One should never fear standing up for something they believe in, even if that means standing alone. For many years, the Journal of Aesthetic Nursing has provided me with a platform to voice my opinions in the form of the written word on matters that affect all healthcare professionals, but specifically nurses, working within the field of aesthetic medicine. I have raised my head above the parapet on many occasions, bravely stating opinions and addressing controversial and sensitive issues that have caused great upset and unrest among my peers and, inevitably, I have suffered personal criticism and attack. I have remained strong in my convictions and, more often than not, I have stood alone. However, I now find myself reflecting on and questioning whether I am seen by my peers as obstinate and dogmatic, with an outdated, inflexible persistence in my arguments and opinions.
I do feel like a broken record, stuck in the same groove, saying the same things over and over again, but am no longer sure if there is anyone listening. I was recently speaking to Dr Raj Aquilla, and he said, ‘Helena, you have been on a crusade since the day I met you.’ These words actually filled me with pride. I am a crusader, never giving up the fight for the field of aesthetic medicine to be recognised and respected as a true discipline of medicine, a branch of modern-day healthcare that should only be delivered by healthcare professionals, that is, doctors, dentists or registered nurses.
Peer recognition and respect is a huge accolade to achieve in anyone's career. I have come to realise that I do strive to be worthy of peer approval, and it is incredibly important to me to have peer respect. However, over recent months, I have felt a sense of becoming marginalised within our sector, and I am recognising that there is a growing gap with wide variations between my beliefs, values and opinions, and those of many of my colleagues. Is it time for me to embrace change?
Change in healthcare is to be welcomed, but only if that change will improve quality of care and patient safety. Change is particularly challenging in aesthetic medicine, because of the complex relationships between the many stakeholders. There are two fundamental questions that must be answered:
It is one thing for you and I to answer these questions and to voice an opinion, but these questions need to be answered with absolute clarity at a higher level, by people who can influence and bring about legislative change.
If aesthetic medicine does constitute healthcare, then the government, with the support and guidance of our governing bodies and professional associations, must urgently intervene and stop the barrage of assault on the public by de facto practitioners. However, if the demedicalisation of aesthetic medicine is allowed to continue, the sector will soon be completely eradicated from the realms of traditional medicine. Then, the rogues and cowboys have truly won the war.
The government continues to turn its back on the cosmetic medicine crisis in the UK. The enormity and horror of what has been allowed to happen to a medical discipline leave me broken. I am not a willing participant in this circus. The UK is a laughing stock around the world.
Allied healthcare professionals now have a firm footing within the sector, with support from their regulatory bodies. Acceptance of one group has opened the flood gates for all. It was wrong to throw open the door to aesthetic medicine because a small minority within these allied groups displayed an exceptional skill set. I see a whole new breed of practitioners scrambling to enter a field that has gained notoriety as a non-regulated, financially lucrative, free-for-all. What is done cannot be undone and, thus, the focus must turn to the unregulated and unaccountable lay people practising within aesthetic medicine. Surely the government will put a stop to this abhorrent dangerous behaviour. It is ludicrous to think that a lay person with no entitlement or right to perform medical procedures is protected by human rights to defend their livelihood, and that we cannot be seen to exclude such groups. This I will never accept or embrace.
However, before we cast a stone at others, we need to get our own house in order. We have healthcare professionals who are simply bad apples; they exhibit counterproductive work behaviours with the potential to rot the whole basket of apples. They train and prescribe for non-medics (lay people) and have an abysmal moral and ethical stance with regard to patient safety and wellbeing. We are bound by our professional codes to whistle blow and report. We must not turn a blind eye nor be an apathetic by-stander as we witness the demise of what I consider to be a specialty in medicine.
Success is not final, failure is not fatal, it is the courage to carry on that counts. This is what I intend to do. I will continue to fight the good fight, and you must too.
I will never embrace lay people injecting patients, nor support the creation of loopholes to legitimise such practice. I will never accept healthcare professionals supporting the practice of non-medics. I will never support a register for non-medics practising within a medical discipline. I will never accept that I am even remotely part of the beauty industry.
I hope that there are health care professionals who read this column and can resonate with my words. I may be considered a dinosaur by some and I am very obstinate in my opinions and beliefs, but the one thing I know with absolute certainty is that what is happening in the field of aesthetic medicine today is wrong. Is it time to embrace change? I will not bow down to the changes I see. The easy option is to look after yourself, do your job well and never compromise your ethics. However, if we take this approach we have for sure become part of the problem.