The GP gender issue

 

IN 1975, one in every 20 doctors who graduated from GP training schemes in the Republic was a woman. By 2003, according to a Trinity College Dublin survey, 70 per cent of GP graduates were female. An old problem, gender imbalance in the medical profession, may have been rectified. A new difficulty, however, has emerged for the health services, with important implications for primary healthcare for patients.

Ireland is facing a future shortage of family doctors involved in full-time clinical practice. The research, conducted by Prof Fergus O’Kelly and his TCD colleagues, surveyed all GP graduates between 1997 and 2003. It found that women GPs are half as likely as their male counterparts to work as full-time doctors at partnership level. Within the next eight years, an increasing number of family doctors will retire – some 40 per cent of GPs will stop working. And most leaving the profession will be men who have been involved in full-time medical practice. How, given the evidence of this survey, will they be replaced?

Not easily, to judge by the research findings. The gender balance in general practice may have tilted in favour of female doctors, who account for a majority of GP graduates annually, but too many have opted to work part-time. Their low rate of full-time involvement in general practice, as the authors of the survey state, “reflects the greater family commitments of females”.

But if so few female GPs are willing to engage in full-time general practice, then the quality of primary healthcare for patients could suffer. Can doctors who operate on a part-time basis provide an acceptable service to patients, particularly those who suffer from chronic illness and want continuity of care from the same doctor, rather than from a variety of part-time GPs?

In medicine, if the old gender imbalance has been reversed, a new one has been created with, potentially, some adverse consequences for patient healthcare. Another rebalancing may well be needed.

In teaching, an old imbalance of the sexes has been further compounded. At primary level, the ratio of female to male teachers in the 1960s was 2:1, but it has widened greatly since then. Today, four times as many women as men teach in primary schools. The decline of male teachers has deprived boys of a much needed adult role model. The training of teachers and doctors is financed largely by taxpayers to help meet national needs. Perhaps it is time for a review of how well these needs are being met by the present arrangements.