Angry Doctor

Friday, July 25, 2008

Two wrongs make a right

A bit of good news to cheer angry doc up at the end of a long week:


Stricter guidelines for aesthetic procedure
By Hasnita A Majid, Channel NewsAsia

SINGAPORE: From November 1, doctors will need to seek approval before offering aesthetic procedures like mesotherapy and skin whitening to patients, and they can only do so as clinical trials.

These doctors need to get the go ahead from the Singapore Medical Council's newly established Aesthetic Practice Oversight Committee if the procedure is carried out at a clinic, or from the Research Ethics Committee if the procedure is done in a hospital.

These guidelines - drawn up by the Academy of Medicine, College of Family Physicians and the Singapore Medical Council - are aimed at enhancing the safety of patients.

Currently, there is no formal training for doctors performing such procedures and injuries sustained during such treatments are often unreported.

Proper documentation must also be carried out for the purpose of audit. If the outcome of such procedures is poor, then the treatment will be terminated. In addition, such procedures can only be carried out as a last resort, after all other conventional treatments have been tried.

Current aesthetic procedures will be grouped into two lists - A and B. List A contains procedures which are generally proven and considered acceptable by experts.

This list includes non-invasive procedures such as chemical peels and microdermabrations, and minimally invasive treatment such as Botox and filler injections.

Invasive procedures, such as eyelid alteration and breast enhancement or reduction, will have to be performed only by doctors who have the appropriate surgical training.

List B reflects aesthetic treatment and procedures that are currently regarded as having low or very low level of evidence and not considered well- established.

Mesotherapy - a procedure to burn fats away through injections - and skin whitening injections fall under List B. So are carboxytherapy, stem cell activator protein for skin rejuvenation, negative pressure procedures and mechanised massage.

For treatments under List B, doctors are no longer allowed to advertise them and those who wish to perform procedures under List B must register themselves with the Singapore Medical Council.

The guidelines also require doctors who wish to perform procedures that do not fall under either list to obtain approval from the Singapore Medical Council.

Any doctor who does not comply with the guidelines will be taken to task and liable for any disciplinary action. The guidelines were drawn up after several months of consultation with professionals in the industry.

Professor Ho Lai Yun from the Academy of Medicine said: "At the moment, it's a cowboy type of practice... when the guidelines come up, we give the doctors some guidelines.

"Of course, the patients will know who are the people they can go to, what are the procedures available to them, what they can expect from the procedures. So, to a greater extent, they are protected."


It's nice to see that as a result of the aesthetic "turf war", we now have a policy that recognises the importance of evidence when it comes to treatment.

For once, truth is not a casualty of war.

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