WEBVTT - The new Botox rules for young people

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<v Speaker 1>Already and this is the Daily This is the Daily OS.

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<v Speaker 2>Oh, now it makes sense.

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<v Speaker 3>Good morning and welcome to the Daily OS. It's Wednesday,

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<v Speaker 3>the fourth of June. I'm Emma Gillespie.

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<v Speaker 1>I'm Sam Kazlowski.

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<v Speaker 3>The growing popularity of cosmetic procedures like injectables and fillers

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<v Speaker 3>has sparked growing concerns about patient safety, regulation and.

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<v Speaker 2>The responsibilities of practitioners.

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<v Speaker 3>This week, health regulators have actually released a sweeping set

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<v Speaker 3>of reforms aimed at tightening the rules around these procedures.

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<v Speaker 3>So in today's deep dive, we're going to explore what

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<v Speaker 3>these new guidelines say, who they'll affect, and what they

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<v Speaker 3>mean for anyone considering a cosmetic procedure as well as

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<v Speaker 3>anyone administering one.

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<v Speaker 1>M Cosmetic procedures are huge business in Australia right now,

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<v Speaker 1>It's nothing new. I feel like they've been around for

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<v Speaker 1>decades in its current form. But give me a sense

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<v Speaker 1>of the backdrop that we're talking about today.

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<v Speaker 3>Yeah, you're right that these kinds of procedures have existed

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<v Speaker 3>for decades, but the industry as a whole has really

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<v Speaker 3>grown quite rapidly in popularity over recent years, to the

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<v Speaker 3>point that we are now talking about a billion dollar industry.

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<v Speaker 3>Now that's according to estimates by the Australian Health Practitioner

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<v Speaker 3>Regulation Agency APRA, So they put the dollar value of

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<v Speaker 3>this industry at a billion dollars.

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<v Speaker 1>And let's be really clear on what exactly we're talking

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<v Speaker 1>about when we're talking about cosmetic procedures. We're not talking

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<v Speaker 1>about getting your nails done right exactly. Sorry, I know,

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<v Speaker 1>I know that's silly, but question here, question, I'm kind

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<v Speaker 1>of new to this industry, so I'm kin to understand

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<v Speaker 1>exactly what you mean here exactly. Well.

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<v Speaker 3>APRA's definition of cosmetic procedures is pretty broad. It defines

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<v Speaker 3>cosmetic procedures as ones that quote revise or change the appearance, color,

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<v Speaker 3>textra structure, or position of normal bodily features to achieve

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<v Speaker 3>what a patient perceives to be a more desirable appearance.

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<v Speaker 3>But narrowing down on that a little bit, this broad

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<v Speaker 3>term can include everything from surgical to non surgical options.

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<v Speaker 3>But specifically today we're going to talk more about non

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<v Speaker 3>surgical procedures, so things like filler anti wrinkle injections Botox.

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<v Speaker 3>Botox is a brand of anti renkal injections, some laser

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<v Speaker 3>skin treatments anything that falls under that umbrella.

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<v Speaker 1>It's interesting how that definition incorporates the why behind the treatment.

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<v Speaker 1>So somebody trying to achieve a more desirable appearance, because

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<v Speaker 1>I know people who get botox for injuries that they've

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<v Speaker 1>had or post surgical stuff for disability.

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<v Speaker 3>There are some medical reasons why people will access botox

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<v Speaker 3>for non esthetic purposes, I suppose, And those procedures are

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<v Speaker 3>subject to different regulations.

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<v Speaker 1>And this space, though, is cosmetic, So who's responsible then

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<v Speaker 1>for that space?

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<v Speaker 2>So this is regulated this space by.

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<v Speaker 3>That regulation agency OPRA I mentioned and the National Boards

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<v Speaker 3>APRA is tasked with ensuring registered health practitioners basically have

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<v Speaker 3>appropriate training, that they have the qualifications to practice, and

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<v Speaker 3>that all of that aligns with prioritizing patient safety. And

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<v Speaker 3>that is the body that's just released new national guidelines

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<v Speaker 3>that will apply to all registered health practitioners performing as

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<v Speaker 3>well as advertising these non surgical cosmetic procedures.

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<v Speaker 1>And do you think there's been a trigger for these

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<v Speaker 1>new guidelines to be released or is it more of

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<v Speaker 1>an accumulation of bad behavior in the industry.

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<v Speaker 2>Yeah, it's been.

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<v Speaker 3>A movement that's been kind of a few years in

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<v Speaker 3>the making. There was an independent review a couple of

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<v Speaker 3>years ago which brought some concerning practices to light, and

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<v Speaker 3>I think there is concern overall from the regulator that

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<v Speaker 3>non surgical cosmetic procedures are still risky procedures, but that

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<v Speaker 3>maybe they're being minimized or downplayed by some providers.

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<v Speaker 2>Over the past few years, more.

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<v Speaker 3>Complaints have been lodged with concerns around unqualified or undertrained

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<v Speaker 3>people offering these services. And until now, some professions have

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<v Speaker 3>had more specific rules than others, like doctors under the

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<v Speaker 3>Medical Board are subject to different frameworks and regulations than

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<v Speaker 3>nurse practitioners, for example, But now APRA is saying that

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<v Speaker 3>it wants to standardize these processes to avoid confusion, so

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<v Speaker 3>the same rules apply right across the board when we're

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<v Speaker 3>talking about non surgical cosmetic procedures.

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<v Speaker 1>And as with any industry, I think it's probably important

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<v Speaker 1>to say that most people who would work in this

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<v Speaker 1>space are well meaning people who follow the rules and

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<v Speaker 1>have patient care at the heart of their practice. But also,

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<v Speaker 1>as with most industries, there's people who don't do that.

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<v Speaker 1>Do we have a sense of the scale of the

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<v Speaker 1>complaints that are being issued from that sector or the

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<v Speaker 1>damage that's being done.

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<v Speaker 3>So between late twenty twenty two and early twenty twenty five,

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<v Speaker 3>APRA looked into about three hundred and sixty complaints related

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<v Speaker 3>to these types of cosmetic procedures. Most of those complaints

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<v Speaker 3>are now closed, but the concerns raised ranged from a

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<v Speaker 3>lack of training from providers to poor patient outcomes. And

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<v Speaker 3>these complaints didn't discriminate across professions. We had complaints about doctors, nurses, dentists,

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<v Speaker 3>even psychologists, Chinese medicine practitioners. So the narrative from those

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<v Speaker 3>complaints speaks to broader gaps in care across the board.

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<v Speaker 1>So there's this gap and care in the non surgical

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<v Speaker 1>cosmetic industry. Some new guidelines come into play. What exactly

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<v Speaker 1>are those guidelines aiming to change.

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<v Speaker 3>Well, there are a few new rules that are really

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<v Speaker 3>interesting that I wanted to talk through today. But one

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<v Speaker 3>of the first ones that stands out is changes around

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<v Speaker 3>the training of staff and minimum requirements so approcalls this

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<v Speaker 3>practitioner's scope of practice and basically in the past or

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<v Speaker 3>up until now, just because someone has a general health qualification,

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<v Speaker 3>so for example, as a nurse or as a dentist,

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<v Speaker 3>that can no longer automatically mean that they are qualified

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<v Speaker 3>to perform cosmetic procedures. So from the second of September,

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<v Speaker 3>in just under three months time, practitioners will need additional

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<v Speaker 3>training or education if they want to safely expand into

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<v Speaker 3>the cosmetic procedure space. So it can no longer just

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<v Speaker 3>be that you are a qualified nurse who decides you

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<v Speaker 3>want to expand your business and dabble in injectibles. You

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<v Speaker 3>will have to undertake more training. On that example of nurses,

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<v Speaker 3>there'll be a certain period of clinical experience required before

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<v Speaker 3>they can begin offering non surgical cosmetic procedures. The regulator

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<v Speaker 3>says this reform is also about future proofing the industry,

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<v Speaker 3>so it warns that maybe some practitioners have been drawn

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<v Speaker 3>to non cosmetic procedures because it's a very lucrative industry. Interesting,

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<v Speaker 3>so these new protections, it said, highlight that many practitioners

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<v Speaker 3>need more than just the foundational qualifications in included in

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<v Speaker 3>their initial training before they can safely perform these procedures

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<v Speaker 3>like cosmetic injections, and trying to get people away from

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<v Speaker 3>that financial motivation to work in this space.

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<v Speaker 1>We'll be right back after a quick message from our sponsor.

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<v Speaker 1>Now one thing that really stood out to me in

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<v Speaker 1>these guidelines was how specific the protections were for young people.

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<v Speaker 1>What's changing there?

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<v Speaker 2>Yeah, this is really interesting.

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<v Speaker 3>There are two big things to talk about. Firstly, any

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<v Speaker 3>advertising of these procedures aimed at under eighteen year olds

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<v Speaker 3>will be completely banned.

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<v Speaker 1>So right now you can advertise cosmetic procedures to under eighteens.

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<v Speaker 3>Well, it's a gray area I suppose about who an

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<v Speaker 3>AD is targeted towards, but there are stronger protections that

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<v Speaker 3>say a vague AD could be seen by under eighteen

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<v Speaker 3>year olds and that that's therefore inappropriate, so clamping down

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<v Speaker 3>on that. And secondly, if a child or teen does

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<v Speaker 3>want an underage cosmetic procedure, there'll now be a mandatory

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<v Speaker 3>seven day cooling off period between their first consultation and

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<v Speaker 3>actually getting the treatment, and so this is aimed at

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<v Speaker 3>preventing impulsive decision making. Regulators say they want to reduce

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<v Speaker 3>pressure on young people to rush into cosmetic work, particularly

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<v Speaker 3>considering the added pressures of social media.

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<v Speaker 1>But just to clarify there, we're still saying that under

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<v Speaker 1>eighteens can access cosmetic procedures.

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<v Speaker 3>Well, the jury is kind of out on that one,

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<v Speaker 3>because I took a closer look at the copy of

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<v Speaker 3>these new guidelines for registered health practitioners. They come into

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<v Speaker 3>effect in September, and there's a dedicated section to additional

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<v Speaker 3>responsibilities around providing these nonsurgical procedures for under eighteen year olds,

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<v Speaker 3>which says practitioners have a responsibility to assess a patient's

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<v Speaker 3>capacity to consent to a procedure, so there has to

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<v Speaker 3>be an evaluation there. It also says registered health practitioners

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<v Speaker 3>should have regard for the views of a parent or

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<v Speaker 3>guardian of a person under eighteen, including whether or not

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<v Speaker 3>they support the procedure being performed. But the regulator does

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<v Speaker 3>not endorse prescribing botox or similar injections, dermal fillers things

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<v Speaker 3>like that for cosmetic purposes for any under eighteen year olds,

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<v Speaker 3>and eligibility can only be assessed by registered nurses or

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<v Speaker 3>nurse practitioners. Now they must quote, know and comply with

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<v Speaker 3>relevant legislation of the jurisdiction in which they're practicing in

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<v Speaker 3>in terms of any restrictions on cosmetic procedures for under

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<v Speaker 3>eighteen year olds.

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<v Speaker 1>So I'm kind of guessing here, but I assume then

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<v Speaker 1>that an update on those guidelines and those jurisdictional rules

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<v Speaker 1>would be part of this added qualification that medical professionals

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<v Speaker 1>would need to be able to perform the procedures. But

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<v Speaker 1>there's many jurisdictions in Australia and that would also be confusing.

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<v Speaker 3>Yeah, it is a gray area and it really depends

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<v Speaker 3>on what the procedure is and where the procedure would

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<v Speaker 3>be taking place. There's actually an interesting report by the

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<v Speaker 3>Royal Australian College of General Practition on this that points

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<v Speaker 3>to concerns about the ethics and the practice of children

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<v Speaker 3>undergoing cosmetic procedures. It says that Australia blacks reliable data

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<v Speaker 3>on this issue and the prevalence of these procedures on children,

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<v Speaker 3>but it points to concerns around kind of these high

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<v Speaker 3>rates that we are hearing about of body image dissatisfaction

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<v Speaker 3>and how that could be driving more young people to

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<v Speaker 3>these procedures. But nationally, the Australian Medical Association's position is

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<v Speaker 3>that patients under eighteen years old should not have procedures

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<v Speaker 3>to modify or enhance physical appearance unless it is in

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<v Speaker 3>their medical and or psychological interests. New South Wales guidelines

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<v Speaker 3>advise a longer cooling off period, so they advise a

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<v Speaker 3>three month cooling off period between the initial consult and

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<v Speaker 3>a procedure on an under eighteen year old, and that

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<v Speaker 3>goes well beyond APRA's new mandatory seven day cooling off period.

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<v Speaker 3>But Queensland is the only state that's actually legislated a

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<v Speaker 3>ban on performing a cosmetic procedure child that was introduced

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<v Speaker 3>in two thousand and eight. Everywhere else, it's kind of

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<v Speaker 3>up to the practitioner. There are steps that they have

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<v Speaker 3>to take, but actually enforcing any of these kind of

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<v Speaker 3>rules is a little bit murky.

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<v Speaker 1>And I'm really interested in this advertising band that you

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<v Speaker 1>spoke about because it brings in the whole other discussion

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<v Speaker 1>that I know you've been very involved with for most

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<v Speaker 1>of this year around the way that social media is

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<v Speaker 1>used to influence the way that young people especially think

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<v Speaker 1>about their bodies. Yeah, can you tell me a little

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<v Speaker 1>bit about how this framework changes what's happening there.

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<v Speaker 3>Yes, So social media has become such a big part

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<v Speaker 3>of how these procedures are marketed. We know that young

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<v Speaker 3>people are on social media, so they're the people seeing

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<v Speaker 3>these messages. As I flagged, any advertising targeting under eighteen

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<v Speaker 3>year olds will be banned in the non surgical cosmetic

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<v Speaker 3>procedure space. But there are some other pretty comprehensive reforms

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<v Speaker 3>that will change how advertising works for high risk procedures.

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<v Speaker 3>Now most injectibles are included under that category. So, for example,

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<v Speaker 3>ads will have to contain information about the practitioner performing

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<v Speaker 3>the procedure so patients know who they're engaging with. And

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<v Speaker 3>there are measures to strengthen a ban on the use

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<v Speaker 3>of testimonials from social media influences. And there's also a

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<v Speaker 3>ban on ads that sexualize or trivialize cosmetic procedures.

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<v Speaker 1>What exactly does that mean.

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<v Speaker 3>It means anything that minimizes the invasiveness of cosmetic procedures

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<v Speaker 3>or misleads patients about how complex a procedure might be.

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<v Speaker 3>It is worth pointing out when I say advertising here,

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<v Speaker 3>this can include any kind of social media post. So

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<v Speaker 3>a practice could post about a procedure that they offer

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<v Speaker 3>that is, under these guidelines considered a form of advertising.

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<v Speaker 1>I feel like the thing that comes to mind is

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<v Speaker 1>the classic kind of before and.

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<v Speaker 3>After exactly, and they will be changing under these regulations,

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<v Speaker 3>So any advertising, all those kinds of posts that include

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<v Speaker 3>things like emojis won't be allowed. Words like transformation, artistry, perfect,

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<v Speaker 3>silhouette sculpting. They're all inappropriate for advertising, and other terms

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<v Speaker 3>that minimize procedures like gentle, simple, safe, quick, easy. They

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<v Speaker 3>appro say detract from the seriousness of a procedure, so

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<v Speaker 3>they will also be banned.

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<v Speaker 1>So there's some pretty sweeping reforms that we've talked about,

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<v Speaker 1>but this isn't the first time that this space has

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<v Speaker 1>had regulation. Give me a sense of what those other

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<v Speaker 1>regulations are, yees.

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<v Speaker 2>So I mentioned earlier.

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<v Speaker 3>There was a review in twenty twenty three, and this

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<v Speaker 3>crackdown is really building on that. APRA shared at the

0:13:31.280 --> 0:13:34.400
<v Speaker 3>time some pretty serious case studies, including the story of

0:13:34.400 --> 0:13:37.880
<v Speaker 3>a patient who suffered severe burns from a light based treatment,

0:13:38.280 --> 0:13:41.840
<v Speaker 3>another who developed an abscess after a threading procedure gone wrong,

0:13:42.160 --> 0:13:45.079
<v Speaker 3>and in one case, a practitioner ignored a patient's skin

0:13:45.160 --> 0:13:48.440
<v Speaker 3>condition and went ahead with filler and that injectable led

0:13:48.440 --> 0:13:51.640
<v Speaker 3>to a serious reaction. The regulator said at the time

0:13:51.720 --> 0:13:55.640
<v Speaker 3>these are not isolated events. They really represent a broader

0:13:55.679 --> 0:14:00.120
<v Speaker 3>pattern of shortcomings within the industry. So that review found

0:14:00.200 --> 0:14:04.040
<v Speaker 3>there was no universal minimum standard of education or training,

0:14:04.200 --> 0:14:07.080
<v Speaker 3>and experts warn that was leaving patients at risk, and

0:14:07.200 --> 0:14:10.840
<v Speaker 3>in response, the Medical Board and OPERA accepted sixteen major

0:14:10.880 --> 0:14:13.240
<v Speaker 3>recommendations to improve patient.

0:14:12.960 --> 0:14:15.520
<v Speaker 1>Safety and those are in place now yep.

0:14:15.400 --> 0:14:20.160
<v Speaker 3>So essentially in the area of injectibles, those regulations have

0:14:20.240 --> 0:14:22.560
<v Speaker 3>been rolled out, but clearly there is more to be done,

0:14:22.600 --> 0:14:25.080
<v Speaker 3>which is why we've seen these new rules. But back

0:14:25.120 --> 0:14:29.600
<v Speaker 3>in twenty twenty three, there were new rules about consent consultations.

0:14:29.680 --> 0:14:32.960
<v Speaker 3>You might remember headlines at the time about psychological evaluations,

0:14:33.400 --> 0:14:37.440
<v Speaker 3>tightening who can prescribe and administer procedures, and that was

0:14:37.480 --> 0:14:40.600
<v Speaker 3>the start of a ban on testimonials from influencers, a

0:14:40.640 --> 0:14:43.960
<v Speaker 3>clamp down on influencer marketing, and these reforms are really

0:14:43.960 --> 0:14:46.160
<v Speaker 3>an evolution of those changes.

0:14:46.520 --> 0:14:48.800
<v Speaker 1>So we have a reaction from industry bodies here.

0:14:49.200 --> 0:14:52.800
<v Speaker 3>Yeah, we've heard from the Australasian Society of Esthetic Plastic

0:14:52.880 --> 0:14:56.920
<v Speaker 3>Surgeons ASAPS. That's a peak industry body and it's welcomed

0:14:56.920 --> 0:15:00.680
<v Speaker 3>the call by OPRA to require better education, training and

0:15:00.760 --> 0:15:06.280
<v Speaker 3>ongoing education for non surgical cosmetic practice. It says regulations

0:15:06.320 --> 0:15:09.840
<v Speaker 3>haven't kept pace with the popularity of the procedures. But

0:15:10.120 --> 0:15:12.720
<v Speaker 3>in addition to clinical safety, the body says there should

0:15:12.720 --> 0:15:16.040
<v Speaker 3>also be greater attention on ethical practice, with a focus

0:15:16.080 --> 0:15:18.720
<v Speaker 3>on patient interest over commercial profits.

0:15:18.840 --> 0:15:20.960
<v Speaker 1>Interesting, there's a lot in that sentence exactly.

0:15:21.000 --> 0:15:22.360
<v Speaker 2>It's a big, big sentence.

0:15:22.480 --> 0:15:26.240
<v Speaker 3>These new guidelines now stipulate that additional training that we've

0:15:26.280 --> 0:15:29.560
<v Speaker 3>talked through. But ASAPS, this body says that there's no

0:15:29.680 --> 0:15:34.320
<v Speaker 3>minimum quality standard for providers ongoing professional development and education

0:15:35.000 --> 0:15:37.200
<v Speaker 3>and no plan for enforcement.

0:15:37.280 --> 0:15:40.040
<v Speaker 1>So it's all very well and good having an education requirement,

0:15:40.200 --> 0:15:43.480
<v Speaker 1>there's no guidelines that this body is saying as to

0:15:43.520 --> 0:15:46.800
<v Speaker 1>who's teaching that and how it's being enforced.

0:15:46.520 --> 0:15:50.680
<v Speaker 3>Exactly, So more to be done, according to ASAPS. Meanwhile,

0:15:50.720 --> 0:15:54.520
<v Speaker 3>the Medical Board of Australia chair doctor Susan O'Dwyer said, quote,

0:15:54.560 --> 0:15:58.040
<v Speaker 3>these guidelines make sure we're all working from similar playbooks

0:15:58.080 --> 0:15:59.520
<v Speaker 3>for the safety of our patients.

0:16:00.080 --> 0:16:03.600
<v Speaker 1>Said. These regulations come into force in early September. What

0:16:03.720 --> 0:16:04.680
<v Speaker 1>else happens next?

0:16:05.080 --> 0:16:09.360
<v Speaker 3>Practitioners have three months to get themselves sorted, be that

0:16:09.600 --> 0:16:14.520
<v Speaker 3>advertisers or healthcare providers. The guidelines are online now, so

0:16:14.800 --> 0:16:18.520
<v Speaker 3>stakeholders essentially have the three months to get ready, update processes,

0:16:18.640 --> 0:16:23.320
<v Speaker 3>get qualified or retrain their staff if needed. For consumers,

0:16:23.520 --> 0:16:28.480
<v Speaker 3>especially younger Australians, you know, nothing will really change dramatically,

0:16:28.960 --> 0:16:32.280
<v Speaker 3>but there is a stronger safety net in place. Essentially,

0:16:32.320 --> 0:16:35.800
<v Speaker 3>that is what the regulator says. These rules don't stop

0:16:35.840 --> 0:16:39.160
<v Speaker 3>cosmetic work from happening, but they shine a spotlight on

0:16:39.240 --> 0:16:42.840
<v Speaker 3>ethics and safety and informed decision making. And I'm sure

0:16:42.880 --> 0:16:45.680
<v Speaker 3>it's not the last we're going to hear about regulation

0:16:45.760 --> 0:16:46.320
<v Speaker 3>in this space.

0:16:46.480 --> 0:16:48.720
<v Speaker 1>It has been an interesting space to watch over the

0:16:48.800 --> 0:16:52.880
<v Speaker 1>years because there seems to be quite a steady flow

0:16:52.960 --> 0:16:55.560
<v Speaker 1>of regulation that has been rolled out. It hasn't been

0:16:55.600 --> 0:16:58.240
<v Speaker 1>this kind of sense of sweeping regulation that turns the

0:16:58.360 --> 0:17:01.200
<v Speaker 1>entire industry on its head, rather kind of tweaks along

0:17:01.200 --> 0:17:03.760
<v Speaker 1>the way to what is the livelihood for a lot

0:17:03.760 --> 0:17:05.639
<v Speaker 1>of people, but also putting a lot of people at

0:17:05.720 --> 0:17:07.159
<v Speaker 1>risk should it be done incorrectly.

0:17:07.240 --> 0:17:09.399
<v Speaker 3>And so often in medicine, I think we see the

0:17:09.440 --> 0:17:12.840
<v Speaker 3>popularity come first and the regulations come second.

0:17:13.119 --> 0:17:15.040
<v Speaker 1>And thank you so much for that, And thank you

0:17:15.080 --> 0:17:17.480
<v Speaker 1>for joining us on the Daily OS this morning. If

0:17:17.480 --> 0:17:19.560
<v Speaker 1>you're catching us on YouTube, it's so great to have

0:17:19.640 --> 0:17:21.440
<v Speaker 1>you here. It would mean a lot if you subscribed

0:17:21.520 --> 0:17:23.760
<v Speaker 1>to our channel. We'll be back in the afternoon with

0:17:23.800 --> 0:17:30.440
<v Speaker 1>your headlines. Until then, have a great date. My name

0:17:30.480 --> 0:17:33.720
<v Speaker 1>is Lily Maddon and I'm a proud Arunda Bunjelung Kalkutin

0:17:33.760 --> 0:17:37.800
<v Speaker 1>woman from Gadighl country. The Daily oz acknowledges that this

0:17:37.880 --> 0:17:40.439
<v Speaker 1>podcast is recorded on the lands of the Gadighl people

0:17:40.760 --> 0:17:43.800
<v Speaker 1>and pays respect to all Aboriginal and Torres Strait island

0:17:43.840 --> 0:17:44.400
<v Speaker 1>and nations.

0:17:44.720 --> 0:17:47.640
<v Speaker 2>We pay our respects to the first peoples of these countries,

0:17:47.760 --> 0:17:48.960
<v Speaker 2>both past and present.