Aesthetics Doctor Suspended For Failure To Consent
We previously discussed here about the importance of informed consent and why it’s so much more than just asking your patient to sign a form.
Indeed, the significance of informed consent has been thrown into the spotlight after Dr Ash Labib was given an eight month suspension by the GMC following a non-surgical rhinoplasty.
What Happened?
Following the treatment, the patient experienced a patch of redness which served as a catalyst for the patient to complain to the GMC. Ordinarily, you would expect the GMC to find no reason to uphold the complaint, given it’s a common side effect of any filler treatment, which patients are made fully aware of and give their informed consent to.
However, the GMC’s investigation found that, unfortunately, Dr Labib failed to:
record why the patient wanted to have rhinoplasty
record what outcome the patient hoped to achieve
undertake an adequate aesthetic examination of the patient noting his skin quality, the presence of rhytids; areas of volume deficiency; the aesthetic proportions of his face and how these might be addressed.
The patient then went on to have Hyalase and it was found Dr Labib failed to:
adequately discuss the risks and benefits of this treatment
explain that it might not make any difference to the redness of his nose
convey the side effects of Hyalase
counsel the patient on his surgical expectations of the treatment
failed to record patient’s written consent
failed to record the treatment had been undertaken
In addition it was found that that:
no review appointments were made
no other options to reduce the redness were considered
failed to refer the patient for a second opinion or to another practitioner
failed to respond to the patient’s concerns
induced the patient to withdraw the complaint to the GMC
The Complication Wasn’t The Problem
Throughout the whole Tribunal report, there is limited mention of the actual complication. All of the allegations and findings are centred on the consultation and consent, and a request for the complaint to be withdrawn in return for a full refund.
Dr Labib accepted that his record keeping had not been sufficient and he told the Tribunal that his reputation and career were important to him and that he knew consultations and treatments needed to be documented. Dr Labib told the Tribunal he had had training on record keeping, and worked very hard by applying a new digital platform. He admitted his record keeping had previously not been adequate and fell below expected standards. He explained that this was since he had left the NHS.
The Tribunal received written evidence from Dr B, an expert witness on behalf of the GMC, whose opinion was that the standards fell seriously below the standards reasonably to be expected in aesthetics, and Dr Labib’s overall conduct fell seriously below the standard expected of a reasonably competent ‘Aesthetic Specialist.’
Making An Example? Perhaps.
The GMC’s counsel certainly made it clear that it felt this was an incident that needed to be considered in the public interests and the misconduct could not be overlooked. The GMC felt it had a direct effect on public confidence and could have a direct effect on the maintenance of standards of the medical profession. The tribunal was told the medical profession and informed members of the public would be ‘surprised’ if Dr Labib’s fitness to practice was not found to be impaired.
However, it is worth noting that the Tribunal viewed the heart of the issue, was Dr Labib’s pressure on the patient to withdraw the complaint from the GMC in order to receive a full refund and considered this serious misconduct. The other other elements were individually below expected standards. Cumulatively the catalogue of fundamental errors was in breach of numerous principles of Good Medical Practice, the GMC’s core guidance for doctors.
The Tribunal also highlighted the fact Dr Labib was still relying on pen and paper and commercial consent forms provided by manufacturers. It was not persuaded that there were satisfactory mechanisms to ensure he did not slip into his old way of working and therefore there was a likelihood of repetition in the future.
It’s Not Fair!
You might feel the suspension is an unreasonably severe punishment or that Dr Labib has been treated unfairly. To be scrutinised so intensely for a non-surgical aesthetics treatment, when the industry is not regulated and non-medics aren’t subjected to any codes of conduct, requirements or expectations feels unjust. A non-medic would face zero consequence from a severe complication leading to a disfigurement, let alone a failure to consent.
But this is the whole point isn’t it?
If we want non-surgical aesthetics treatments to be considered as ‘medical’ procedures by patients, the wider public and policy-makers, they have to be conducted as any other medical treatment should be. The guidelines determined by the medical statutory bodies should be adhered to and if they are breeched and a practitioner is found to have fallen below the expected standards, they must face the consequences.
There probably is an element of bad luck here for Dr Labib particularly given, clinically, the complication is relatively normal. Dr Labib isn’t unique and there are many medical practitioners who cherry pick the parts of their medical guidance, when in their aesthetics clinics, in a way they wouldn’t dream of doing in the NHS. The foot is taken off the pedal and there is a level of complacency. Unfortunately, Dr Labib got caught out and while we can feel sympathetic and acknowledge the inconsistencies and unfairness that operates in the aesthetics industry, we can’t minimise the importance of informed consent and professional conduct.
What You Can Do
GlowdayPRO is on your side and aims to protect both you and the patient. This is why our patient management system stores your treatment records digitally, safely and securely, with time stamps and the associated notes and, if relevant, digital facial mark-ups. We also provide you with templates for consent forms which go beyond those provided by manufacturers, or give you the option to design your own.
While GlowdayPRO gives patients the ability to review consent forms prior to their appointment, it does not allow consent forms to be signed ahead of treatments and treatments can not be progressed on the day until these are signed by the patient following your discussion.
GlowdayPRO is a digital evidence file. It’s where you can show you have consulted, disseminated information, discussed risks, side effects and complications and prove that the patient was informed before they signed their consent form.
Your profession is too important to screw up, don’t risk it.
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