Navigating Aesthetic Terminology

Eddie Hooker, chief executive and founder of Hamilton Fraser asks, does the language we use matter?

At the start of 2025, Hamilton Fraser released its trends report and predictions for what would be shaping the market in the coming months. One of the key shifts we have seen is towards the medicalisation of the market.

We always try to keep our finger on the pulse of what’s happening in the sector, and recent conversations have got us thinking about the language we use in aesthetics and why it matters.

Aesthetics has evolved outside of the parameters of traditional medicine, and as such, the terminology used to describe professionals and treatments has, at times, been a contentious issue. Misleading job titles and ambiguous language can impact patient trust, regulation, and even legal claims. With professional bodies, legal experts, and insurers weighing in, there is growing recognition of the need for clarity in how practitioners describe themselves and their work.

INDUSTRY, SECTOR, OR SPECIALITY - WHAT’S THE RIGHT TERM?

The debate over whether aesthetic medicine should be classified as an industry, market, sector, or speciality remains ongoing.

Traditionally, “industry” suggests a profit-driven enterprise, whereas “sector” implies a broader professional field, and “speciality” denotes a medical discipline.

Gareth Lewis, head of operations at the British Association of Medical Aesthetic Nurses (BAMAN), advocates against using the term “industry” when referring to medical aesthetics. “We see it as a specialism or sector, not an industry, because our focus is on patient care, professionalism, and medical responsibility rather than a profit-driven model”, he says. “Referring to medical aesthetics as a sector supports these principles by emphasising the elevation of standards and the protection of the public. Using the term industry undervalues the specialism and suggests profit-driven care over prioritising patient care, which contrasts with BAMAN’s values of integrity, professionalism, and patient safety.”

Independent nurse prescriber Cheryl Barton adds, “Industry is defined as economic activity concerned with the processing of raw materials and the manufacture of goods. We have transport, pharmaceutical, manufacturing and fashion industries. Sectors relate to people. We don’t have a private health industry. It is a sector. Until we start challenging and changing these words and phrases, people, politicians especially, will continue to consider us as ‘fill and freeze factories’.”

While aesthetic medicine is not currently a GMC-recognised speciality, medical practitioners argue that its increasing legitimacy within institutions like the Royal Society of Medicine strengthens its claim to being more than just a commercial industry.

Dr Catherine Fairris, president of the British College of Aesthetic Medicine (BCAM), reinforces this view: “We need to refer to aesthetic medicine as a speciality, especially as medical professionals practise it. The Royal Society of Medicine’s recognition of aesthetics as a medical speciality underlines the importance of accurate terminology and correct titles.”

PATIENT VS. CLIENT: MORE THAN JUST SEMANTICS

The “patient versus client” debate resurfaced following a discussion led by the Joint Council for Cosmetic Practitioners (JCCP) regarding the terminology used for individuals seeking non-surgical treatments. Professor David Sines, executive chair and registrar of the JCCP, advises, “Whenever regulated healthcare practitioners provide non-surgical procedures, the term ‘patient’ should be used. 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’.”

Dr Fairris supports this perspective: “The word ‘patient’ refers to someone who is receiving medical care and ultimately implies an ethical and legal responsibility in the relationship to this person.

Aesthetic procedures carry medical risk, and this must be reflected in our language.”

Lewis adds, “Using ‘client’ diminishes the medical responsibility practitioners have. The public must understand that aesthetics is not purely cosmetic - it involves medical treatments that require appropriate training and accountability.”

THE PROBLEM WITH JOB TITLES: WHAT IS AN “ADVANCED AESTHETICS PRACTITIONER”?

The use of unregulated job titles in aesthetics is a growing concern. Terms like “advanced aesthetic practitioner”, “cosmetic surgeon”, and “aesthetic specialist” often lack standardised qualifications.

If you are describing yourself as an “aesthetic practitioner”, best practice is to clearly outline your professional background and training. Are you a doctor, a nurse prescriber, a dentist, a pharmacist, or a beauty therapist? If you are a registered healthcare professional, make it easy for patients to view you on your professional register by including your GMC, GDC, NMC or GPhC number. If you are a therapist, share what level you are trained to and with whom. For example, do you hold a VTCT (ITEC) Level 5 Certificate in Laser Tattoo Removal (this is the most advanced and recognised OFQUAL-regulated non-medical aesthetic training available)?

Lewis comments, “BAMAN’s members are all registered nurses or midwives, with many also holding qualifications as Independent Nurse Prescribers. Beyond registration, the work of these professionals is highly complex, requiring advanced skills and clinical judgement.

“Our newly updated competency framework, which is about to be published, provides structured levels of competency for our nurses to map their skills against. This framework defines medical aesthetic nurses under the categories of:

• Registered Nurse

• Registered Nurse – Enhanced

• Registered Nurse – Advanced

“However, the titles practitioners use are often self-defined, leading to public confusion. BAMAN’s Code of Conduct requires members to present themselves truthfully to maintain transparency and trust with patients.”

On International Nurses Day this year (May 12), the Department of Health and Social Care issued a press release saying: “Anyone misleading the public and describing themselves as a nurse without the relevant qualifications and registration will be committing a crime, under new measures announced by the government to protect the title ‘nurse’ in law. “

There are also challenges when it comes to the use of the title ‘doctor’. As the word ‘doctor’ can also be an academic title, it is not a protected title in the strictest sense of the term; however, misrepresenting yourself as a medical doctor when you do not hold a medical qualification is a criminal offence under Section 49 (1) of the Medical Act 1983.

Misrepresentation in advertising and social media can also cause you to come under the scrutiny of the Advertising Standards Authority (ASA) and Committees of Advertising Practice (CAP).

The CAP posted on the topic: “Advertisers wanting to refer to themselves as ‘Dr’, ‘a doctor’ or similar, should take care not to imply that they hold a general medical qualification if they do not. The need for clarity is greatest when marketers are making health-related claims, and the ASA has taken the tough line on marketers calling themselves ‘Dr’ in the context of health. The safest and simplest way to avoid confusing consumers is that if they do not possess a general medical qualification, advertisers should not call themselves ‘Dr’.”

You should also be careful when using the term ‘specialist’ if you are not on a specialist register. Dr Fairris stresses, “The GMC is clear: misrepresenting qualifications is a matter of probity. Doctors should not call themselves a specialist unless they are on a specialist register. However, aesthetics is not yet a recognised GMC specialty, which creates a grey area.”

Similarly, BAMAN highlights concerns over terms like “advanced aesthetic practitioner,” often used by lay injectors. “There are no universal standards for what qualifies as ‘advanced.’ Without regulation, these titles can be misleading,” Lewis notes.

The British Association of Aesthetic Plastic Surgeons (BAAPS) also warns against the misuse of the term “cosmetic surgeon.”

Nora Nugent, president of the BAAPS, says, “The public needs to be aware that many doctors call themselves ‘cosmetic surgeons’. They may be plastic surgeons, but often are not – they may be surgeons from another speciality who do some cosmetic surgery or doctors without full surgical training. A plastic surgeon in the UK (UK-trained – other countries have different qualifications) should hold the FRCS (Plast) qualification and specialist registration in plastic surgery with the GMC. It is not enough to just be specialist registered – it needs to be in the right speciality, so you should check the speciality as well as the specialist registration.”

THE “DR” TITLE FOR DENTISTS

Another area of contention is the use of the title ‘Dr’ by dentists. In the UK, many dentists refer to themselves as ‘Dr’, though they do not hold a medical degree. The General Dental Council (GDC) allows its use but mandates clarity to avoid misleading the public, stressing that practitioners should accurately represent their qualifications, especially in a field where trust is paramount. It says: “You are able to use the title ‘Dr’ as a courtesy title. However, you must make clear the services you are offering and must not imply that you are a medical doctor unless you are registered with the GMC. It is a good idea to make clear that you are a dentist and not a medical doctor, for example, “Dr A Smith, Dentist” or “Dr B Patel, Dental Surgeon”.

Dr Fairris warns of potential confusion: “If a dentist refers to themselves as ‘Dr’ without explicitly stating they are a dentist, it can mislead patients into thinking they have a general medical qualification. Transparency is crucial, although it is important to stress that dentists are very highly trained and regulated, the importance is around transparency and recognition of skill set”.

The CAP Executive also issued guidance on this topic. It says: “CAP recommends that if marketers do decide to use the ‘Dr’ title in advertising, they make sure they are on the GDC register and should clearly and prominently qualify the use of that title with a statement that makes clear it is a courtesy title and that a general medical qualification is not held.”

MEDIC, NON-MEDIC AND LAY INJECTORS

Terminologies such as medic, non-medic, layperson, and healthcare professional are frequently used, yet these terms can also be ambiguous for the public. Understanding the precise definitions of these categories is essential for clarity, maintaining professional standards, and safeguarding patients.

● Defining “medic”: The term medic is commonly used to describe individuals involved in medical work or study. According to the Merriam-Webster Dictionary, a medic is “one engaged in medical work or study; especially: corpsman.” Similarly, the Cambridge English Dictionary defines a medic as “a medical student or doctor” or “someone who does medical work in the military.” However, these definitions can vary, and the term is not universally protected or regulated, leading to potential confusion about the qualifications and roles of those who identify as medics.

● Healthcare professionals: The JCCP provides a more specific definition of healthcare professionals. They define healthcare professionals as those “designated registered healthcare professionals” who operate within the limitations of their competence. These individuals are registered with recognised professional statutory regulatory bodies and are authorised to perform certain medical procedures following an informed pre-treatment consultation and the exercise of clinical judgment with the patient. This definition underscores the importance of formal registration and recognised qualifications in distinguishing healthcare professionals from other practitioners.

● Non-medics and laypersons: The terms non-medic and layperson are often used to describe individuals who do not possess formal medical qualifications or registration. In the context of aesthetic treatments, non-medics may include beauty therapists or other practitioners who have received training in specific cosmetic procedures but do not have a broader medical background. Laypersons typically refer to individuals without professional or specialised knowledge in a particular subject. The JCCP emphasises that non-healthcare practitioners whose scope of practice is related solely to the provision of cosmetic procedures should not refer to their clients as ‘patients,’ highlighting the distinction in roles and responsibilities between registered healthcare professionals and non-medically qualified practitioners. Lewis comments, “We (BAMAN) recommend using ‘non-healthcare professionals’ instead of ‘non-medics’. It provides greater clarity by differentiating those without a healthcare background while avoiding stigma and offering patients a more transparent understanding of practitioner roles, promoting informed decision-making. However, we do not have current guidance that we provide to members.”

From an insurance and legal standpoint, misleading job titles can have serious consequences.

Emma Bracchi, Hamilton Fraser’s Senior Client Services Technician, clarifies, “A claim will be affected if a policy is cancelled due to false material facts, such as someone falsely posing as a medical doctor. This could have serious legal repercussions.”

Legal firm Clyde & Co., which we work with, warns that misrepresentation can lead to litigation. If a patient undergoes treatment under false pretences - believing their practitioner to be more qualified than they are - it could strengthen legal claims against the practitioner.

THE FUTURE: STANDARDISING TERMINOLOGY IN AESTHETICS

With regulation on the horizon, there is a growing push to standardise terminology within aesthetic medicine.

Lewis suggests a cross-sector agreement on terminology, advocating for a memorandum of understanding between associations and insurers to set a best-practice standard for language. As aesthetic medicine continues to grow, providing clarity in language and professional titles will be crucial in protecting both practitioners and the public, and as an insurer, this is something we would support.

EDDIE HOOKER

Founder and chief executive of Hamilton Fraser, Eddie Hooker, is an expert in the cosmetic insurance sector with more than 28 years of experience. Hamilton Fraser was the first company to offer medical malpractice insurance specific to the cosmetic industry in 1996, and Eddie is passionate about continuing to raise standards in the sector. Eddie is an accomplished speaker who regularly provides support, advice and education to practitioners as an industry commentator on key topics such as aesthetics regulation, legislation, insurance and business growth.