Over many years I have heard colleagues repeatedly say that we may have lost the battle but we haven't yet lost the war. Many battles have been fought and continue to be fought by healthcare professionals (HCPs) who passionately believe that aesthetic medicine is an important branch of modern-day medicine, and one that it is deserving of respect and recognition as a medical specialty. Many continue to fight tooth and nail to protect our professional integrity and to keep medical aesthetics a medical discipline. It has been an upward struggle to fight against many obstacles, the biggest being the lack of government intervention to stop the unaccountable rogues and cowboys that perform medical treatments within a healthcare sector where they have no right or entitlement to be.
Hope represents an ability to conceptualise our goals and to find pathways to reach these goals despite the obstacles that stand before us. Optimism sparks the feeling of hope. It takes great courage to find optimism when all around seems so skewed. I want this first column of 2019 to generate some hope and optimism. I believe that aesthetic nurses are a force to be reckoned with, and if we stand collectively we can shape the future of aesthetic medicine in the UK. It is sometimes necessary to lose the small battles in order to win the war.
News from the Netherlands
Our esteemed colleague Dr Jani Van Loghem recently announced on social media that the Netherlands will be the first European country to welcome aesthetic medicine as a medical profile specialty from July 2019. This is ground-breaking news. Dr Van Loghem is the vice chairman of the Dutch Society of Aesthetic Medicine (NVCG) and the head of Department for Aesthetic Medicine at the European College of Aesthetic Medicine and Surgery (ECAMS). The Royal Dutch Association (KNMG) is the professional organisation for physicians of the Netherlands. The primary role of the KNMG is to improve on quality of medical care and to improve public health. This is achieved by responding to developments in healthcare and society by the development of guidelines, policies and by lobbying.
Moreover, the KNMG regulates vocational training and the registration of specialists. It would seem that they were able to collaborate with both medical and government authorities to gain recognition for aesthetic medicine as a medical specialty within the Dutch healthcare system.
This is a huge step forward and although our nursing colleagues in the Netherlands do not yet inject autonomously within the field of aesthetic medicine, the battle was not about which professional disciplines should work within the sector—this is a battle for another day. This enormous accomplishment is of immense importance as the rest of the medical world takes note—aesthetic medicine will be recognised and respected as a medical specialty. If this could be achieved in the UK, the hideous situation of non-regulated and unaccountable people performing medical procedures would end.
The UK situation
In the UK, The British Association of Cosmetic Doctors (BACD) was originally founded in 2002 to encourage regulation within our sector and to help make Aesthetic Medicine safer and more ethical for the general public. In 2012, the BACD became the British College of Aesthetic Medicine (BCAM) and the vision remained virtually unchanged. It is now 17 years since the founders aspired to bring change to fruition, to enable Aesthetic Medicine to take its rightful place as a medical specialty.
How can it be that no progress has been made? We also have the British Association of Cosmetic Nurses (BACN), a powerful force within our field. Surely, collaboratively, these bodies can lobby government and professional governing bodies to influence change? The UK should be a leader at the frontline of healthcare delivery, and public safety should take precedence. There continues to be no legal statute in the UK to restrict either a beauty therapist or other person to deliver medical aesthetic treatments. This is a shameful situation. No other country in the world is in such disarray.
I do feel concerned that both BCAM and the BACN supported the Joint Council for Cosmetic Practitioners' (JCCP) stance on non-HCPs being part of the UK medical aesthetic practitioner register, and although the JCCP did finally withdraw their decision to include non-HCPs on the register, it left many feeling untrusting of the organisation. There should be no discussion, no debate, no creation of loopholes; the field of aesthetic medicine should take its rightful place as both a medical and nursing specialty with no one other than a doctor, dentist or nurse delivering medical aesthetic care. This farcical situation in the UK is embarrassing.
Enthusiasm and optimism
‘Without confidence, enthusiasm and optimism, victory is scarcely obtainable.’
I recently listened to a key note address speech delivered by Dr Christian Jessen. Dr Jessen is a UK doctor, television presenter and writer, best known for presenting channel 4 programmes such as Embarrassing Bodies, Supersize versus Superskinny, and, more recently, Dr Christian Will See You Now. However, he also has a very important role as a brand ambassador for Save Face, the voluntary national register of accredited practitioners who provide non-surgical cosmetic treatments.
Dr Jessen also practices within the field of aesthetic medicine, giving him true insight into the daily plights of this field. I was so inspired, not only by his charismatic and charming manner, but also by the fact that it was so clearly evident that this was a doctor that had a strong moral and ethical stance. I found his words very inspiring; fame and fortune had not swayed him from understanding that to practice medicine is a privilege and not a right and that the Hippocratic Oath is sacred.
Dr Jessen shared my concerns about the distortion of the faces of our young generation, especially with regard to the lip crisis and asked the question: who is doing this? One audience member commented that surely it was safer for the patient to be treated by a HCP than seek treatment from a non-HCP; that if ‘we’ don't treat these patients, they will simply go somewhere else. I applaud Dr Jessen as he retorted, ‘Then let them go somewhere else!’ I left feeling confident, optimistic and enthusiastic about the future of aesthetic medicine. It reminded me of just how many good people are still out there, fighting the good fight!
Finally, UK nurses are very highly educated and skilled individuals, with many practicing at an advanced autonomous level with a very broad knowledge and clinical skill set in comparison to their European counterparts. However, I note that for the second year, UK nurses have had limitations imposed on them whilst attending the International Course on Ageing Science (IMCAS) in Paris. Furthermore, there is no representation from the nursing profession presenting at this world congress.
Nurses have been restricted from attending surgical, cadaver and clinical dermatology sessions, yet there have been no limitations placed on doctors or dentists working within the filed. I find this very discriminatory and would urge the nursing profession to make a stand and challenge the organisers on this issue. I submitted an abstract in the hope of finding a platform for UK nurses; however, my work, which consisted of 6 months of research and has in fact been published in the UK, was considered only suitable for electronic publication at the conference. It is an absolute travesty that UK nurses are not been shown equality or professional respect, as we have so much knowledge to share with our peers.