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Aesthetic clinics and beauty centres are mushrooming across Malaysia, catering to the growing demand. However medical professionals have raised concern that some of these procedures may be carried out by unqualified practitioners. Just how tightly regulated is the aesthetic medicine industry, and what risks could consumers be facing? On this episode of #ConsiderThis Melisa Idris speaks with Dr Ungku Mohd Shahrin Ungku Mohd Zaman, President of the Malaysia Registered Aesthetic Doctors Organisation. He’s also the Program Director of the Medical Aesthetic Certification Program.
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00:10Hello and good evening. I'm Melissa Idris. Welcome to Consider This. This is the show
00:14where we want you to consider and then reconsider what you know of the news of the day. Aesthetic
00:19clinics and beauty centres are mushrooming across Malaysia, catering to the growing demand.
00:25However, medical professionals are raising red flags and concerned that some of these procedures
00:33that are being offered and carried out by unqualified practitioners. So just how tightly regulated
00:40is the aesthetic medicine industry in Malaysia and what risks could consumers be facing? That's
00:47what we want to explore today. And joining me on the show to do that is Dr. Ungku Muhammad Sharin,
00:52Ungku Muhammad Zaman, who is the President of the Malaysia Registered Aesthetic Doctors
00:57Organisation. He's also the Programme Director of the Medical Aesthetic Certification Programme.
01:03Dr. Ungku, it's good to have you on the show. Thank you so much for joining me. I wanted to
01:08begin our conversation today maybe by refining or having a better understanding of the terminology.
01:13What exactly do we mean when we talk about aesthetic medicine? What does that refer to in terms
01:20of specific procedures? Can you maybe elaborate?
01:25Okay. First of all, I'd like to say thank you to Melissa for inviting me. Thank you, Astro Awani.
01:32Actually, the concern or the topic that we are about to talk today is something, nothing new in
01:39Malaysia. It's been talked about for quite a while. But before I go into that, I think to in brief
01:45the
01:46definition of aesthetic medicine basically is any aesthetic procedures that deem to be medical in nature,
01:57meaning that there will be complication, there will be risk, there will be outcome or it could be a bad
02:04outcome also. So these procedures can only be done by medical practitioners, licensed medical practitioners
02:12in Malaysia. And in our country, actually, we are one step beyond that, what do you call,
02:23in terms of qualification for doctors, we had this so-called letter of credentialing privileging.
02:30So doctors with this certificate allowed to do aesthetic procedures or medical aesthetic procedures in
02:37Malaysia. So bottom line, I guess, aesthetic medicine is a procedure meant for cosmetic or aesthetic
02:46improvement in a person, done by medical personnel.
02:51Okay. So when you say this is a kind of a long-standing issue, I'm curious to know how the
02:57situation has evolved
02:59in recent times. We do see this proliferation of aesthetic clinics nowadays. And I do wonder what you're
03:08seeing on the ground. How widespread is the issue of, say, non-certified practitioners performing medical aesthetic
03:17procedures? Are you seeing a rise? What are your observations, Doctor?
03:23Okay. Actually, when, during the early stage, I mean, me, myself personally, I started way back in 2002,
03:322001. So at that time, it's, normally it was done in a small scale in a clinic or even in
03:41some British
03:41centre. But then as time goes, I guess, in the past 10 to 15 years, the demand is rising, not
03:48only locally,
03:49but internationally. And in fact, we are talking about revenue that anticipated from, we can anticipate
03:58from this industry. From, I think, couple of hundred millions a year in Malaysia, by 2029, it was expected to
04:07be more than 1 billion. Meaning that, I guess, the demand, the requests from the public is getting higher and
04:16higher. Hence, this, initially, this medical aesthetic procedure is only meant for medical personnel or
04:24medical doctors. But I guess, when the demand is increased, so this is where we start to see
04:30a lot of centres, a lot of premises, offering such services. So, and we are talking about also
04:40unregulated non-medical aesthetic personnel or centres. So, again, these, those centres operate under the
04:52beauty salon licence rather than a medical clinic licence. And I guess that the, with the, with the
05:04increasing advertising, freedom of advertising your services in social media platform, also can cause a lot of
05:16misinformation, misguided information to the public. And lately, what we noticed also on the ground, is that there's a lot
05:26of
05:26this, uh, non-medical personnel that, uh, portraying themselves as a medical personnel or even, uh, blatantly, uh, tell them
05:36to, to their, to their, uh, client or to their
05:40patients as if they are, uh, qualified to do such, uh, procedures in their centres. Okay. Dr. Ungku, what are
05:48the patient's safety concerns then, if,
05:50uh, unregulated non-medical personnel, um, uh, are performing these types of procedures? What does that mean for
05:57patient's safety and also for the standard of care? So, actually, uh, there's, there's a lot of issues, actually. This
06:04is where, um, the difference
06:06between, uh, if you are doing it, uh, in the proper way by a medical personnel in an aesthetic clinic,
06:13because, uh, in order for you to approach or to see even
06:16the patient or what the British Centre said, they are the client, uh, there's a, a few procedures. And mainly,
06:24all the procedures are
06:25based on, um, uh, a basic medical, uh, SOP. We need to, to, to do, uh, assessment, history taking, uh,
06:35medical checkup, uh, a basic one before
06:37we do the, the procedures. However, and, and hence, because of, I think, lack of those, uh, medical, uh,
06:46knowledge or experience, this is where we can't, we start to see a lot of complications such as, uh, burn
06:51because of laser, complication because of toxin injections, infection, and, uh, quite a number of cases
07:00that was referred to medical doctors or even hospital, uh, uh, poorly managed complication. Uh, you know,
07:08as simple as burn wound, they don't really know how to manage, and this is where they start to, to
07:13either
07:14treat that, uh, according to what they understand, or they, uh, when this, they refer to us, uh, the, the,
07:21the complication already getting worse.
07:24Right. So, I, as I understand it, Malaysia has guidelines, right, for the aesthetic medicine
07:30practice. How do you see these, uh, these regulations? Are they sufficient to cater for
07:37the growing industry, or is it more of, um, enforcement that's the bigger challenge?
07:43Yeah, um, I guess the, when we talk about aesthetic industry or aesthetic treatment as a whole,
07:50uh, uh, uh, is a big domain. We need to separate that into two, actually. We're talking about medical
07:57aesthetic domain and non-medical aesthetic. So, the regulations that are in place now are mainly to
08:04control the medical aesthetic practitioners. They are governed by, uh, the Ministry of Health, of course,
08:12uh, under the Act 786, uh, Medical Act 786. And, of course, under medical aesthetic, we are regulated
08:21under the guidelines of, uh, medical aesthetic practitioners in Malaysia, whereby the non-medical
08:28personnel, there's, uh, this is where it's a bit, uh, difficult to say because, uh, that at one point,
08:37uh, KPD and HEP, if I'm not mistaken, are the one who are going to, to, uh, uh, supposed to
08:43govern, uh,
08:44the group, uh, they did that, but when the, their guidelines came out, we noticed that there's some clash,
08:53uh, in terms of their guidelines because, uh, the way they do things, or the way they are, they, they,
09:00they propose for the non-medical to do procedures, uh, almost similar to medical personnel.
09:06And, of course, um, enforcement, uh, the, the, the enforcer, uh, under KKM also, I think they do have,
09:15uh, a handful of, uh, complaints and reports, uh, apart from, uh, the medical doctors in the medical also
09:24having some issues, you know, that they need to go and check, uh, when they got complaint from the
09:29non-medical centers or personnel diseases where, uh, they, I think they have, uh, hard times to,
09:37to go and to, to, to check on every premises that performing medical procedures in, in a beauty center.
09:45Yeah. All right. So, so from, as a, as an industry insider, what do you think ought to be the
09:52way
09:52forward? You mentioned, um, a lack of certified practitioners in this respect because of the
09:58growing demand. What are, what are your, um, recommendations or your views in terms of how
10:04do we address this? Where are the, the gaps that need to be looked at?
10:10Actually, um, our, our problem that, the, the, the problem that we're facing now in
10:15Malaysia is, um, not really new. I mean, it has been happening in, in all over the countries.
10:22You know, we're talking about in European countries or even in Southeast Asia, uh, where there's, uh,
10:29a lot of, uh, uh, misinformation or, uh, or what, how can I put it, uh, in terms of
10:38lacking of enforcement or guidelines when it comes to who, uh, the person supposed to perform the
10:46procedures? Is it the medical doctors or is it the non-medical doctors? And the way forward,
10:52I think in Malaysia, apart from the guidelines that we can, we can, uh, come up with, you know,
10:58we have, uh, edition one, two and three for medical personnel, and they are trying to do something with
11:03the medical, I mean, the non-medical. I think the best thing is to, to educate the public,
11:08public awareness, I think is something, uh, is an effort, uh, that we need to do continuously,
11:16not only from the public sectors, but also on the private side. Even in, in, uh, our society,
11:24our organization, we are advocating a lot of public awareness, so that let the public understand
11:31clearly complication of every procedure, because when we, when we talk about medical aesthetic
11:37procedures, uh, as the medical term itself, uh, clearly stated that any medical procedures,
11:45including aesthetic procedures, do have risk involved. So, this is where we need to educate
11:51the public, we need to let them know the risk, you know, blindness probably caused by, uh, certain
11:57fillers, uh, laser can cause burn, you know, can cause nerve damage. So, let them understand,
12:04let them digest, let them decide, uh, on their own term, which, uh, center they need to go.
12:13Dr. Ngu, you're absolutely right. An empowered, uh, consumer will be the best line of defense
12:18for this industry. Can you then maybe, um, share what you think ought to be the practical steps
12:25for, um, any viewers tonight who are considering aesthetic procedures? What should they be taking
12:32into consideration? What should they be ensuring that they're seeing in terms of a properly qualified
12:38practitioner before agreeing to any procedures? Dr. Nguyen, Okay. Uh, and, uh, again, I have to make,
12:44uh, uh, uh, a disclaimer. I mean, when I say this doesn't mean that I, uh, I'm telling the everyone
12:51that they shouldn't be any beauties. They can do. Beauty Center MediSpa, they have their own, uh,
12:58services. They have their own, uh, domain that they can offer to their, to the client. However, I think
13:06when we talk about medical aesthetic procedures for consumer, uh, let the medical personnel, uh, perform the
13:13procedures properly, but for the consumer, for the patient, when they come and see, uh, try to see a,
13:19a doctor or, uh, going to, to a center, first thing they need to know, and it's their right to
13:25ask,
13:26uh, whether the, the clinic or the center, uh, do have a doctor. That's number one. And make sure the
13:33doctor do have a LCP license or certificate. Not all doctors, uh, in Malaysia have their LCP. They need to
13:41go through a rigorous, uh, process, you know, exam, uh, interviews, and, uh, before they can get the
13:48certificate. So there's only, uh, for information, there's about, uh, almost 1,962 doctors in Malaysia
13:57have that LCP. And then they need to check also, which is their right as the patient, whether the
14:04clinic or the center have a license. This is where what we call Borang B or Form B or Form
14:10F,
14:10uh, they can obtain that from, uh, KKM. I mean, the clinic need to obtain that from KKM. And it
14:16should be
14:17displayed, uh, in their clinic, in the center. And, uh, uh, lastly, they need to know, so the procedures that
14:26the doctors can do. So even among doctors, yeah, uh, not all doctors can perform anything under the sun. Uh,
14:35in fact, we divide
14:36that into three categories, chapter one, two, and three. For chapter three, for instance, they can do
14:40all the surgical procedures. These are mostly or mainly plastic surgeons. Chapter two, mainly a medical
14:48specialist, such as dermatologist. And chapter one, uh, non-specialist. They are general practitioners who can do
14:55uh, a lot of this, uh, basic aesthetic procedures, injectables, lasers, machines, and devices. So if they
15:04can identify all these three items in that center of premise, then they are, uh, I mean, they can,
15:13they can safely say that, you know, they are in a good hand to get treated.
15:17All right. Dr. Ungku, thank you so much for sharing some of your knowledge with us today. I appreciate
15:21your time. Dr. Ungku Muhammad Sharin, Ungku Muhammad Zaman there. We're going to take a quick break on
15:25Consider This. We'll be back with more. Stay tuned.
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