The sexism particular to general practice

Editor Jaimie Kaffash reflects on Pulse’s new sexism investigation to consider how the profession can tackle gender inequality

There has been progress in redressing gender inequality in general practice. The very fact that 57% of GPs are female is testament to this.

But even though women are the majority in the profession, there are still issues around sexual abuse, harassment, casual sexism, hampered career progression, pay inequality and gendered work that female GPs face on a consistent basis in the practice. And these issues are very particular to the nature of general practice.

For example, take the partnership model. Although most GPs – and I – would still support this model, there are elements of it that do discriminate against women. It is a societal issue that women still do the majority of childcare, but when translated to the partnership model, this prevents career progression for those female GPs who do need to work flexibly.

General practice has the biggest gender pay gap in all of medicine, even when controlling for variables. The small business model and lack of uniform contract means that women are often expected to sacrifice salary to work flexibly – there is no justification for such practices, if the GPs are doing the same amount of work. It also leads to GPs being asked in an interview whether they plan to get pregnant, or whether they were using contraception, or being made redundant when they fell pregnant, because the practice couldn’t justify two GPs on maternity leave at the same time.

The hierarchical nature of general practice enables situations such as the GP who, as a medical student, was pushed against the wall by a senior male partner, who she later had to work with.

The intimate relationships formed with patients leads to greater individual abuse, and even – in the case of one GP who spoke to us – a sustained stalking campaign from a patient.

Meanwhile, the generalism inherent to the profession means increased levels of burnout. Female GPs are often given ‘women’s work’ even if they have no interest in, say, mental health or gynaecology.

This is not to necessarily apportion blame. It shouldn’t need saying – but does – that this is of course not all men. Indeed, it may well be other women perpetuating these problems (almost half of GP partners are female, after all).

Many of these problems are societal. It is not the fault of anyone in general practice that it is still the mother who is expected to provide the majority of childcare. And – while some male GPs will palm off what they think of as ‘women’s work’ to their female colleagues – no female patient can be blamed for asking for a female GP for certain conditions.

Hopefully, what our four-part analysis can do, is make all GPs – male and female – have second thoughts when automatically diverting certain work to their female colleagues, or considering if there should be a salary pay off for flexible working.

Only by understanding the issues particular to general practice, can all GPs – male and female – help introduce positive change. 

Read our sexism investigation here:

The effect of sexual harassment and abuse on female GPs

How sexism affects female GPs’ career progression

The GP gender pay gap

Female GP leader numbers growing…but still work to do

Jaimie Kaffash is editor of Pulse. Follow him on X (formerly Twitter) @jkaffash or email him at editor@pulsetoday.co.uk