AMET – Who, what, “Why you need to know about AMET”

AMET Founders Bronwyn Granata and Elena Currie are experienced Aesthetic Registered Nurses with extensive local and global commercial sales and training experience. Having each worked in private clinics and also with leading pharmaceutical and device companies, both Bronwyn and Elena knew first-hand the enormous unmet industry need for unbiased and evidenced based aesthetic safety education and adverse event support. With their extensive industry insight and understanding of both practitioner and patient needs, they teamed up to create and launch AMET in early 2021.
Complication prevention and management is by far the greatest unmet need in Global aesthetics. Many treatment complications that arise are avoidable, however even the most experienced of aesthetic health care practitioners will still encounter adverse events. For this reason, AMET has established an unbiased Aesthetic Complication Advisory Panel, to ensure there is a more structured framework for complication management based on current and emerging evidence.
In addition, AMET has also established ANZ’s first Ocular Complication Support team as well as an extensive nationwide network of highly experienced industry experts comprising plastic surgeons, dermatologist, ophthalmologists, radiologists, cosmetic physicians and nurse practitioners. AMET’s vision is to raise aesthetic medicine safety standards and optimise patient outcomes through providing all aesthetic practitioners with 24/7 access to unbiased, evidenced based aesthetic safety education and complication support. Whilst adverse event management has been the primary focus of many training seminars and conferences, adverse event prevention and knowledge is absolutely paramount to minimising treatment risk and raising industry safety standards.
Becoming an AMET member enables any registered health care practitioner to gain access to an educational platform dedicated to aesthetic safety. Aptly coined “The Safety Portal”, the members area includes advisory panel approved AE protocols, detailed anatomical resources, hyaluronidase training, anatomical safety guidelines, off label information and guidelines, unbiased product information, product selection tables, consultation and body dysmorphic disorder support…and so much more! The AMET team are also able to connect members to a nationwide network of industry experts who are willing and able to assist with complication management should a member request additional support. Facilitation for medical intervention is included within the membership, however specialists may charge additional fees for their time and resources which is dependent on the complexity of the case. Despite many successful achievements within the first year, the long-term success and impact of AMET relies entirely on practitioner support. As an industry we need to normalise adverse events and reduce the fear surrounding them through empowering practitioners and sharing regular cases. We need to unite for the greater good and ensure we are all supporting each other in times of need. Statistically, most adverse events have excellent outcomes when managed well. Whilst we can do our utmost to prevent complications, in the end it is a numbers game, and when our time comes, we all need to feel confident and supported to achieve the best possible outcome for our patients.
Enjoy today’s podcast, and if you want to find out more, DM us and we will send you a link.

Transcript – AMET – Who, what, “Why you need to know about AMET”Trish

Hello, listeners. It’s Trish Hammond here and

Nic

Nicole Montgomery, hi Trish!

Trish 

And today we are joined by AMET Founders Bronwyn Granata and Elena Currie. Now Bron and El have just read well, I don’t know how long ago but we’ll find out now just the co-founders of Aesthetic MET. And today we’re going to talk about, well, first of all, how they started and what they do and why they are so amazing in this industry. So welcome, everyone.

Bron and El

Thank you so much, Trish and Nicole.

Trish 

Oh my god. So excited to have you here because we’ve kind of been communicating for a few weeks now and I didn’t really know about Aesthetic MET, because not being an industry practitioner just to consume I didn’t really know but once I found out I thought oh my god, this is so needed and so good. So, tell us, so how did you first of all, where did you guys start your career and what brought you to where you are now? Oh, who’s gonna go first?

El

I’ll go first then Bron looks like she’s handing over to me. Um, well, firstly, I’m a Registered Nurse, so I’ve been nursing for a long time, longer than probably what I’d like to admit. But I first got into aesthetics, actually, in London. So I worked in a clinic in Knightsbridge that was a very experienced Cosmetic Doctor, Dr. Rita Rakus and I actually got into aesthetics in about 2007. And just sort of started kind of working my way up, I suppose both so to speak, I suppose in the clinic, so starting just from literally reception, and pre and post treatment and eventually obviously got trained up into various different types of energy based device treatments, and then obviously injectables. And then I made my way back home back to Australia and I actually knew the General Manager of Solta Medical out here at that time so I’d worked with him over in the UK and so I actually did some sales and clinical training for Solta Medical for a few years. And then Bronwyn approached me in the midst of my maternity leave and said that they were looking for a trainer for Galderma and then yeah, I spent the next sort of four and a half years really working for Galderma and then since then I’ve kind of done some training and all that kind of stuff. It’s a contractual basis, so yeah, I certainly, have obviously, in that kind of role in those roles have developed a bit of a commercial interest in understanding, I suppose, from a company like a pharmaceutical and a device background, as well as what it’s like to obviously be in the clinic and I think it just naturally identified a lot of gaps, I guess that really the pharmaceutical companies and the device companies, they’re not actually able to fill and that’s very much in unsafety space. 

Trish 

I guess you kind of, you’ve got that outsider looking in as well, even though you’re in it, you’ve kind of come from the outside looking in as well.

El  

Yes, no, absolutely. And I think, you know, and I’ll let obviously Bronwyn tell her experience, but um, I like, I have so much respect for Bronwyn. She’s got so much commercial knowledge as well as clinical knowledge as well. So I think what we both bring to the business is very different, I think as well, which is really important. I think I feel both bring the same kind of experience and I don’t think it really gives us much of an impact, I think.

Trish 

Yeah. And how good is it to share the load with someone? I mean, that’s how I feel with Nicole but how good is it to not have to be out there on your own? Just you know,

El 

oh, absolutely. Like we both feed off each other really, don’t we? Bron?

Nic 

I would love to ask you a few years ago, there was a bit of a shockwave through the industry when it became I guess public knowledge that somebody went blind from having a cosmetic injectable. Had AMET been around at that time, would that have happened?

Bron 

Well, I think the article that came out and the news about the patient that went blind in Sydney, I think it was a bit of a wake up call for the industry and AMET has only been, we’ve just had our first year anniversary so we haven’t been around for a very long time. But I think that definitely has been a contributing factor and lead there now would have that happened. Well, today there’s still only one reported reversal of a patient going blind with dermal filler. That was done in Sydney, and so we may not have been able to prevent it, but I think there’s much more awareness now and we have an ocular complication team, that hopefully, if a patient ever experiences vision loss and blindness after a dermal filler treatment, we will be able to intervene so, I’m actually aware of the Physician, a Physician who treated a patient and the patient went blind, and how not only that impacted her life and the patient’s life. But it is a big call to change our industry, I think and wake up and make sure that we do have an ocular plastic ocular complication team, and nationwide support. So one thing, I guess, from giving you my background, I’ve been in this industry for 18 years, my background is really being commercial, so both internationally and in Australia, it’s really focused on the commercial element of aesthetics. So I was really fortunate that I’ve grown up in this industry. I’m also a registered nurse and practising clinic, but my background is very much commercial and one challenge you have with that is regulatory, when you’re working for big pharmaceutical devices where there isn’t an emphasis on safety, there’s actually an emphasis on making sure the drug is administered to a certain way and essentially, there’s a commercial element to that and very high profit so safety is there, but it’s not the main focus. El came to me with the vision of AMET. And I think it’s stemmed from, I suppose being in the industry and feeling like our hands are tied from a regulatory component where people would call us and say, what do I do in this situation? How do I manage that? And I always love to share knowledge so I almost overstepped the line several times to make sure the physician was aware and then obviously, the patient was safe and El actually had the brainchild of this to say, Hey, I think it’s something we should be looking at doing. And I said, it’s the best idea I’ve heard, I need to jump on this journey and want to be involved in, hopefully, if a patient experiences vision loss or partial vision loss, we can go into action and have that emergency support for the Physician to make sure, hopefully, we can reverse that blindness. So and that’s the extreme of what AMET is all about. On the worst day, we’re there to help support you but we’re more about trying to shift the focus from people being scared about adverse events and getting them to be empowered, that they’ve got the confidence to manage adverse events and complications, and how to prevent it. So we really focus on that, what these things are gonna arise and instead of everyone not sharing the knowledge or not feeling supported or well connected, we want to offer that and it can be. We did a recent survey, actually, in vascular occlusion in the audience is about 30% of complications people have experienced, but one of the most common ones is a delayed onset nodule. And it’s mostly a lot harder to treat and having that support and the protocol on how to manage it. And then if needed, have field experts and specialist care, I think is really critical in making this industry safer for the consumer at the end of the day and the HCPs are aware more so than what they’re being taught or trained from a big pharmaceutical company, essentially.

El

Yeah. And I think it’s important to highlight like Bron mentioned in terms of, there just is no framework so yes, we have obviously an educational platform that is kind of, you know, this subscription service. So there is kind of immediate access to whatever knowledge you possibly could need and want all you need aesthetic safety. But, the idea of the business, I suppose, is to provide as much structure and framework and to be able to help practitioners manage the adverse event in the fastest possible time frame, essentially, because at the end of the day, we are all aware that, let’s say for example, somebody does experience vision loss now, even just the protocol from getting to the clinic, to the nearest hospital, people are panicking. It’s a very emotionally driven event. This is a hugely emotional space that we’re in people absolutely freaking out, obviously, and quite, quite rightly so then that obviously impacts the patient and actually also impacts a lot of the management that comes after that and then getting into a hospital that is not familiar with aesthetics, and even Ophthalmologist stat here that this is a side effect of a filler treatment like they unfortunately have, there is a stigma and that patient isn’t prioritised as what they would be if it was a typical case of vision loss in an emergency department so I think we just need to make sure that like nets our ocular team, right or people that obviously Ophthalmologists, Oculoplastic Surgeons, but that are also have an understanding about aesthetics, and absolutely willing to help and that may be via FaceTime, telephone, giving another ophthalmologist advice but as much of that connection that we can kind of promote and share is always going to give the patient the best possible outcome, whether that be an inflammatory nodule being managed as fast as possible, or whether it be an occlusion, perhaps like there’s been multiple cases where we’ve had to refer an occlusion case, because it’s not responding to highlights, right. So a lot of people just think, oh, just dissolve it and it’s not quite that simple in every single occlusion case so we’ve had to refer to a radiology network as well. So I think it’s just about the connections that Bronwyn and I have established from having worked with these pharmaceutical companies, we know and we can see, and we’ve had our own experiences of adverse events and even with our networks, it’s still very nerve wracking. And I think we can see how isolated people are in those settings and how, even if the prescriber, 30 nurses example, even if their prescriber is helping and he’s contactable, you’re still kind of by yourself, aren’t you like, and I think it’s just being able to pick up the phone and realise that okay, oh, this is happening to a lot of other people, you’re not alone.

Trish  

I was gonna ask, so does AMET kind of kick in when something goes wrong? Or is it what you guys offer, like a preventative, as well to help people on the way because they’ve got the safety portal? So can you tell us kind of how that works?

El

Bron, do you want to go through that? Or?

Bron

You can, go for it. 

El

Look, I mean, I think yeah, absolutely. I think there is a perception obviously, that we are just complication management but that is only very much one part of the business really, and very much more what we’re trying to focus on as an advocate is adverse event prevention. Now, absolutely adverse events are always going to happen, and they happen inherently in any healthcare setting. Right. What I found kind of is that it seems to be sort of this irrational perception that, oh, it won’t happen to me. I mean, it is literally a numbers game, it doesn’t matter what healthcare setting it is, right? There’s always going to be something that will go wrong and I feel like people take it very personally when something goes wrong, right? Whether it be an occlusion, they take it, the practitioner takes it on board as it’s, they’ve done something wrong, because even when we’re helping facilitate the same, but I used to cannula but I did this, but I did that right, and now our job is to just literally triage the case to refer on. So we’re not, there’s a million different ways to inject, right? And so I think it’s about actually bringing people information that is anatomically based with regards to techniques. So, in other words, we have safety guidelines on there, but they’re very top line, we have to be very careful with that because we don’t want people to look at our platform as an alternative to training on how to inject so we know we have to kind of give the right information. But we’re not in the space of teaching you how to do cheeks or how to do lips, we’re in the space of, do you know what if you’re doing a lip treatment? This is where the vessels lay and if you’re using a needle, you need to be in X STEP or if you’re using a cannula, you will be in this step, right, so just be mindful of where you are and so it’s very much kind of getting them to really, when they’re injecting, peeling back kind of the layers in their head and kind of going, what layer are in and what vessel is there? And what is kind of the best technique in terms of safety, right? So it’s very much looking at safety first, aesthetics results second, okay, because there’s certainly a lot of techniques that give amazing aesthetics results, but maybe perhaps they’re at a higher risk, right. And so it’s just kind of making people a little bit more respectful, I suppose, of the anatomy, as well as the immune response to these treatments as well and then we’ve got obviously protocols which have been reviewed and we do review them kind of least annually if not, if not more frequently by the advisory panel and then unbiased filler and botulinum toxin information in there so that so you’re not relying on the pharma companies give you their version of events, I think is really important but most importantly, we’ve got hyaluronidase information in there. So there is no I mean, whilst there might be some kind of analyst training within static injectable courses, it’s very limited, as is complication training, because they’ve got to use their time to get them to learn how to inject and that’s we’re taking it the other way around. And so we’ve got videos there showing dilutions, and also hyaluronidase isn’t something that you use on a daily basis. So if you kind of aren’t using it very often, and it’s your turn, if you don’t use it, you lose it so it’s about making sure that even if they’ve learned in a training course, many months ago or years ago, when it comes time to using it, they have a very quick resources and refresher, which is really, really important and I’m sure I’ve missed some other things, which from, Bron.

Bron 

The thing we are able to provide as well is really good in depth, because we are unbiased and unpolitical, we don’t provide, we don’t sell any medicine. We do provide a lot of off label indication information that is based on scientific literature and that’s where I think Physicians struggle, because they’re taught a certain way, which is what the PIs states in terms of the medicine, but they’re actually not talked about the off label indications that are used very frequently in this industry and have a really safe way, and an educational way to find, you know, the scientific literature and then we’ve made it in a really digestible educational platform for people to have their so but I think El covered it, we’ve tried to really go away from the hell to but the consultation process and very much what you guys are brad as well. It’s about, how do you recognise body dysmorphic patients? How do you manage body dysmorphic patients? Is it ethical to treat, how do you treat? And so we have a lot of literature and guidelines and information on areas that may not be as sexy as a beautiful pair of lips, but it’s really looking at that patient holistically and so I think we can provide that in an unbiased way, it’s a bit more of a safer field for patients to come into the aesthetic space, and be confident that the Physician they’re choosing has information at hand, that’s going to give them the best service overall. 

El 

Yeah, the other thing I forgot to mention as well, actually is we have a centralised regulatory section. So for people getting into the industry, obviously, they even are in the industry there’s a lot of different departments is the health departments, there’s opera, there’s medical board guidelines, and obviously the health department’s vary from state to state, right, and they all have different kind of rules and regulations, and you’ve got poisoned standards, and that you have to go to I don’t know how many different websites to kind of get the right information that’s relevant for you in your state and in your practice and so we’ve basically brought all of those documents, and some of them will be on links to so they’re not necessarily PDFs, but we’ve put the links in a centralised section. So as an example, there’s been recent updates, in particular, with regards to TGA, looking at making a mandatory requirement for what they call patient implant cards, or any kind of medical device, which is what dermal filler is, requires the patient to have a copy or, or patient implant card, which shows the product, the batch, the area, injector, the date, that kind of thing and so factoring site, actually, and I think that the communication from those regulatory bodies into the aesthetic space is definitely needs improving. And so what we’re trying to do is obviously, to have enough of a reach to be able to kind of be some sort of assistance, right with that communication pathway. And so and then the other notion is, as well, we were also kind of aware that the patient implant cards are being done in the actual film box itself right. Now, I don’t know what you guys know in terms of aesthetics, but I use many different fillers and I might use two or three different types on a face, right? One from one company, one from another. Now, I’m not going to give three cards to a patient, like that just seems very disjointed. And for me, I actually feel like a patient that looks very disjointed and actually is kind of reflective that there isn’t a centralised kind of framework of regulation in the industry. So we’ve kind of created an implant card which we’re in the process of getting reviewed and things like that, but just makes it easier for a member to just download that chick that has everything there. It’s one card question.

Trish  

So when you say that card, is that something that you give to the patient? And is that like a protocol that you guys recommend that members actually do? I think because I love that because I’ve had injectables everywhere and I’m like, what did you have done? I have no idea what they’re doing, I’d like to do what you need to do.

Bron

Yeah, that’s very common, you know, patients never know what they’ve had where. So it’s not an AMET, it initially actually comes down from the TGA as a requirement. But unfortunately, the TGA doesn’t send an email out to every city HCP and says, Hey, guys, you’ve got to do this now. It’s kind of like you stumble across it so we’re trying to centralise it. And I think for us, COVID was quite fortunate timing when we decided to do this, because it gave us time to do all the science and the research. And if we’re in clinics, we wouldn’t have had that opportunity to be able to do it so yeah, so it’s not advice. One thing that we were really careful of El and I is we’re essentially the vessel to help get the information out so we’re not opinion based at all, what we think is good practice or bad practice. It’s really just what’s the evidence stating, and what’s the regulatory stating and the science, Yeah, so that’s coming. That should be in effect now as far as I understand. 

Nic

And it’s interesting that it hasn’t been? Yeah, I was thinking about it, um, implants have had cards for years. When you get implants, you get your card that says, you know, it’s this brand, you know, this is where, how, and all the details and like, a barcode. And, and same with, like, if you had a pacemaker put in your body would have details, you would have follow ups, you know, and so on and so forth. If you change cardiologist, you’ve got all the details there. So it’s, I think, 

El 

It’s yeah, it’s sort of changing from it being implants to a medical device. So that might even be, mesh that too soon in a repair hernia repair or anything. So it’s really, I think the only thing that is excluded is sort of sutures, dissolvable sutures and things like that. I think they’ve, they’re not necessarily considered that they needed.

Nic

There was a huge class action with a mesh that was used. Yes. And yeah, so imagine if there was, if no one knew what mesh was, they would have never been able to correlate, hey, all of these patients are having the exact same side effect

Trish 

So is this a requirement then?

Bron  

Yeah, from the TGA.

El 

We have, yeah, we have the document within the regulatory section, the members, and we are looking at, obviously, promoting even more awareness about it. And I know that yeah, maybe it may well be your topic, we are talking at ASCD. So we’re just in the midst of obviously, that is one of the topics that we’ll be kind of chatting about. But I, I think in terms of we just want to make sure that the card that we’ve created is kind of got a bit of a tick of approval from these advisors, just to make sure if they wanted to add anything as well, that there is their recommendation, I think is really important to have their input. So what we’ve kind of learnt, I think from even just past experience and commercial experiences, it’s one thing to create something very quick. But if we just do a knee jerk reaction it doesn’t necessarily benefit people so we would just want to make sure we get it right, first out the gate, so that everyone feels pretty comfortable with what kind of thing. 

Trish 

Yep, so it’s better to be proactive than reactive highly, because I tend to be like that.

Bron

So and even in my career in this industry, I know HA’s and medicines that have been recalled as actual take back products of certain batches. So it’s not something that doesn’t happen, just because it’s a medical device, it actually happens more often than you think so it’s really really important.

Nic

I was gonna say from two different cosmetic things have worked out from a customer service point of view, which is obviously not a requirement, we in recovery, we would actually scan the cards and scan the details and not only upload them to our patients software, but like literally in team we did like chin implants and that type of stuff and we would scan it and say you know, thank you so much for attending a one day post op please see attached you know, in case you lose it, whatever and then they also had that digital copy.

El 

Yeah, that’s good practice.

Trish 

And I guess this is probably where it’s up to everyone to kind of make the consumer where so that it gets to the point where the consumer has their injectables, and it’s like okay, well, where’s my card? Like the fact that they know that they should get this because I had no idea. 

Bron

Yes, it’s really important. I think the more we can empower consumers as you know, you have kind of that checklist of what they should be receiving, I think then that will help increase industry standards.

Trish 

Yeah. And I think as well, like, as a consumer, you kind of get a bit of bad because, like, you’re kind of a bit and I’ve been embarrassed say, Well, what’s that, where, what are you putting where, or whatever, but I try and do that now not because I doubt what they’re doing but I just want to know, and I just make notes on my phone now. 

Bron  

You want to be informed. But there’s a, it’s because there’s a power shift, you know, someone’s really vulnerable when they’re having a treatment so even when I get all the treatments down, I kind of put my trust in the Physician that they’re going to do the right thing, right? And then there’s that power imbalance. So, yeah, it’s a very natural thing as a consumer to do. Right?

Trish  

I was gonna ask you so. So you’ve got a whole, like a panel? And you’ve set up the ocular complications support team, how do you pick these people?

Bron  

That’s a good question. So I’m really like, I think I’ve worked in quite a bit like New Zealand and Australia, as well as internationally. And so I’ve been very fortunate to work with really well respected Physicians that are trainers that have written really good documents and papers. So with the advisory panel, in particular, we tried to make sure we had a Specialist from each sort of area of need. But it’s also kind of their own credentials, in terms of being published, contributing, being supportive and helping people because essentially, a lot of advisors in particular, more so than we dropped down to the field experts, they have been having patients knock on their door, find them or Physicians pass it on to them. But there wasn’t a framework, there wasn’t a structure that was a poor handover so one of our really experienced advisors, I think, when we spoke to him, he was saying he’s having around 15 patients, that is managing other people’s adverse events and we said that we saw that there was a need so we think we chose them on their willingness to be supportive and help empower and share information that they’re published as well, as they’re dedicated and focused on safety and the very experience they’ve all got, I think some of them they’ve got over 20 25 areas that their brains and minds, yeah, incredible and then regarding our field experts, we’re fortunate that we’re really well networked, which unfortunately, is not often the case and our field experts assisted in terms of some are quite specialised. So there, they have their own surgery where they do like ultrasound guided hyaluronidase for us, and if there’s a vascular occlusion, and we need support that some radiologists, so if we need to do an MRI, and all of them are quite passionate about aesthetics, most of them either had trainers, or have published a paper and very heavily invested and I would say all of them are very willing to share, be open, and really want to help improve industry standards so we’re very fortunate. I think, at the moment, we have something like 35, throughout the whole of Australia so we have a large team, and it’s constantly growing, we’re in New Zealand as well. But essentially, there’s not one kind that fits all we speak with the advisors as well, and make sure they are covered. We have insurance, both ourselves in there so there’s a few checklists that we do but that’s essentially how the field expert teams come about. I might have missed anything else El in regards to. 

El

No, no, I think you’ve absolutely nailed it, I think yeah, this is very much a business that stems from passion. Really. I think that that’s a really important part of obviously, we could have the most experienced practitioner out there, but there are a lot of people and quite understandably so that don’t want to see complications coming and I totally understand and respect that as well. Right. And I think yeah, our experts and advisors are those that you know, kind of, I guess similar to partner knives. This business really fills up our cup like we really are very passionate. We really want to help when you know something hits the fan so to speak, and so it takes a certain type of person, I guess, with that, as well as having extensive experience within aesthetics and that willingness to kind of, yeah, just have their arms open to any practitioner that needs help in any, because at the end of the day, it’s really about the patient and I think one of the things that what we’re trying to kind of showcase is also to create a bit more unity in our industry, because we’re all in this for the patient to make the patient look and feel better, nobody who’s injecting is willingly trying to put the patient in harm’s way or create a new kind of an unsafe environment. So they’re certainly cases where obviously, some people don’t know what they don’t know, maybe perhaps they knew, maybe, perhaps, they don’t, they’re not aware of that latest research and that’s kind of obviously what we’re trying to do is funnel this information through so that people have to spend less time looking for the latest advancements.

Trish 

I agree with that, oh, sorry. It is such a helpful industry, like I’ve seen at conferences, and just the fact that the practitioners, that they want to help each other, they want to impart their knowledge on to the next person and that’s something that I’ve always noticed so it is good to have that a little bit more structured, I guess. 

Nic

I see a huge disconnect between, like bridging the gap between knowledge and the theory and the actual practical. So I don’t know if you guys are aware, but one of the Australians of the Year this year was a mother whose daughter was in a car accident, the daughter unfortunately died. Now there are a lot of people on the scene and none of them knew first aid. And through the current report, and everything had somebody on that scene out of a dozen people known first aid, she would be alive and would have been saved. So that propelled this woman who lost her only child to then go on and do free first aid courses and set up all these different first aid courses across the country. Most people I know, most of you would know, tons of people do first aid courses every single day, you know, through St. John’s, and all the different various things and work and places and whatnot. But then most people obviously don’t, perform CPR or attend to a snake bite or all these different things, but we go to the first aid course. I’m sure you guys have done one too and we, yeah, we’ve all done them. And we do, we actually do, do the donor, for someone gets impaled with something and we do the state dressing and all the different things. In aesthetics, and I’ve been to tons of conferences like you ladies, we don’t actually roleplay like you do have the anatomy shop with you and anatomy course and you do how we’re, like I said before cannulas and whatnot, different needles and gauges, but we’ve never I’ve never actually seen somebody do an actual roleplay of this is what we’re going to do an adverse event. But could you imagine if you went to hospital and there’s a met call, your alarms are going off, and all the nurses and doctors and surgeons started butting heads, didn’t know what they were doing, because it had never happened before but they’ve read 1000 books on it, as opposed to having okay, this person’s airway this person circulation, and everyone’s ready to go knows exactly what they’re doing, what their role is, and how they’re going to do it and I just find that really bizarre.

Bron

It’s not so we did a recent survey in Australia of when was the first time you’d reconstituted hyaluronidase, over 60% of the respondents either hadn’t reconstituted it ever, or the first time they reconstituted an adverse event and like you said, no one’s role playing. No one’s practising for this so that’s something that we have recognized as well. And it’s something that is in the safety portal with the hyaluronidase section that is there but we were just talking about this other day that we are actually in the development of actually having really short shot videos of actually showcasing what it’s like so that in clinic, they can actually roll this out and have a tutorial ready to go and they do it annually. Like we do our annual CPR. I take CPR annually.

Nic

We know it works, sales, role plays of you know, cold calls.

El

100%. And I think I know I didn’t. I certainly know I’ve seen Dr. Steven Liew and Bernie Sanders actually have done a little roleplay in terms of protocol and conference and I think that that’s great. And I think we absolutely need more of those sorts of things and it doesn’t always have to be about blindness obviously, naturally, we definitely want one for that but it could be an occlusion or it could be a consultation ways to which we could actually look at a whole roleplay from before with a consultation, treatment up, we’ve got an occlusion, how you manage that patient afterwards that kind of thing. So yeah, there’s certainly, we’ve got a lot of learning plans in terms of the development. I think it’s been a bit tricky for us to obviously be able to even do the filming during Cairo, particularly Victoria with both places. So, this year, I’ve got a lot of really catching up to do, I guess but you’re right, I think that the crux of the name, setting met is literally a met call rise to have that framework at any time.

Nic  

You throw it away, like it’s useless, but you’re staying there, and you’re primed the line until you can get it and eventually, it’s second nature, but you’re literally practising something.

El 

Yeah, yeah, no, 100%. And, you know, we would love to get to the kind of the point where, you know, we can possibly have enough resource to run safety workshops. So whereby, yes, we can have experts and actually showcase how to inject a certain area, but the focus is less on the aesthetic result, the focus is, okay, so this is where I am, my needle tip is here, this is the anatomy I need to consider and you can still see the aesthetic results, right, but it’s shifting that way of thinking about it and then it’s kind of talking about, well, why did you choose that product? And because of these unbiased, right, so that practitioner can talk about why that product in that location is based more on rheology, rather than the branding, so to speak. 

Nic 

Yeah, the other thing I was asking you, ladies, was where is the accountability with expiry dates. So for instance, if you’re working in a nursing home, or you’re working in a hospital or somewhere, you check the S8 book every night, or you check this book every morning, or whatever the process is for that facility. But I’ve never actually noticed anybody having an S8 book or actually checking every single drug because you don’t have to, because it’s not an S8.

El  

It’s not an S8, but there are certainly log books for it is an S4. So there’s supposed to be a locked cupboard and you’re supposed to have a logbook.

Nic   

So what happens if something is expired from or let’s say, you know, you got a clinic that has all of their filler that’s about to expire next week? Do they put it all on sale? Oh, well, do you know what I mean? Like, what is the premier? 

El

I think that process comes down to well ordering stock. I think there’s internal clinic processes that I certainly know from a pharma company perspective, but there is a minimum amount of an expiry date that you kind of have to adhere to in terms of how to sell the product. So if on the clinic level, they’re running close to the expiry date, then yeah, they need to figure out a way to use that. 

Nic

And as a consumer, we just have to trust?

Bron

Yeah, they need to trust and hopefully with these implant cards, that gives a little bit more accountability. But essentially, yeah, you have to trust they’re doing the right thing. They’re storing it the right way. You know, they’re single use a lot of the things that are being used, but essentially.

Nic 

You see ads for 0.5, you know, 199, 250, and I’m thinking how do you do 0.5 mill?

El

Oh, there’s a lot of people doing what they call decanting. But yes, certainly, there’s a lot of different practises that are kind of, I suppose the pharmaceutical companies would consider off label and they don’t, I don’t advocate that doesn’t necessarily mean again, that it’s not commonplace, or that it’s incredibly unsafe, even right. So it’s just a case of understanding, but I think certainly with the expired product, as the implant card will definitely help because the practitioner parallel to you know, 

Nic

Making sure to backup products if there is an adverse event. 

El 

Yes, and I found that really interesting.

Nic

Something which is what happens with S8s is why they do constantly go out of date, because that you’re not using it to PRN you know, it’s only if required.

El  

On the survey, the largest proportion in terms of how many highlights files are on hand, the largest percentage, and I can’t remember exactly what it was, but the highest percentage was from one to five vials, which blows my mind. No, I like that, that needs to be the, that’s when you get to five vials, you need to order more like that’s 100% what you need, right? And a lot of people are not prioritising hyaluronidase stock, which is so again, another reason why the survey is kind of helping us to kind of pivot out, then we need to identify the need to be able to pivot our business towards that so that’s certainly something that I found quite interesting.

Trish 

You know, and I love that you guys are standing for, unity the fact that we need to be united for or you guys need to be united for, like you said the better good of patients and practitioners and I also like, the fact that you’re not saying, do this and you won’t have any complications, you are saying that complications will happen. It’s a numbers game, but the important thing is what happens after that complication happens, I think, which is where AMET, you know?

Bron 

And no adverse event is mismanaged. Yeah. And they’re not scared to contact someone. Because, yes, there’s 24 hour support for people. Sometimes when people call, it’s actually not the scariest thing. It’s they’re reconstituting a different botulinum and they just need help, because they want a better outcome for that patient to prevent an adverse event occurring, or if it has occurred, they want to know, are they doing the right thing, and we’re a safe place for them to call and just talk it through often they don’t need further field expert or further oculus  support team or things like that. It’s just knowing that they’re well supported and connected. And in terms of our subscriptions, we were unbiased. But you know, it’s dentists, it’s nurses, we’ve got plastics, we’ve got derms that are members, which we’re quite grateful for. It’s doctors, so it’s everyone who in Australia is legally allowed to administer the medicine, and our field experts array from a whole range of specialties, and all of them are willing to help any Physician.

Trish  

Yes, and is the goal of AMET to have like, basically, you want everybody on board? Hey, 

Bron   

Yep, yep. Oh, look, this is a passion project about like, this is something that we’re very fortunate we’ve got such a supportive network, but it’s essentially it’s a love project. And for it to evolve and get bigger, we would love people to get to a point where when they think about getting into aesthetics, or when they think about their learning and education, they actually think about AMET first, because you should think of safety before a set of results. Results can come, you can always tweak the acidic result, you sometimes can always tweak the safety element. So we need as much uptake as possible and I guess for us, we try to make it as affordable as possible. So people think of this, like their insurance, we’re trying to work with some insurance companies to see the benefit of getting better pricing for HCP in their insurance if they’re an AMET member. We’re really trying to use as much networks as possible but yeah, El and I need as much industry support as possible to make this actually, you know, sustainable.

El

And I think we need that uptake as well, to have a more universal voice and industry. You know what I mean? Like, you know, if we only have a small pool, then the need coming from that small pool, that member pool is not necessarily going to be representative of the industry needs. So I think it’s really important in the survey that we did, we actually had 50% of them were members, and we just sent well, which is fantastic. That’s exactly what we want, right? We don’t want all of our data coming just from our little member port, we want it coming from the industry. So I think we want people to feel a part of something greater, something bigger, something where we are all united and it is that point of coming together. Like I said, so I think yeah, look, we have a big vision and a big, big goal but we know it’s a long way off yet.

Trish

Yeah, but tell us how people can join your safety movement? 

Bron 

From sorry? Because, you know, we look at each other like,

Trish 

Yeah, we know, we do the same thing.

Bron  

So essentially, you just jump onto the website, you can just Google Aesthetic MET. And yeah, you just jump on and you sign up and there’s a few questions. Everyone has to be an opera, remember and things like that the register so there’s a few checks and balances. I’m terrible at saying that, but yeah, and then and then you sign up, and that’s it, or you go, you can contact us straightaway on 1800 number. Or you can jump on once you’ve been approved, you can jump on the safety guideline and start looking at the resources there. The interviews with some of the advisors, so there’s lots of information you can obtain there but all the information on how it works is just on the website.

Nic  

As a consumer, how do I know what practitioner or professional is an AMET member?

El

Um, so now that’s a really great question. We’re actually in the process of launching, finding an AMET practitioner so that patients that are looking and we currently do have unbiased information about injectables or patients so obviously, because we know our website will be found by anybody about searching. And so the idea is that obviously patients can actually have a look at unbiased information about risks, side effects, what the products are, with links to opera and things like that they’ve got fact sheets out there. But yeah, essentially there will be a find a name for a practitioner. So if a patient is looking for somebody that is an AMET practitioner, or obviously, it’s just a way for the patient to kind of, I guess, filter through to find somebody that is very well connected, should something go wrong. So if they are quite anxious, in terms of the patient, then that may be very much an easy way for them to make that decision between practitioners and that this person’s obviously, well connected to something. Yeah, and that’s just gonna be very much a value add for our members. It’s not we’re not charging anything for that, that just comes as part of being a member. We’re just grateful and wanting to give something back to the people that are supporting us.

Nic  

I think I’m making, as a consumer, make you feel more confident and comfortable with, you know, the person that you choose to do your injectables with. Yes, 100% definitely have to put that on our site so people can make sure to check that their members and AMET members. 

Bron

Yeah, that would be fabulous. 

Trish

Even like a checklist for patients. If you’re going to inject injectables, make sure this this this, you know, I mean, there’s those six key things that they should, you know, 

El  

Yeah, there’s certainly a pre-treatment checklist. Yeah, get on there not to, you know,

Bron 

Sorry, if a patient finds our website, because it’s very much in the healthcare space. But if they do, all the information they can find for a patient is actually not in a subscription service or anything so it does have the checklist, it actually has signs and symptoms to watch out for. And so if they have been treated, and they can’t get ahold of their Physician, they at least know what they should be looking for. So yeah, we’ve tried to make as much information as possible for consumers, if they do stumble upon the site.

Trish

That’s a really good idea. Because, like, we’ve got a Facebook close support group and sometimes, well, people will go in there and say, Oh, my God, this has just happened, but really the point for us to just renew.

Bron  

Yeah, we try not and that’s great. One thing we try, also, we’ve had patients contact us directly and that’s a really hard one for us, because we are a Physician service. So we’re really encouraging that patient to go back to the practice, however, there has been a case where you know, at the end of the day, I think whatever we can provide to a patient will benefit the industry. So we have had a few patients that we have helped to make sure that they’ve been able to see somebody. So they’re safe, if they haven’t been able to get in touch with their physician, but it’s not the cause of what we’re trying to do but we do so if a patient did find us and call us, we would definitely be supportive and help. 

Trish  

Yeah. Amazing.

Nic  

Thank you so much ladies.

Trish 

If you’ve got any other questions, I’m like, my brain is like, Whoa, that was so interesting.

Nic  

I know so much information, you guys are just incredible. And kudos to you the amount of people that have, you know, told Trish and I about Aesthetic MET and said how great it is, and all that they remember, they’re really proud of being a member is just so cool. You’ve done it in a short time.

El

Thank you so much. Lovely to hear from you.

Bron 

And we really appreciate the support and thank you so much for this opportunity. Because I think, if we just keep chipping away, our goal is that hopefully, we can spread a bit more awareness. And I think you got what you guys are doing brilliantly as well. I think it’s about making aesthetics welcoming and acceptable and safe for every person and trying to change the shift of the kind of reputation to a consumer, the industry may and sometimes be perceived as.

Trish

Yep. And you know, what, before we go, I reckon you’ve got a massive market there even just getting to people before they become qualified to do injectables. Because, like, the Unis and the Colleges are probably a great market because if people realise that you should actually this is the number one priority, before we even get into it. I think it’s just gonna, over the years, it’ll just change people’s perception of okay, I’ve got to do the safety bit first, and then I can do the study or whatever 100%.

Bron 

You know, we say quite often, the first injectable you should ever inject is hyaluronidase and learn how to inject that first before you learn how to inject a pair of lips and we really want to change the shift of the reliance on the big pharmaceutical companies because they can’t teach that so they just teach the pair of lips but they don’t teach you the safety part first. So yes, if we can get there, I think that’s fantastic. It will change our industry in a positive direction.

Trish  

Awesome. Well, thank you so much for joining us today ladies. 

Bron and El

Thank you so much for having us. 

Trish

Awesome. Awesome, and this is looking good. If you do want to find out more, you can just go to the Aesthetic MET website which is aestheticmet.com and Bronwyn and El, they’re just amazing. You girls are amazing. Thank you so much for joining us.

Bron and El

Thank you. Thank you bye bye.

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Well, like all good quickies it's time to dust off and get back to our day jobs! If you liked the podcast please rate us because we need the validation for our fragile hearts. If you have a story to share or have a burning question you would like us to cover please slide into our DM’s on Instagram at @transformingbodiespodcast. Stay positive, keep your boobs and chins high until we chat again xoxo Trish