An unintended victim in the quest to rein in dodgy cosmetic doctors could be rural generalists and GPs with advanced training in surgical disciplines.
The definition of surgeon used in proposed national legislation could be such that GPs who have special interest in surgery or obstetrics could end up slapped with a $60,000 fine, ACRRM and the RACGP have warned.
A bill currently before Queensland parliament seeks to restrict use of the title “surgeon” to doctors who hold specialist registration in either surgery, obstetrics and gynaecology or ophthalmology.
The laws are part of a suite of reforms aimed at cleaning up the cosmetic surgery industry and are a direct response to non-surgically trained doctors marketing themselves as cosmetic surgeons.
Doctors who use the title while ineligible run the risk of copping the hefty fine or doing jail time.
Dr Megan Belot, president of the Rural Doctor’s Association of Australia, told The Medical Republic that being able to use multiple titles was an important component of the rural generalist brand.
“I would never call myself ‘an anaesthetist’ because, to be honest, I’m more than that – I’m a GP anaesthetist,” she said.
“I’m very proud of having that skill set and being able to do both.
“I think it’s quite important that we’re using all the titles available to us.”
Medical practitioners who hold specialist registration in “another recognised specialty in the medical profession with the word ‘surgeon’ in a specialist title for the specialty” will also be permitted to use the title.
It’s not immediately clear what this final provision actually relates to. In a submission to the Queensland Parliamentary committee handling the bill, the RACGP said the term “recognised specialty” did not clarify the process of recognition of the term surgeon with respect to the specific recognised specialty.
Whatever the intention of section, both colleges seem fairly certain that it does not make it clear whether GPs and rural generalists, regardless of additional training, will be able to call themselves a surgeon.
RACGP fellows who have completed the Surgery – Advanced Rural Skills Training program, for instance, have training in a range of common surgical procedures, such as ultrasound-guided drainage of a breast abscess, circumcision and emergency fasciotomy.
ACRRM also offers Advanced Specialised Training programs in surgery for presentations including perianal haematoma, corneal abrasion and renal tract tumours.
Both colleges also offer an advanced skills training program developed in conjunction with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Doctors who complete that course are awarded a diploma of the RANZCOG, rather than fellowship.
The rural college said the proposed title restriction communicated a “lack of confidence” in the rural generalist profession and warned that it could serve to discourage budding rural generalists who would instead elect to pursue a non-GP surgical discipline and never leave the city.
“ACRRM Fellows holding [advanced specialised training] in surgery or in obstetrics and gynaecology have the necessary surgical training and qualifications yet will not be entitled to refer to themselves as surgeons, nor will they be able to clearly communicate their services to their patients, employers or communities,” the college said in a submission on the bill.
“Title restrictions will lead to competent and qualified practitioners in rural and remote areas being discouraged from providing critical surgical services, and the people in these locations who already face significant barriers to accessing this care, will have their access restricted even further.”
The RACGP said it supported introducing changes to increase patient safety and care, but not at the cost of undermining GPs with advanced training.
It proposed a new definition for the title surgeon, arguing that it should instead be for practitioners who, at minimum, have a Bachelor of Medicine and Bachelor of Surgery, are members of a postgraduate college, have a predominantly surgical practice and have completed relevant training.