October 17, 2007 - The Council of the College of Physician and Surgeons of Ontario approved a four-point plan to address concerns about doctors who perform cosmetic procedures who are not registered as specialists in Ontario.
These included:
1. To assess physicians performing high-risk cosmetic surgical procedures where there is no evidence of adequate training.
2. To review the College’s Change in Scope of Practice policy to determine the best way to ensure compliance.
3. To evaluate and propose different approaches that could be used to oversee out-of-hospital facilities/clinics.
4. To develop a public information initiative to inform the public about cosmetic procedures, including their risks.
The CPSO has now identified members who perform cosmetic procedures through a variety of sources and they will be receiving a letter with a detailed questionnaire to complete about the cosmetic procedures they are providing to patients. This will help them understand where they practice, the services provided in their facility or facilities and the formal training and continuing professional development that has been completed. An explanatory letter and the questionnaire were sent to these physicians by mail on October 17, 2007. The Questionnaire must be returned by November 5, 2007.
A copy of the letter and the questionnaire are at: http://www.cpso.on.ca/Info_physicians/CL_Questionnaire.pdf
and
http://www.cpso.on.ca/Info_physicians/Questionnaire_cosmetic.pdf
Completion is mandatory for physicians performing cosmetic procedures.
The College is committed to having complete information about all physicians working in this field and ensuring that members are practicing only in areas where they have the knowledge, skills and training generally but in particular for medical procedures that involve significant risk.
The CPSO intends to assess all physicians who are performing high-risk cosmetic procedures where there may not have been adequate training. In addition, Council has approved the development of an implementation plan to require members to comply with the policy to report a change in scope of practice or re-entry to practice.
Dr. Jeff Turnbull, MD, FRCPC, the president of the CPSO said that this action is an extremely high priority for the College and he would appreciate the cooperation of the members of the College. He said that he would keep members informed of any new initiatives particularly after our Council meeting in November when additional measures will be considered to ensure adequate oversight of high risk procedures in out-of-hospital facilities.
Monday, October 22, 2007
Monday, October 1, 2007
American Society of Plastic Surgeons Consumer Advice
Cosmetic Plastic Surgery vs. Medically Necessary Surgery
- Nearly 8 out of 10 patients (80% cosmetic plastic surgery/78% medically necessary surgery) surveyed were satisfied with their overall surgical experience.
- Nearly 40% of cosmetic plastic surgery patients and 29% of patients who had medically necessary surgery believe they should have been more proactive in learning about the possible side effects and complications of their surgeries.
- Nearly one-third of cosmetic surgery patients (28%) did not check their doctor’s credentials before surgery; 37% did not check if their surgeon was certified by the American Board of Plastic Surgery; 54% did not check if their surgeon completed an accredited residency training program in plastic surgery.
- The majority of patients believed their surgeons: answered all of their questions (90% cosmetic plastic surgery/96% medically necessary surgery); addressed how to properly prepare for the day of surgery (82% cosmetic plastic surgery/89% medically necessary surgery); and informed them of the details of their surgical procedure (77% cosmetic plastic surgery/ 74% medically necessary surgery).
- The majority of patients (82% cosmetic plastic surgery/86% medically necessary surgery) were satisfied/very satisfied with the overall quality of pre-surgical discussions with their doctors; however, nearly 30% of cosmetic surgery patients and nearly 20% of patients who had medically necessary surgery admit feeling uncomfortable asking their doctor or surgeon questions prior to surgery.
- Nearly three-quarters (73% cosmetic plastic surgery/75% medically necessary surgery) believed their doctor completely addressed potential side effects and complications before surgery.
- Before surgery, 91% of cosmetic surgery patients and 95% of patients who had medically necessary surgery said they knew what to expect in terms of post-surgical side effects and complications; however, fewer than half recalled being informed of some common side effects and complications such as nausea and vomiting (42% cosmetic plastic surgery/43% medically necessary surgery), blood clots (34% cosmetic plastic surgery/28% medically necessary surgery), or suture complications (34% cosmetic plastic surgery/25% medically necessary surgery).
- About 1 in 2 patients (57% cosmetic plastic surgery/56% medically necessary surgery) expressed some concern about the outcome of their procedure as it relates to post-surgical side effects and complications.
- 60% of all patients surveyed had outpatient surgery (released the same day as their surgery).
- Nearly one-third of patients (30% cosmetic plastic surgery/33% medically necessary surgery) who experienced post-surgical side effects or complications found them to be at least somewhat difficult to manage.
- Among those who experienced a post-surgical complication, roughly 70% of patients said it negatively impacted their daily life in such areas as an inability to accomplish necessary tasks (35% cosmetic plastic surgery/ 44% medically necessary surgery); a decrease in energy level (32% cosmetic plastic surgery/53% medically necessary surgery); and time away from work (27% cosmetic plastic surgery/39% medically necessary surgery).
- 35% of cosmetic plastic surgery patients and 39% of patients who had medically necessary surgery who experienced a post-surgical complication reported missing four or more days of work due to their complication.
¹Survey respondents were never directly asked about side effects at any point in the survey, but instead were asked about risks and complications, which in several questions included some well-known side effects such as nausea, vomiting and pain.
The survey was conducted online within the United States by Harris Interactive® for the American Society of Plastic Surgeons and Merck & Co., Inc. between January 15 to 29, 2007, among 617 adults, of whom 301 had cosmetic plastic surgery under general anesthesia in the past two years and 316 had non-emergency medically necessary surgery under general anesthesia in the past two years. Please see press release for full methodology statement.
The American Society of Plastic Surgeons (ASPS) is the largest organization of board-certified plastic surgeons in the world. With more than 6,000 members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 90 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
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