Scrapping ban on patient testimonials would give free rein to cosmetic ‘cowboys’, experts warn

Lifting a ban on patient testimonials would worsen the exploitation of young women by unscrupulous cosmetic surgeons, medical and social media experts warn.

The proposed removal of the prohibition on using testimonials in medical advertising is part of a suite of amendments to the national health practitioner laws backed by state and territory health ministers in February.

Social media expert Maddison Johnston says young women are being brainwashed by their social media idols into thinking they need tummy tucks, breast implants and liposuction.

But peak medical bodies have criticised the push to allow testimonials, particularly while the Australian Health Practitioner Regulation Agency (AHPRA) is midway through an inquiry into the cosmetic surgery industry, which was launched after The Sydney Morning Herald and The Age lifted the lid on allegations of misconduct by some surgeons.

Social media experts Michael Fraser and Maddison Johnston, whose research has uncovered disturbing online practices by cosmetic surgeons, said the ban was already being breached daily, but its removal would worsen the problem.

“Cosmetic surgeons on Instagram – it’s not uncommon to see them using hashtags #bodyinspo, #summerinspo,” Johnston said. “It’s just not appropriate for a registered health practitioner to be selling a painful, risky surgery by targeting people who will be following those hashtags. It’s dangerous.”

She said young women were being brainwashed by their social media idols into thinking they needed tummy tucks, breast implants and liposuction, with surgeons profiting from their body image issues.

Fraser said the regulator seemed to be asleep at the wheel, claiming some cosmetic surgeons asked patients to give testimonials immediately after surgery, often while they were still affected by painkillers.

Health regulation consultant Dr Margaret Faux, who has worked in the sector for 40 years, said “buying health is not like buying a TV” because patients lacked bargaining power.

“I’m really worried about the impact this will have on patient safety,” she said. “You will never see a bad testimonial on a platform that a doctor controls.”

Faux said neither AHPRA nor the Australian Competition and Consumer Commission was making a concerted effort to pursue doctors who breached the rules. Influencers who profited from promoting cosmetic surgery should also be held to account, she said.

“It’s income-generating for them and potentially puts vulnerable young people at risk, usually women, who look up to these influencers as role models,” she said.

The Health Practitioner Regulation National Law and Other Legislation Amendment Bill 2022 is currently before the Queensland parliament – the host jurisdiction for the national law, which governs more than 800,000 medical professionals across Australia.

A committee of the Queensland parliament is considering the bill and will hold a public hearing on Wednesday, with a report due next month. If the amendments were passed, they would apply automatically in states and territories except for NSW, South Australia and Western Australia, which must take additional steps to adopt them.

NSW Health Minister Brad Hazzard said he had instructed his department to “look closely” at the legislation and consider the impact on patients of lifting the ban.

“You will never see a bad testimonial on a platform that a doctor controls.”

“Clearly, we need to consult with the medical community,” he said.

Queensland Health Minister Yvette D’Ath said the bill “would see testimonials treated the same as other forms of advertising” and, consistent with general consumer law, they must not be false, misleading or deceptive.

Testimonials would be prohibited if they were provided in exchange for gifts or inducements without stating the terms and conditions, created an unreasonable expectation of beneficial treatment, or encouraged the unnecessary use of regulated health services.

Australian Medical Association president Dr Omar Khorshid said patient testimonials were impossible to verify and could be “completely misleading”.

“It’s not a reasonable way to measure the quality of medical practice,” Khorshid said.

He said it was “bizarre” that health ministers were moving to end the ban while the AHPRA’s review of the standards in cosmetic surgery was underway.

Khorshid said the changes would give free rein to “cosmetic cowboys who’ve been promoting themselves in ways that we believe are unethical and practising in ways that we believe are below the standards”.

Dr Naveen Somia, the past president of the Australasian Society of Aesthetic Plastic Surgeons, said while there might be a role for testimonials, any change was premature while the inquiry was underway.

Australasian College of Cosmetic Surgery and Medicine president Dr Patrick Tansley said the college did not support testimonials as they were often paid for, might not be accurate, and could not be verified.

“Patients should be very, very careful about placing any weight on them whatsoever,” he said.

Macquarie University’s head of plastic surgery, professor Anand Deva, said in a submission to the Queensland parliamentary hearing that misleading testimonials were associated with serious risk of harm and complications, especially in commercially driven areas of medicine such as cosmetic surgery.

“There is no way of policing whether or not the use of testimonials in medical advertising is
compliant with AHPRA advertising standards,” he said. “Failure to enforce these standards will only embolden the use of testimonials as a marketing and advertising tool rather than one that provides factual information to patients seeking a particular treatment.”

Deva said social media influencers were being used as “surrogate testimonials” to get around the ban, in a trend that AHPRA is examining as part of its review.

“We need to ensure that we hold the highest standards and protect patients from both misinformation and unscrupulous and undertrained practitioners,” he said, calling for the ban to remain in place at least until AHPRA handed down its findings.

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