As responsible professional surgeons we are always concerned with the safety of our patients. Any surgical procedure carries a degree of risk.
Many every day activities we undertake involve risk, the best example of which is driving. We are all aware that we can be injured or killed in a car accident. However, if we maintain our cars properly, train our drivers well, adhere to road laws and have a vigilant, responsible, attitude when driving, the risk of injury is minimised.
How is this applied to the practice of surgery? Linley Plastic Surgery and Linley Skin Health are dedicated to minimising the risks of treatment for their patients. How we do this is explained below.
Training of Surgeons
In Australia, the Royal Australasian College of Surgeons trains all specialist surgeons including Plastic surgeons. The RACS is accredited by the Federal and State Governments via their Health Departments, by the Australian Medical Council which is the Federal Body set up to approve specialist Colleges, by the ACCC and by the Medicare Australia.
Specialist Surgical Training in this Country generally involves an 8 to 10 year specialist training period after graduating as a doctor from medical school.
If your surgeon does not have an FRACS (Fellowship of the RACS), he or she is not an Australian specialist trained surgeon, and in fact is probably not a specialist surgeon at all. At this time, oddly enough, it is not illegal for any medical practitioner i.e. a GP, to call themselves a surgeon in this country. In this area of surgery there are many GPs' calling themselves surgeons, and you can be easily confused. Beware .
It is up to you to establish that the surgeon you have chosen is in fact a fully qualified specialist surgeon with an FRACS qualification.
If your plastic surgeon is a member of the Australian Society of Plastic Surgeons, they are a real specialist plastic surgeon. Check on www.plasticsurgery.org.au
Licensing and Accreditation of Facilities
Medical facilities such as Day Surgery Centres and Private Hospitals must be registered with the Health Department. This registration covers facility design but not standards of care.
Further to this, most Hospitals and Day Surgeries will seek to go through an accreditation process which is a regular quality evaluation of its standards of care, staff, equipment, systems and procedures. Unaccredited facilities are not proven by independent assessment to have adequate safety equipment or procedures. The Health Insurance funds in Australia will only contract with accredited facilities for this reason.
For your safety, ensure your surgeon operates only in registered and accredited Day Surgery Centres and Hospitals. If they do not, check your surgeon's credentials. Only real surgeons generally pass the credentials test to operate in accredited Hospitals and Day Surgery Centres.
If the surgeon you are considering does not use a registered and accredited facility, your safety is at risk. You have no way of knowing if all the necessary safety procedures are in place, and all necessary safety equipment is present and in good working order.
All Hospitals and Day Surgery Centres used by Linley Plastic Surgery are fully registered and accredited, and all have contracts with all major Health Funds.
Assessment of Surgeons by Facilities
All registered and accredited Day Surgery Facilities and Hospitals have a Medical Advisory Committee.
This Committee is composed of independent expert medical specialists. They meet regularly to ensure that the hospital is maintaining its standards and keeping up with acceptable practices. All specialists, i.e. surgeons, anaesthetists and physicians who want to work at a particular hospital must apply to its Medical Advisory Committee for "Admitting rights" and "Operating privileges".
The Committee will examine the qualifications and references of an applicant and grant or refuse them rights accordingly. Normally, only specialist surgeons are granted operating rights.
All Specialists using a Hospital or Day Surgery Centre are reassessed every 2 or 3 years by the Committee, to ensure maintenance of standards.
Professional Development
The Royal Australasian College of Surgeons has a comprehensive Continuing Professional Development Program.
The RACS Program for Plastic Surgery is administered by the Australian Society of Plastic Surgeons. If your surgeon is a real Plastic Surgeon (FRACS), and a member of ASPS, they will be participating in the CPD program. It uses an audit system, a scientific meeting attendance record, and a peer review process to ensure that your surgeon is keeping up with his or her education and with developments in the specialty. This program is a very important quality assurance tool for the College to ensure that its Fellows are keeping up to date.
If the surgeon you are considering is not a member of the Australain Society of Plastic Surgery, they will not have access to the CPD program, and may not be keeping up to date.
Responsible Practice. Your rights.
Expect and accept nothing less than a systematic, professional and helpful office staff, an adequate, clean consulting area, attention to privacy, adequate consultation time and clear explanations.
You should feel comfortable during the consultation process, including examination, and a nurse chaperone should be available if appropriate or if you would like it.
Procedures, costs and systems i.e. bookings should be explained to you.
If a practice makes you feel uncomfortable, go elsewhere.
Linley Plastic Surgery Consulting Offices have achieved ISO 9002 quality accredition.
Informing Patients of Risks
In Plastic Surgery, the most common cause of patient dissatisfaction is when something unexpected occurs: either the result is different to the patient's expectation, a complication occurs the risk of which was not explained, or the recovery is very different to what is expected.
Usually, the main problem is poor communication. You should not agree to a procedure without feeling clear in your mind that you understand what you expect from the procedure, and have discussed this fully with your surgeon.
Common risks, complications, scars and expected recovery times should be discussed openly.
If the surgeon or practice is evasive, or promises no unexpected problems, go elsewhere.
Howard Webster is on the Australian Society of Plastic Surgeons Risk Management Committee. He is working with Plastic Surgeons nationally, and the Medical Indemnity Organisations, to improve processes within practices in this important area.
Our Responsibilities
Our responsibility is to be honest, open, professional, fair, as good at what we do as we can possibly be, up to date and to look after our patients as well as we can.
Building Linley Plastic Surgery and Linley Clinic Private Hospital has enabled us to provide our patients with a unique environment for their care, and we constantly work at improving it. We are responsible for maintenance of standards and quality in both our practice and our unique hospital.
Your Responsibilities
To listen with an open mind, to ensure that you understand the procedures and the risks, and to tell us if you do not. You should participate in the process of your evaluation and treatment, and become truly informed.
To inform us completely of your past medical history, and any personal issues which are relevant to your decision to consider surgery.
To accept that while we will always try to assist you, there are some conditions which currently cannot be helped by surgery.
To take responsibility for your health and well being by diet, exercise, sun protection, not smoking and regular medical checkups from your GP. Understand that surgery achieves its best results in people who take good care of their health. Surgery is no substitute for neglecting your health.
To understand the qualifications of the doctor treating you, and what they mean.
To ensure that your expectations of surgery are realistic - an area you should specifically discuss with your surgeon.
To be generally sceptical of claims made by magazines or doctors of the greatest, or the newest treatments. Don't forget, these companies must sell magazines, and any doctor claiming that they have "the secret", or "the latest" or "the quickest recovery" or "the best" is marketing to you for your business. There are no miracles, and there are no instant recoveries.
How to maximise your chance of a satisfying outcome Ask advice from your family doctor, friends, or the Australian Society of Plastic Surgeons. Consult one or more highly trained, properly credentialed surgeons in your area. Become well informed. Get to know the practice, be sure of their professionalism.
Have the procedure in an accredited facility.
Appreciate that even in the best hands and best facilities, complications can occur, and can happen to you. Most complications are minor. In good hands, serious complications are rare, but if they occur can compromise the expected result or even your health. If you do not understand this, you should not have surgery.
Accept that people heal and recover at different rates. This can mean a longer bruising time, or a delay in getting back to work or all activities. Allow plenty of recovery time and beware of doctors who promise you an exceptionally rapid recovery time.
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