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Face off over expanded prescribing rights spreads

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Cosmetic physicians have backed warnings from the AMA that a decision to extend prescribing rights will put the health of patients at risk.

The Cosmetic Physicians Society of Australasia has joined the AMA in calling on the nation’s Health Ministers to reverse their decision to give non-medical health professionals authority to prescribe medicines without supervision from a medical practitioner.

The Society said there were already instances where patients had been disfigured and suffered significant infections because Schedule 4 medicines, including anti-wrinkle treatments, had been injected by inadequately trained and inexperienced practitioners without doctor supervision.

“We have always been concerned with the number of reported incidences where nurses are practising without the supervision of a doctor and are setting up cosmetic clinics to administer such injections,” Society spokeswoman Dr Cath Porter said. “It is evident that current regulations require greater enforcement, rather than considering further expansion of prescribing for non-medical practitioners, as this will only exacerbate the current problem and put more patients at risk.”

AMA President Dr Steve Hambleton warned last month that the decision by the Standing Council on Health to approve the Health Professionals Prescribing Pathway recommended by Health Workforce Australia over the objections of doctors was a dangerous move that could fragment care and potentially put patients at risk.

“In the interests of patient safety, the AMA is strongly opposed to autonomous prescribing by non-medical health professionals,” Dr Hambleton said.

The Cosmetic Physicians Society said current rules require that doctors can only delegate the administration of Schedule 4 medicine injections to a registered nurse if specified procedures are followed, including that the patient must first have a face-to-face consultation with the doctor, and be given a written treatment plan.

Dr Porter said aesthetic medicine procedures require an understanding of complex facial anatomy, and an intimate knowledge of the medicines used and their placement for best aesthetic effect.

She said the value of existing safeguards had been underlined by a number of cases where doctors had been bypassed and procedures were performed by inexperienced practitioners who placed injections in the wrong areas, causing disfigurement and inducing infections.

Such malpractice had caused issues such as dropping eyelids or, worse still, deep dermal infections and associated morbidity, Dr Porter said.

She added that advances in technology meant the effect of medicines were no longer-lasting, meaning that the damage caused by misplaced injections was often prolonged, causing patients great distress and anxiety.

The risks involved in sub-standard medical treatments have been underlined by the death of a 68-year-old New Zealand man who contracted an antibiotic resistant superbug following surgery for a hernia in India.

The Age reported that the man, who spent the last six months of his life in isolation, was infected with Klebsiella pneumonia, a strain of bacteria that produced enzymes rendering it resistant to all known antibiotic treatments.

Dr Hambleton said the prescribing competency framework developed by NPS MedicineWise last year should be upheld.

Adrian Rollins