification online.

The public relies on you reporting patient harm to Ahpra to keep them safe. Especially in the cosmetic surgery industry where practitioners are often best placed to identify reportable behaviour as it occurs, such as when a patient sees a second surgeon for revision surgery; or goes to their GP or presents at an emergency department for care after surgery.

It is also a legal obligation as a registered health practitioner to report unsafe practice. These are called mandatory notifications. A failure to make a mandatory notification can constitute unprofessional conduct. Ahpra and the National Boards also encourage health practitioners to notify of behaviour that falls below this legal threshold, but is still otherwise reportable (voluntarily notifications).

We remain concerned that there is significant amount of under reporting in the cosmetic surgery industry (in terms of both mandatory and voluntary notifications).

Examples of when to report

The National Law provides protection from liability for making notifications in good faith. You can also make a confidential notification where we will not pass your details to the practitioner who is the subject of the complaint.

Making a notification is not a breach of your professional etiquette or ethics. It is consistent with professional conduct and your ethical responsibilities. It is the right thing to do. 

Find out more about protections for notifiers.

Here are some examples to help you decide when and what type of concerns should be raised with us.

Repeated poor surgical outcomes (medical practitioner and specialist medical practitioner)

Dr A, a specialist plastic surgeon, has recently seen three separate patients seeking revision surgery following abdominoplasty performed by the same practitioner, Dr B. All three patients were experiencing chronic pain. Dr A has determined that, in each patient, too much skin was removed causing tightness and pain and restricting their normal range of movement. All three patients had significant scarring and poor repositioning of their belly buttons. Dr A is concerned about the poor surgical outcomes she’s observed and considers that Dr B’s practice represents a significant departure from the accepted standard of care. Dr A should raise her concerns with Ahpra to protect the public. 

Uncommon, serious incident (medical practitioner)

Dr C, a medical practitioner working in a busy emergency department, is caring for Patient D. Patient D was brought in by paramedics with serious complications following liposuction and butt lift surgery. Investigations confirm that Patient D’s liver has been perforated during the liposuction procedure. Dr C is concerned that the practitioner who performed Patient D’s surgery is practising in a way that represents a significant departure from accepted professional standards and has contributed to significant harm. Dr C should raise their concerns with Ahpra to protect the public.  

Risky and unprofessional behaviour (medical practitioner and nurse)

Nurse E, a registered nurse working in a popular cosmetic surgery clinic, is concerned about the behaviour of Dr F, a doctor at the clinic. Nurse E has seen Dr F take pictures and videos of patients while they were under sedation. Dr F has been making jokes, dancing and talking to the camera while performing liposuction surgeries. Dr F also regularly asks Nurse E to provide aspects of care and treatment prior to surgery which are not within Nurse E’s scope of practice. Nurse E is concerned that Dr F is not focusing on patients during surgery and is putting patients at serious risk of harm. Nurse E should raise their concerns with Ahpra to protect the public. 

Poor care delivered at unlicensed facility (nurse)

Nurse G, a registered nurse working in a busy emergency department, is caring for Patient H, who recently had liposuction and has presented to emergency with a high fever and pain at the surgery site. Patient H has contracted an infection during or after surgery and the incision is not healing. Nurse G learns that Patient H underwent this procedure at the doctor’s home office. Patient H has mentioned that she sought help from the doctor who performed the surgery but he hasn’t returned her calls. Nurse G is concerned that the surgery may have been performed at an unlicensed facility with poor hygiene practices. He is also concerned by the lack of follow up care Patient H has described. Nurse G should raise his concerns with Ahpra to protect the public.

Concerns about a colleague (medical practitioners)

Dr J works at a popular cosmetic surgery clinic. He’s had concerns about another doctor at the clinic, Dr K, for some time. He feels Dr K takes unacceptable shortcuts and doesn’t follow infection control guidelines. Her rate of post-surgery complications, including infections, is much higher than anyone else working at the clinic. Dr J has tried raising concerns with the clinic director, but he hasn’t seen Dr K change her behaviour or practices and her patients are still contacting the clinic with issues. Dr J isn’t sure what else he can do to protect patients and is considering raising his concerns with a journalist investigating the cosmetic surgery sector. He decides to seek advice from a colleague, another surgeon who works at a public hospital. His colleague confirms that Dr J should raise his concerns with Ahpra to protect the public.

Guidelines and resources

The Medical Board of Australia has published updated practice and new advertising guidance for medical practitioners who provide cosmetic medical and surgical procedures. 

Resources for practitioners

 
 
Page reviewed 5/12/2023