THE PATIENT VERSUS CLIENT DEBATE

The JCCP clarifies its position following backlash

TheJoint Council for Cosmetic Practitioners (JCCP) has re-clarified its position on the terminology used to describe those seeking aesthetic treatments following criticism from healthcare professionals and industry stakeholders, including the British Association of Medical Aesthetic Nurses (BAMAN) and The British Association of Cosmetic Doctors (BCAM).

The 'patient' versus 'client' debate was reignited after the JCCP put a post up on social media about its recommendations on future standards and qualifications for non-surgical cosmetic practice, suggesting individuals seeking non-surgical treatments be referred to as 'clients' or 'service users' rather than 'patients'.

The post was met with opposition, particularly from BAMAN and BCAM, with both groups strongly advocating for the continued use of the term 'patient' for individuals treated by regulated healthcare professionals, emphasising the medical nature of many aesthetic procedures and the corresponding duty of care required of clinicians.

In response, the JCCP clarified its position with Professor David Sines, executive chair and registrar of the JCCP, reiterating that the term 'patient' should be reserved for individuals receiving treatments from regulated healthcare professionals such as doctors, nurses, and dentists. This distinction was further reinforced in an updated competency framework and educational materials.

Professor Sines said, “The JCCP has no hesitation in advising that whenever regulated healthcare practitioners provide nonsurgical procedures to members of the public, the term ‘patient’ should be used. This has always been our position and will continue to be so.

“We recognise that the title ‘healthcare professional’ is restricted to those persons associated with either a specialty or a discipline and who is qualified and registered by one the designated Government Professional Statutory Regulatory Bodies to provide a healthcare service to a patient.

“Conversely, the JCCP is of the opinion that non-healthcare practitioners whose scope of practice is related to the sole provision of ‘cosmetic procedures’ should not be permitted to refer to their clients as ‘patients’.

“The JCCP will seek to clarify these matters further when we revise our policy and competency framework over the next year in association with the demands of the Government’s anticipated licensing scheme.”

PERSPECTIVES FROM MEDICAL PROFESSIONALS

Dr Catherine Fairris, president of BCAM, expressed her concerns, emphasising that the relationship between a healthcare professional and a patient carries significant ethical, legal, and professional responsibilities. She noted that the JCCP's initial guidance caused "alarm bells" within the medical community but acknowledged the organisation's subsequent retraction and clarification. "We at BCAM were very surprised to see that the JCCP had released such guidance. We reached out to Prof Sines and Andrew Rankin privately to clarify their position, and they reassured us that they did not mean to include medical professionals in that blanket statement, but rather, it was intended to ensure that ’lay practitioners’ were not erroneously using the term ’patient’.

“The bottom line is that as medical professionals (doctors, surgeons, dentists and nurses), we have a greater ethical and legal obligation to anyone that we treat. Our responsibility is enshrined in medical law, and whether we are performing a ‘cosmetic’ treatment or a treatment with wider medical implications, the person we are treating is our ‘patient’, and as such, we will always be held to the highest of standards in that relationship.

“I am working on the assumption that the original statement that they made was indeed an error and that they did not have any expectation of enforcing a change in terminology as it pertains to medical professionals treating ’patients’.

“Moreover, the majority of aesthetic treatments are fundamentally medical procedures or involve the use of prescription medications. All the more reason why ensuring that proper terminology is adhered to is to reinforce to the public that these procedures do carry risk and are medical.”

Similarly, BAMAN highlighted that the term ’patient’ aligns with ethical standards upheld by healthcare professionals. In a statement posted on its social media, the organisation underscored that individuals treated by non-regulated practitioners should not be categorised under the same terminology, reflecting the differing levels of care and accountability. Gareth Lewis, head of operations at BAMAN, commented, “At BAMAN, we are pleased with the JCCP’s clarification, following our communication with Professor David Sines, that it has always been their position that regulated healthcare professionals, such as nurses, doctors, and dentists, should continue to refer to those they treat as ‘patients.’ As the leading organisation for medical aesthetic nurses, we believe this distinction is vital to reflect the medical and ethical responsibilities unique to regulated medical professionals. We strongly advocate for clear and appropriate terminology to highlight the significant differences in accountability and standards of care between regulated medical professionals and non-regulated providers. This clarity is essential to ensuring public confidence, safeguarding patient safety, and maintaining professionalism within medical aesthetics.”

THE COMPLEXITY OF TERMINOLOGY IN AESTHETICS

The debate underscores a broader challenge within the aesthetics industry: the coexistence of regulated medical professionals and non-regulated providers. While some clinics cater to individuals who view aesthetic treatments as commercial services, others focus on the medical and health-related aspects of these interventions.

Professor Sines addressed this complexity, stating that the JCCP uses generic terms like ’clients’ when referring to the general public in its guidance. He said, “The JCCP’s explicit mission is the promotion of patient safety and public protection and therefore, the Council makes generic reference in its policy statements to 'members of the public’ or ‘clients’ when referring to people who use non-surgical procedures (bearing in mind that many members of the public seek to procure such services from non-regulated health care persons). Of equal significance is the fact that the non-surgical sector is regarded for the main part as being ‘commercial’ thus resulting in many practitioners referring to the persons who procure their services as ‘clients’.”

However, he maintained that healthcare professionals must uphold their distinct obligations and terminology to differentiate their practice from non-regulated providers.

Reflecting on the situation, Dr Steven Land of Novellus Aesthetics acknowledged that the debate highlighted tensions within the industry's efforts to maintain professional standards. He noted that the JCCP’s initial guidance was not perceived as adequately supportive of the medical aesthetic field's dedication to patient safety.

“Many medics obviously, and rightly, deem these procedures to be medical, as well as cosmetic and that therefore the people getting them should be deemed ‘patients’,” he commented.

Ultimately, the controversy has served as a reminder of the critical importance of language in shaping public understanding of aesthetic treatments and the risks, responsibilities, and professionalism associated with these procedures.