Sunday, 28 March 2010

Becoming a Doctor: But let’s be careful what we wish for.

Way back in the early 1970s Sainsbury’s, the supermarket company, taught me how to bone a side of beef, cut up huge blocks of cheese and master the concept of JIT ordering and stock control. At that time I was part of a very good management trainee scheme. It was my youth and impetuosity resulted in my leaving the scheme prematurely. I wanted to travel. However, I convinced myself that what I perceived to be double standards in the way in which the managers were treated compared to the checkout operators and shelf stackers was unacceptable. I thought that leaving was some form of powerful protest (I was also idealistic and unable to easily accommodate compromise). And there was of course, an element truth in my belief and feelings over the perceived inequalities. At that time it was a lot more difficult for women to gain the same benefits and opportunities as men. Today, ensuring equal opportunities exist for all employees is something most companies strive hard to achieve.

Despite such improvements, it appears a lot harder to achieve is any significant move away from the stereotypical views we have around gender related roles both in the home and at work. I was interested to note this week that Sainsbury is to withdraw children’s play outfits which have been described as sexist. After receiving complaints that doctor, solicitor and pilot outfits were labelled for boys and nurses’ uniforms for girls, the company said it would remove these items from the shelves as soon as possible. These stereotypes, although hackneyed, still appear to persist despite much evidence to the contrary.

At present, women account for 40% of all doctors, 42% are GPs and 28% consultants. By 2013 most GPs will be female. By 2017 females will make up the majority of the medical workforce. But according to the report Equality and diversity in UK medical schools, only one in seven successful applicants are from the lowest economic groups, despite this group making up just under half of the UK population. Six in ten students entering medical school still come from the middle classes.

Likewise, in a separate report published by the British Medical Association last year it was revealed that the traditional image of the British family doctor as a serious, besuited white middle-aged man is out of date. For most patients the perfect GP would be someone diametrically the opposite: young, female and Asian. Female doctors under the age of 35 were judged to have a preferable personal manner, superior technical skills and more effective powers of description.

White, male doctors over the age of 50 were the least preferred group of GPs.

Paradoxically some might say and in a almost Cluedoesque coincidence Prof (Dr) Carol Black, president of the Royal College of Physicians, once said that breaking the dominance of male consultants and ‘feminising’ the medical profession will result in it being less influential in society. She noted that: ‘medicine has been a profession dominated by white males, what are we going to have to do to ensure it retains its influence?’

She also noted: ‘Years ago, teaching was a male-dominated profession - and look what happened to teaching. I don’t think they feel they are a powerful profession any more, and look at nursing, too’

Prof Black recived hate mail for making these comments. Whilst I think the inference was that nursing has suffered as a profession because of being a predominately female occupation, I don't accept this view. I consider the development of the nursing and midwifery professions has been hampered by a largely conservative desire to expand our knowledge and skill base and demonstrate strong leadership. I believe this situation is changing and changing rapidly. Nurses are responsible now for a ever increasing number of nurse led service provisions, and the Advanced Practitioner role illustrates how the exponential growth in professional autonomy, practice knowledge and enhanced skills for nurses and midwives can provide new solutions to the problems in medicine and health care. These developments need to continue. Across the NHS, 43% of all women doctors are under the age of 35, so many will not yet have started families. Many of the women choosing medicine will opt for specialties with more predictable working hours and/or work part-time. In hospitals, 8% of men and 21% of women are on part-time contracts. Women tend to specialise in less high-status areas of medicine, because the hours are more compatible with having a family. Now is the time for nurses and midwives to step up a gear and really show their leadership in finding new way to safeguard the NHS of the future.

We can worry about what Sainsbury’s puts on its shelves later.