Rose Park Confidential was recently seconded to undertake Licensed investigation into the practices of unauthorised and unsupervised prescribing of controlled drugs in South Australia by nurses cashing in on the unregulated cosmetic surgery industry. Out of the five individuals investigated, four worked for RACS plastic surgeons. The nurses practice involves prescribing Scheduled drugs used in cosmetic medicine without a doctor seeing or examining the patient which is unlawful in South Australia.
A sixth non-plastic surgeon aligned nurse was found to be following the industry guidelines of working under the guidance of the supervising doctor observing the Code of Conduct for doctors of Australia, Australian Health Practitioners Regulation Agency, Section 2 which requires the doctor to physically examine the patient, the taking of a proper history of the presenting concerns, acquiring informed consent to proceed with a treatment plan that incorporates options and alternatives and being careful to select only those patients who are suitable and have realistic expectations of the outcomes of treatment.
Proper medical follow-up and preparedness to treat any potential complications and ensuring that treatments are carried out in medical environments that observe universal precautions designed to avoid cross infection from previous and other patients is essential to the care of all patients, yet the investigations found these essential components of care to be absent or severely neglected.
The Poisons and Controlled Substances Act in South Australia is much more explicit in its regulation of scheduled drugs than most other states yet my team found that the laws were not observed.
My client, who wishes to remain anonymous, brought this matter to our firm and the discoveries were worse than expected. Nurses were exploiting the association with plastic surgeons by practicing outside their scope of practice in order to make substantial profits. With no opportunity for a doctor to physically examine the patient, warn regarding side effects and complications, discuss alternative measures or even turning away inappropriate patients with unrealistic expectations, exposes the patient, who has become a client instead, to practices that are not within the codes of conduct of the medical profession. In two separate cases we investigated, one nurse was not even on the nurses register of the Australian Health Practitioners Regulation Agency, and a second case involved a supervising doctor who practices under a special Notation to his registration which excludes all other practices other than a specific type of surgery.
The investigations are continuing and the cases have been referred to the AHPRA to determine if the supervising doctors should also be closely looked at for permitting the illegal prescribing.