Thursday, 18 July 2013

Should an Apprentice Run a Cosmetic Procedures Business?

There are several ironies involved in Dr Leah Totton winning The Apprentice.

First, Dr Totton was trained at a cost to the NHS estimated by one report to be £250,000, the very same amount Lord Sugar is to invest in her private medical company, thereby inducing her to leave the NHS. So the taxpayer, through the NHS has funded her training and then, through the BBC, has helped deprive the NHS of her services.

Second, Sir Bruce Keogh's Review of the Regulation of Cosmetic Interventions recommended a prohibition on offering cosmetic procedures as competition prizes yet the BBC has now given a whole cosmetic clinic as a prize in a competition. That takes it to another level!

Third, although Dr Totton's selling point was that she is a proper doctor, the British Association of Plastic Reconstructive and Aesthetic Surgeons has expressed its concern that "a very junior doctor" should be held out as an authority in cosmetic interventions.

So, to BAPRAS she does indeed look like "The Apprentice" when it comes to offering cosmetic procedures.

The business will be called Dr Leah (not Niks as she had planned) which will emphasise her medical qualification. She is a registered medical doctor and was given a full licence to practise in August 2012. Accepting that her medical training might put her in a better position to offer cosmetic interventions than the local beauty salon, the question is whether she has the qualifications and experience to be held out as an expert in the field of cosmetic procedures.

BAPRAS writes that The Apprentice final, "highlights the on-going trivialisation of non invasive cosmetic surgery procedures and dismisses the associated risk of physical and emotional harm in favour of financial gain and entertainment."

Prospective patients need to make sure that Lord Sugar remains the only person taking a risk. If anyone is considering undergoing Botox injections, facial fillers or similar so-called "non-invasive cosmetic procedures" at the hands of any provider, they should consider asking:

- What are the risks and possible complications associated with the treatment and what evidence is there of the long term effects of the treatment?

- Will further treatments be necessary to maintain results, and at what cost?

- What qualifications does the practitioner have for providing the   particular treatment? 

- What experience does the practitioner have of providing the particular treatment?

- What investigations into the medical and psychiatric history and condition of the patient have been carried out and for what reason?

- Is the individual practitioner insured in respect of any claims for injury attributable to the treatment and the obtaining of consent? Does the insurance provide full indemnity irrespective of when the claim on the policy is made? What is the excess?

- Is there a contract between patient and provider and what are its  terms? Who is the contract with and are there any exclusion clauses?

- Are there other ways of achieving the same or a similar outcome which do not involve injecting substances or removing layers of skin?

- What written information is available about the treatments and is there sufficient time to read and consider it?

Dr Leah may become an expert in this field of practice and her business may help drive out the rogue practitioners. Meanwhile as she begins her work, the cosmetic procedures industry, perhaps with renewed vigour, continues to draft enforceable standards and regulations which will serve to protect all patients.

Let's hope that future regulations are sufficiently strong to enable the authorities to point the finger at any rogue practitioners and tell them: "You're fired."

1 comment:

  1. I think the other pertinent point is the recent changes on prescribing rules in the last few years. When a doctor is granted full registration with the GMC, for the first 12 months of practice he or she only has the authority to prescribe within the context of an 'Approved Practice Setting' which to all intents and purposes means an NHS hospital. This is a significant deviation from previous prescribing regulations whereby any doctor with full GMC registration could prescribe anywhere.

    In the course of the Apprentice there was at least the implication that Dr Leah had indeed been carrying out these treatments privately. This was either incorrect, or if she has been doing these treatments privately then she has been doing so in contravention of the GMC prescribing rules.

    Dr Leah will not be able to legally prescribe independently until August 2013.