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10 Things Reputable Doctors would Never Do

Patient safety is a pet peeve of ours here at Skin Essentials.

In as much as is possible, we pride ourselves on doing everything we can, from the time you book a consultation to the day of your planned treatment to aftercare and followup, to work in a way that is ethical and safe while keeping you informed every step of the way.

So it is surprising to regularly see media articles about cosmetic cowboys as well as the sleight of hand that frequently shows up on social media feeds as medical aesthetics but which is largely clever marketing and gimmmickry to lure unsuspecting patients into procedures.

So how is a patient to know and what are some red flags to watch out for to help yourself stay safe? Read on to find out our thoughts!

1. Your provider should state their credentials and qualifications clearly. 

In Australia, only AHPRA registered healthcare workers (HCWs) are cleared with appropriate training, to inject for medical aesthetics - medical doctors, nurses and dentists. Dermal technicians can additionally, undertake some skin therapies that are within the scope of their practice.

As doctor is not a protected term, you will find some people including naturopaths among others using the term “doctor” in their title, while not being a medical practitioner, which is a protected title.

Equally, not all doctors are of equal standing - a dermatologist (FAAD) is not the same as a plastic surgeon (FRACS, Plastics) and not the same as someone like me an FRACGP. All three specialities are additional training years in respective fields, with scopes of practice, so it is important to understand these, versus doctors who have the base degree (MBBS, or MD or BMed) or a dentist (BDS) or a registered nurse (BN) to know who is treating you and their likely skillset and qualifications.

2. You should have a good idea of their years of experience in aesthetics and any prior medical experience. 

In Australia, anyone can look up their AHPRA registered provider using the AHPRA website to check their provider’s qualifications, whether they are specialists as well as whether they are of good standing to practice in the community and how long they’ve been working for.

Someone who has qualified in 2016 is not the same as someone who qualified in 2001 and has been working all this time. Likewise, someone who has the base MBBS degree since 2016 is not the same as someone who has the MBBS, FRACGP title for example. Speciality training programs involve extra years of a structured training program, as well as multi-part examinations they must pass to qualify for fellowship which ultimately serve to benefit patients.

3. They never promise or guarantee an outcome 

No one can ever guarantee you won’t bruise, or only need a single treatment or even an outcome. The face is the most mobile part of our body and we rely on it to communicate our thoughts, mood and so much more. As such, none of us is completely symmetrical and it is impossible to guarantee an outcome no matter how diligent the provider, so be wary of anyone who over promises.

Equally, unforeseen patient factors may be at play in consultation that may mean the procedure needs to be abandoned partway and either revisited at a later date or referred as is appropriate. When this happens, it is important to understand what the options are including around payment and your obligation for equipment and your doctor’s time.

4. They seek clarity with you regarding your wishes to allow your photos to be used to show other patients or on social media, and any conditions attached to these, in writing. 

It is a direct violation of your rights as a patient to have photos or information disseminated without your consent. Being a highly visual industry, your doctor may ask for your consent to share photos with patients in clinic, or even on social media. If you say yes, they should clarify with you the extent of your consent, preferably in writing so there is no miscommunication.

5. They use machines and products that are TGA registered. 

This is a big one. Terms such as “low level laser” and “medical grade” and even “standard dose” are in and of themselves, meaningless. What you are seeking to know ultimately is, whether your provider uses machines and products that have passed safety requirements ie are TGA registered (and therefore more expensive to buy, own and to maintain, raising cost of treatment) and not bought off back alleys or overseas or via eBay.

6. You know what is done and what products are used 

At Skin Essentials, we aim to minimise paper wastage and email itemised receipts to you after each consultation and treatment with the name of the product that was used as well as the dose used if appropriate and cost included any discounts applied so you are in the know, and can also use this information with any other care providers you see in future.

Equally, our initial comprehensive consultation plan is usually a written treatment plan emailed to you for your records of what was discussed including consent to share photos and for you to share with any other care provider.

We aim to be as upfront and transparent as possible to minimise misunderstanding barring unanticipated patient factors.

7. They will refuse to treat at “injectables parties” and the like 

We have all, at one time or another been asked if we’d treat at these parties. The problem with this is manifold. Injectables parties and medical procedures do not mix:

  • guests may be drinking alcohol and may not be able to properly consent in the event of an adverse outcome
  • alcohol is generally avoided at least 24 hours prior to injecatables
  • in gatherings, we cannot guarantee privacy for patients, who may not want their medical history disclosed to friends.
  • in the event of an adverse outcome, a home or party venue is not suitable to manage unlike a clinic

8. They don’t insist on a deposit for a procedure prior to the consultation to assess suitability 

The consultation is not just a cursory token box to tick before you get down to business.

With a reputable doctor, the consultation is a comprehensive detailed process to determine your concerns, your medical history, any reason why you may not be suited to the procedure you want, costs and a discussion of risks and side effects as well as appropriate time to cool off and change your mind if you are undecided.

As such, no one should be asking you for a deposit for a procedure prior to the consultation to first determine if you are suitable and eligible for the procedure or if something else may be better suited to your needs, including no treatment at all.

9. They don’t offer incentives or payment for positive reviews nor do they offer refunds to avoid negative reviews 

This is a big no-no and can get someone warned or even deregistered even though it is rife in the industry.

All medical aesthetics are medical procedures and treatments and with adequate consent patients should understand that they are paying for a treatment, not a guaranteed outcome. As such, there should be no pressure to write positive reviews in exchange for free or discounted treatment nor should a refund be offered to avoid a negative review in the event of an adverse outcome.

10. They don’t do paid promotions and advertisements 

This one is controversial, because many doctors and nurses do this, but it is my opinion that as doctors (and HCWs in general) we have a duty of care to first do no harm but also not to seek to unduly influence our patients who place their trust in us, through the promotion of products to generate sales for another company that pays us for it.

If we genuinely like a product, we can by all means promote it to our patients, and likewise if we do not, we can speak freely about this, but the exchange of money to talk about a product, and influence patients, in my opinion, crosses a line that is a form of upselling for a company and I’m personally uncomfortable with it.

What are your thoughts on the points above? Any others you’d add?


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