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A faulty production line

Do we need more men in general practice?

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We are witnessing a major decline in the number of male GPs. In the current intake women outnumber men two to one, and many men in their 50s will soon retire.

Men are an endangered species in a primary care environment, where the overwhelming majority of other staff are women too. For some, this might be cause for celebration - the end of male dominance in a branch of medicine. But this feminisation will become an issue in itself, for patients should be able to choose the gender of the doctor they see. But to advocate for men (as a man) is a fraught business, and risks accusations of misogyny and mansplaining.

We need male GPs in the front line to help men help themselves

The current equality agenda seems detached from suburban regional life. It seems more designed for the Americano-sipping-ultra-privileged-Oxbridge-London-elite-urbanisters. Or FTSE 100 board members. But my reality is burnt toast breakfast; kids’ homework; instant coffee; shopping at Lidl; taxiing kids to clubs; hanging out the washing; no clean socks; drinking too much on a Friday night.

A different world where equality arrived long ago, girls do better at school, are more likely to attend university and much more likely to enter the all professional courses. Did you know that currently 80% of newly qualified vets are women? Also in my world, men and women actually care about and respect each other. We are just sisters and brothers trying to make the best of our ordinary lives.

And as a boy from a free-school-dinner comprehensive, the most marginalised and unrepresented group, I find the concept of  ‘male privilege’ a hard circle to square. We seem to have forgotten that class is the great oppressor, not just gender. 

Today, fewer men are applying for medicine. Fewer still are considering GP as a career. It is common to hear negativity expressed towards men, even in medical school - and this goes unchallenged. Men, too, are victims of crude and out-of-date stereotyping - not all men are the same.

And the single greatest health inequality is maleness – men die on average four years earlier than women. (The causes being violent death, suicide, extreme poverty, homelessness, late presentation of cancer.) Despite these facts, there is limited recognition, research, advocacy and care for men’s health. Men are rarely seen as victims and there is a pervading sense that it is our own fault, that we are to blame. Men are marginalised and are reluctant to engage with health services. We need male GPs in the front line to help men help themselves.

But there is a more important and fundamental reason why we need men in general practice. The presence of women in medicine is the greatest advance in the last half-century. Not simply because of the academic contribution, but because women have delivered better working environments for all, made the profession more humane and family friendly. This allows male doctors to be better parents and have a healthier work-life balance. Mixed-gender working environments are simply better, happier and more productive. That’s mixed; not monopolized by one group or another.

Is it time to do the unthinkable and start advocating for men in general practice? 

Dr Des Spence is a GP in Maryhill, Glasgow, and a tutor at the University of Glasgow

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Readers' comments (21)

  • Its not a politically correct thing to say but I do think we need more men in general practice. The balance has been skewed too far. Workplace atmosphere, patient choice and workload implications all change otherwise.

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  • I totally agree about the bias against men for applying to medical school and GP recruitment. Men and women are different and have different strengths and weaknesses(with exceptions of course)You only have to raise kids to see these genetic differences at play - not necessarily gender based differences, but obvious innate differences which have nothing to do with their environment.

    I work in a multi-cultural area and we couldn't possibly be without our male GPs because many Muslim men will refuse an intimate examination from a female GP. It is deeply worrying that the feminisation of the workforce will soon mean these men will not get this choice, just as women didn't get a choice many years ago.

    As to the comment about women taking more time off with children and parenting - well that's personal choice isn't it? It doesn't have to be this way. Why is a dad less important in the parenting process than a woman? As the only earner in my household, I have had short periods off for having children and continued breastfeeding for a year each time.

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  • OMG - I got into SO much trouble for suggesting that having several entirely female intakes onto GP VTS many of whom have taken planned maternity leave in their GP jobs, become part-time GPs and often move following their spouse out of the area, might create problems. Recruitment and retention being just two!

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  • well said j smidt! excuse me for mixing my metaphors, but i feel you need to "grow some". we must stop pussy-footing around these issues and call a spade a spade.
    just read the artcle on making denigration of general practice an offence , which can be whistleblown to the GMC, far easier to include such statements as "sexist" and bobs your uncle, we can get the mysogenist old codgers struck off...

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  • Vincenzo Pascale

    Absolutely indifferent, the gender. The
    peculiar job of GP is a mixt of Scientific and Humanistic preparation. I had a strong humanistic preparation in my secondary school (old Greek, Latin, Philosophy, Psychology). This is exactly that the NHS has erased with its rigid rules and tasks. So, men or women but with humanistic preparation

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  • Well if it's so important for patients to be able to choose the gender of their doctor, maybe it's important to be able to choose the gender of their nurse too. So how about we aim for an equal gender distribution in supportive, as well as managerial healthcare positions first? And should we encounter any problems with this, maybe review whether we actually have achieved true equality.

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  • On a purely practical point.
    My old practice was run by 4 full time doctors. (Three men and one woman).
    It is now run by 9 doctors; 2 full time men, one salaried part time man and six part time women.
    Nine doctors have had to be trained, even allowing for their own contribution, at a cost of £200,000 each, instead of four for the same practice.
    Yet another reason why the NHS in it's present form is unsustainable and needs a completely new way of financing.

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  • Some 20 years ago I was at a lecture when a fellow gp said that general practice would become 'a part-time girly ' job. This was greeted with derision, but it seems true .

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  • The politically correct action (in the true meaning of the phrase) would be to positively discriminate for men as entrants to medical school and subsequently for GP training schemes.
    Unfortunately, 'political correctness' now really means public cowardice, with understandable fear of being viciously attacked by the liberal left, equality-obsessed fascists.

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  • Let's get real
    No night or weekends i.e. No emergency
    medicine not even terminal care in other
    words lightweight doctors with knobs on
    No independence
    Nurse practitioners dong the same job
    ( don't shit me you know it's true )
    No whole patient medicine diabetic COPD
    asthma clinics all run by nurses so the
    minute a patient gets anything serious
    you get rid of them ( and lessen your skill
    base at the same time)
    No street cred whatsoever
    General Practice is for those who want to
    set up home permanently early on and of
    course these are women
    No self respecting decent doctor should
    even consider GP land any more
    If you have other agenda's then fine
    but don't look for job satisfaction because
    there isn't any

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