Broadly defined, healthcare is the care of the sick and diseased, undertaken by qualified and regulated healthcare practitioners (HCPs). A healthcare professional should be trustworthy and have the respected characteristics to make a decision regarding treatments that will improve the health and wellbeing of the patient (Collier, 2019).
Although it has yet to obtain this official status, aesthetic medicine is a branch of modern-day healthcare, and, as such, the healthcare provider of aesthetic medicine has a medical justification for conducting the medical procedure, even if the outcome is for cosmetic purposes. Aesthetic specialities have evolved from their parent discipline, aesthetic surgery from plastic surgery, maxillofacial from ear, nose and throat (ENT) and aesthetic dermatology from dermatology.
Generally, medical aesthetic treatments are aimed at healthy individuals who have appearance concerns and require aesthetic improvements. Therefore, aesthetic clinicians are not treating the sick and diseased or saving patients, but, instead, are treating the aesthetic seekers who may have different psychological states (Feng, 2020). Yet, this raises the question of whether this should in any way lessen the moral and ethical responsibility and professionalism of the registered HCP. There are still codes of conduct to be upheld, and the HCP is still a representative of their governing body.
Aesthetic medicine is an elective choice for the patient and, generally, with few exceptions, a private enterprise by the practitioner. The medical aesthetic clinic is a business and, therefore, a commercial commodity. People go into business to make a living, have financial security and success and be seen as successful, so there needs to be growth and expansion. This is when competition with others can begin to influence the management and running of the business. This is where the two worlds collide.
» As professionals, we must make sure that we take the time to remind ourselves of these guidelines from the Medicines and Healthcare products Regulatory Agency, Advertising Standards Authority and our own governing bodies regarding prescribing and advertising «
Falling foul of the need to succeed
I have often thought that the commercial aspect of business and the medical aspect of the treatments that aesthetic clinicians carry out do not gel naturally in the UK. In the US and other countries, it is not uncommon to pay for healthcare, so to pay privately for treatment can be considered the norm. However, in the UK, we are used to a national healthcare system where necessary healthcare can be obtained without charge.
The aesthetic business and practitioner can fall foul of the need to succeed. With social media as it is, it is impossible not to see the competition on your own doorstep and potentially lose sight of the medical nature of one's profession. This is where a breakdown in morals and ethical behaviour may begin to be seen, which can then translate into a reduction in standards of care. It is possible to become so caught up in the ‘BOGOF’ culture to attract more custom that the basic principles of the medical aesthetics codes of conduct can begin to fade into the background.
Examples of this are reported on a daily basis in various aesthetics-related social media forums and, sadly, the laypeople and non-medics, who are viewed as intruders into the world of medical aesthetics, cannot just be blamed, as examples are seen from our own cohorts. Perhaps this could be argued as a lack of knowledge and a naivete of the newer aesthetic practitioner, but ignorance is no excuse.
It should not be necessary to have to remind ourselves how to behave and how to be seen as the consummate professionals that we claim to be. However, it would seem that it is, in fact, necessary to have the occasional reminder, as we, as the medical practitioners must lead by example.
Staying on the professional straight and narrow
Therein lies the problem: to have a successful business, grow, gain customers and compete with the competition, it is easy to fall into the trap of the reduced price, buy one get one free or special offer model of business. Social media has a strong and constant influence, and, with the lack of regulation, it can be a challenge to stay on the professional straight and narrow (Collier, 2018).
There is, of course, some regulation, but this is being ignored by some, either deliberately, as there are no real hard-hitting penalties, or, as mentioned, through ignorance.
As professionals, we must make sure that we take the time to remind ourselves of these guidelines from the Medicines and Healthcare products Regulatory Agency (MHRA), Advertising Standards Authority (ASA) and our own governing bodies regarding prescribing and advertising. If the lack of knowledge is a result of being unaware of these guidelines, then there is a lack of basic knowledge at the foundation training level. Therefore, anyone in a training capacity should ensure that the new practitioner is aware of these rules and guidelines, and it needs to be part of the novice training.
By the nature of how aesthetic practitioners work, we may find ourselves working in solitary situations, rather than, for instance, with the multidisciplinary team we may have been used to within the NHS, where guidelines and updates in mandatory training are provided. Instead, aesthetic clinicians are responsible for their own knowledge and professional development. As responsible practitioners, we need to have a continued awareness of what is occurring in the world of medical aesthetics.
We are entering into a phase of increased challenges and changes, and, in the busy aesthetic clinic, it is easy to become focused on the day to day that we do not see the bigger picture and then slip into bad habits. Being a member of an organisation such as the British Association of Cosmetic Nurses (BACN) is invaluable, as knowledge can be shared and practitioners can keep up to date with this vast and changing world of medical aesthetics.
Useful links
- Medicines and Healthcare products Regulatory Agency. Blue Guide: advertising and promoting medicines. 2014. www.gov.uk/government/publications/blue-guide-advertising-and-promoting-medicines
- Department of Health and Social Care. Government to crack down on unregulated cosmetic procedures. 2022. https://tinyurl.com/2p9ae8uu
- Advertising Standards Authority, Committee of Advertising Practice. Guidance on the marketing of surgical and non-surgical cosmetic procedures. 2016. www.asa.org.uk/resource/cosmetic-interventions.html
- Advertising Standards Authority, Committee of Advertising Practice. 12 Medicines, medical devices, health-related products and beauty products. www.asa.org.uk/type/non_broadcast/code_section/12.html