The NHS says 65 percent of consultants are male. If that’s the case I feel sure that I must have seen at least 50 percent of them. I’m exaggerating, and perhaps the area of medicine I fall under, or into – rheumatology, is not that interesting for women (frankly, it’s not even that interesting to me). Either way, in three years (the last month or two withstanding) I have seen precisely one woman in a consultation about my condition and she was a default because the incumbent had ‘a rush on’ that day.
Why does this matter? Well, let’s start with the nuts and bolts of the gender imbalance. First, a statistic: the male percentage of the total NHS workforce is just 23 percent, yet 22 percent of that percentage are doctors and dentists, whilst the number of women doctors and dentists who fall into the remaining 77 percent is just 5 percent. That’s a problem right there. Before we even begin to discuss the fact that inevitably far more women are treated by doctors, NHS or otherwise, than men (think: fertility and childbirth). There’s a gender pay gap too (of course there is) but it’s cleverly obfuscated with statistics around bonuses and ‘awards’. One thing is clear, six times as many male consultants as female were paid the highest bonuses of £77,000 in the year they counted (2015).
I say all this because most of the men I’ve seen medically (and I’ve seen many) have been great at their jobs (diagnosis, analysis, prescribing drugs) and utterly rubbish at doing the other stuff which matters – offering advice, support and the c and e words: compassion and empathy. Granted men and women communicate differently (we don’t need a study to prove that – though there are thousands). And it would be sexist to suggest that men can’t do compassion, though as I write I’m counting them on one hand.
In any case, do the drugs or the empathy and involvement matter more? Obviously, the jury’s not out on this one if the drugs and medical intervention are crucial to life. But for thousands of people living with chronic conditions, it’s actually understanding how to live and deal with their illness that matters most.
I hate to make this all about me – but I’m the best example I have, so, If you’ve been unwell for a number of years, are unable to work and there’s no indication of when you’ll get better, be able to work again, or worse, no one can predict when you can call a halt to the cocktail of toxic drugs that makes you a: crazy b: sick c: impossible to live with; then you’ll likely want a few milligrams of sympathy and understanding, as well as that prescription. You may even, like me, want a degree of ‘say’ in your treatment.
You are likely to find that any of the latter requests, get short shrift, in my experience, if the doctor is male. The mantra ‘we’re incredibly busy’ seems to be an excuse for ‘I can’t be bothered to explain’ or worse ‘you’re too thick to understand’. One of my most brilliant consultants (he probably qualifies as a genius) has a chair for patients, beside his desk in his office. I don’t know why. The average timescale for each patient is about 3 minutes – barely enough for your bum to hit the seat. It used to be that when I asked him questions and slowed up the process, he would get annoyed, take his glasses off and rub his forehead in despair. Now every time he sees me he takes his glasses off as a reflex.
I don’t think most people who are sick want someone to hold their hand or wipe their brow, unless of course they are giving birth. And I experience on a weekly basis and NHS pushed to its limits. I do think that, as patients, male or female, we want to be dealt with sensitively, as intelligent, consenting adults. I’d stick my neck out here and say that, women are a whole lot better at this stuff than men, and therefore, it matters to both sexes that there aren’t more of them in senior medical positions. I’ve recently seen both a female GP and a female consultant. Both of them provided me with more salient answers and sensible suggestions in thirty minutes, than I’ve had in three years, with one or two notable exceptions. The key to this? Listening.
‘The trouble with male consultants is that they’ve been treated like gods for too long’ said one nurse to me during a recent visit to hospital, ‘it starts when they are medical students and doesn’t stop until it’s all over, or until they get ill themselves. Then they finally realise what it’s all about’. Which may or may not, be far too late for many of us.