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CAMHS won't see you now

General practice's gender problem

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It is a truth universally acknowledged that, when a male GP works part-time so he can pursue roles within the CCG, the RCGP, or the BMA, he is a leader; but that when a female GP works part-time so she can spend time with her family, she is singlehandedly destroying the NHS.

Has general practice become the dumping ground of the NHS because it is seen as ’women’s work’?

Of course, plenty of women take up leadership roles, and plenty of men have childcare responsibilities, but the mainstream media narrative is that the feminisation of medicine is creating a workforce crisis, with the blame aimed squarely at part-time female doctors rather than the politicians and managers who have failed to anticipate the problem and expand medical school places as a result. The shrill, haranguing tabloid think-pieces about lazy part-time female GPs rarely engage with wider issues, such as the vexed question of why women are more likely to work part-time in the first place, and whether this is due to biological urges or social conditioning or the calamitous cost of childcare.

I don’t have a vested interest in this debate: I don’t have children yet, and I work full-time (albeit part-time in a clinical role, and part-time undertaking a paid Fellowship). However, over recent weeks I have increasingly been wondering whether general practice does have a gender problem, albeit not the one that the Daily Mail keeps talking about.

Looking at the wider employment market, rather than just the medical profession, it is recognised that female-dominated jobs typically attract lower pay, status and respect than male-dominated ones. Indeed, research has shown that, when an occupation becomes female-dominated, average wages drop. One profession that has become female-dominated in recent years is general practice. GMC statistics show that 51% of doctors on the GP register are female. The gender split is likely to widen in future: approximately two-thirds of current UK GP trainees are women.

Has general practice become the dumping ground of the NHS because it is seen as ‘women’s work’, and is hence undervalued? It is not hard to see the parallel between the mindless drudgery of domestic wife-work and the avalanche of unpaid, unfunded tasks being dumped into GPs’ laps.

Within the home, the emotional labour of remembering family birthdays and organising playdates typically falls to the female partner; perhaps the medical equivalent is the assumption that GPs have the time and desire to mop up their patients’ social problems, performing boiler checks and food bank referrals. And why shouldn’t we agree to perform unfunded post-operative reviews, when otherwise, surely, part-time female GPs would just be in the kitchen at home baking cakes?

Those three hated words which so devalue our time, ‘GP to chase’, cast the modern GP as a medical secretary, rather than a highly-trained professional with a CCT just as valid as that of the hospital consultant who is trying to delegate their work to us.

What is the answer? I don’t pretend to know how to address the systematic, ingrained sexism which still permeates society. But within general practice, women and men alike must learn to say the magic word: ‘no’. No, we will not prescribe Calpol for an afebrile child ‘for nursery’. No, we will not complete that 10-page insurance form for the ‘suggested fee’ of £30. No, we will not agree to monitor complex secondary care drugs without additional funding. Enough is enough: male and female alike, GPs must fight back and grow a pair. 

Dr Heather Ryan is a GP registrar in Liverpool. You can follow her on Twitter @DrHFRyan

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Readers' comments (22)

  • Excellent blog and analysis of how we will be perceived in a predominantly female profession.

    The area that really grates me though is the fact that most of us are not part time. Why do we keep saying we are? A GP working 6-7 practice sessions per week can easily clock up full time hours. We do ourselves a disservice by calling this part time.

    The increase in length and intensity of our day in the last 5-10 years has meant that if we were to work 5 days a week, (a concept only those outside of general practice consider full time) we would be working around 55-60 hours per week.

    This is what we should be shouting from the roof tops - not down grade ourselves to saying we are working part time when we work 3 days a week.

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  • Women are underpaid and that is a well known fact. I don't think the feeling that female GPs undermine NHS by working part time is shared by male GPs and almost all of us appreciate the hard work done by our female colleagues who also have to go home and cook a meal and tuck kids to bed and then get them to school next morning before rushing to the mad world of general practice.
    I would say that this piteous state gp land is in, is also dictated by the emasculated male GPs - our so called cardigans and leaders who will just not put up a fight to keep their positions safe. We need to fight to survive but who's gonna bell the cat if the guys who get paid more than their female colleagues actually do not have the balls.

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  • Anonymous | GP Partner07 Jul 2016 10:31am
    I'm embarrassed for you. Welcome to the 21st century. Its not expected that chaps balance the books - that's a role of all partners EQUALLY.

    I think we all need a greater sense of work-life balance, and a flexibility about what full time working really means. I'm lucky enough to work in a partnership who truly understand this and value each other and their staff enough to be flexible where possible. Patterns of attendance a broadly predictable, and if you allow the pre-booked clinical work to flex you can do quite of a lot of creative thinking.

    Declaration of interest: I'm male.

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  • "the vexed question of why women are more likely to work part-time in the first place"

    - and this is where the predominately female JDs are trying to make a stand on working conditions. HMG just doesnt get it, and still expects us to sacrifice our lives to the NHS.

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  • I don't see this as a male/female issue, more young/old (most 50s male).
    If I was 50 partner, and the buck stops with me. So if the salaried doc wants to go at 4pm, or arrive at 10am, and can't do a Saturday morning or a Friday afternoon, then muggins here has to cover the unsocial hours.
    It's a dirty job but someone's gotta do it.

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    (Most 50s male)
    Damned iPad auto correct!!

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    (Most under forties female, most over fifties male)
    Seems you can't use greater than or less than symbols on here!

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  • Dont be embarrassed for me - merely stating how it is in the real world - unfortunately there are not enough of anyone in the system to accommodate the current view of flexible & part time working. Sadly the buck stops with the older & dare I say it frequently male GP who is still there at 1905 getting a bit of relief from Pulse....

    What would make it better? lots more bodies on seats (I dont mean patients) & a realisation by government that they have created a problem by changing the proportions coming out of medical school - the numbers need to go up substantially if we are to be able to have the luxury of pick & mix working..

    What is interesting is this seems peculiar to medicine - the lawyers (Barrister types) seem to get their heads around the need to continue professionally

    What ever - unless the system changes it is going to be a bit thin on the ground i a few years time when the current props fall over or give up!

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  • This article encourages GPs to become more lazy

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