A report published in the Journal of the Royal Society of Medicine has provoked controversy by claiming that female consultants working in the NHS are responsible for fewer patient episodes each year than their male counterparts. Researchers from the Universities of York and Birmingham claim that male consultants conduct 20% more episodes.
“We were disappointed with this report as it suggests that women are not as productive as men – I do not believe that the authors can answer that from the data they have looked at,” Sue Ward, president of the MWF, told The Clinical Services Journal. In particular, she pointed out that the time spent on teaching was not addressed.
“If students are having an educationally valuable experience in clinic (taking histories and presenting patients) rather than just sitting in the corner listening, this takes a lot of clinic time and should be taken into account or excluded in any future studies,” she commented.
“If the researchers want to conduct a study to establish whether there are variations between genders, they should compare clinics where there are a lot of medical students with other similar clinics. Teaching is a significant variable and this study does not compare like with like. “There are some specialities where women predominate such as obstetrics where complications can take a lot longer. The analysis did not examine the data by specialty and should compare female paediatricians with male paediatricians, for example.”
She also pointed out that the number of clinical episodes completed in any particular clinic nominally under the name of a consultant depends on the number and seniority of the doctors actually working in the clinic. “In my own Trust, some of my male colleagues have staff grade and associate specialist doctors working in their clinics as well as trainees and nurse specialists, whereas my female colleagues only have an SpR and/or an F2 doctor. Future study should look at the patients actually seen by the consultant himself/ herself rather than other doctors in their clinics. “I believe the researchers need to give the data a much more thorough examination than they have given – the way it has been put together is unfair. If they are seriously suggesting that this study should inform work planning decisions, then there need to be further studies.”
Further study needed
Karen Bloor acknowledged that there could be gaps in the data, such as the consultant’s speciality, requiring further investigation which may help to shed light on the reasons for variations. She told The Clinical Services Journal that she had been aware that the results could be viewed negatively and had therefore “taken every effort to write the paper in such a way as to avoid the potential tabloid headlines.”
However, she said she was saddened by the fact that the BBC Today Programme had presented the work as suggesting “women consultants are more lazy”, which was her “worst nightmare”. She added that more research is required to explain why these variations occur: “We need to know if women have a different balance of clinical versus non-clinical work or perhaps a different working ‘style’. We do not know whether ‘more’ is necessary better. For example, women may spend more time with patients and may have better outcomes but this is not covered by this study.
“I would like to see further research to examine whether any barriers exist within the NHS that affect women’s productivity and to consider whether anything can be done, such as more flexible working for example.” Sue Ward responded by saying that she felt that it was “naïve” to think that the study would not be viewed as a negative portrayal of women in medicine and said that it would not help the current situation. She said that the increasing number of women entering the medical profession is already being questioned by some senior figures in the sector and she had read a number of internet “blogs” where male consultants cited the report as evidence that they make better surgeons than their female colleagues.
