Roxanne Mehdizadeh
It is no great secret that the workforce within healthcare is becoming increasingly more and more female. Dentistry is not exempt from this, and it has been reported that by 2020, over half of general dental practitioners (GDPs) will be women(1). Undoubtedly, this shift in the demographics of the field will have an impact on the profession, and is becoming an increasingly debated topic within the profession. This post aims to explore some of the complex major issues and discussions surrounding the topic, which of course does not exist in isolation and are to the backdrop of extremely complex societal issues - some outside the remit of a blogpost!
Women are more likely to work part-time than men
Research has shown that female GDPs are more likely to take a career break than their male counterparts, with 61% of female practitioners taking a break as compared to 27% of male GDPs. In addition to the relative proportions, of those GDPs taking breaks, females are more likely to be off for a more extended period of time – cited as an average of 9 months, as compared to 4 months for males(2). This, in conjunction with the understanding that the proportion of female GDPs overall is increasing, has implications on the balance of work in the future and ultimately on the planning for the workforce. However it is important to note that while this is the current situation, it is difficult to predict the future state of play.
Additionally, it is vital to consider the societal context within which this issue stands. While the government introduced shared parental leave in 2015, a move which one would anticipate may allow mothers to return to work sooner, (thus counteracting some of the aforementioned negative effects), uptake of the scheme has been incredibly low – reported at 1%(3). This may be due to the paltry sum offered to fathers – at £139.58 a week it may not be financially viable for them to take time off work. In countries where shared parental leave has the uptake of 85% and upwards such as Sweden and Norway, families are remunerated at least 60% of their pay while on leave.
A move towards a sharing of this leave, as seen in countries such as Sweden and Norway where over 80% of fathers take part, could lead to women being able to return to work sooner, thus evening out the supposed “burden” their leave to have children places on the system. Ultimately, women should not be punished for taking a brief break in order to give birth, which is fundamentally essential for the continuation of the human race.
Will feminisation of the workforce affect the prestige of the profession?
This is a controversial argument, but historically, it has been considered that professions dominated by white males have held greater standing within society. In 2004, the president of the Royal College of Physicians, Carol Black, was quoted as saying, “We are feminising medicine. It has been a profession dominated by white males. What are we going to have to do to ensure it retains its influence?”(4). It was a divisive comment which led to many articles and discussions regarding the increase of female doctors as having catastrophic consequences for the profession. Comparisons were made to the situation in Russia, where the feminisation of healthcare led to what is regarded as a loss of status of medicine, leading
to less pay and acknowledgement politically for the profession and ultimately a downgrading of the field. Clearly, the devaluation of the profession is not desirable, and may lead to a dissatisfied workforce. However, one must challenge the notion that it is the feminisation itself which leads to the perceived diminishment of the profession. Arguably, it is part of a broader context – one encompassing society’s misconceptions regarding the capabilities of women, which are of course, equal to that of a man’s. While it is important to ensure that there is no gender imbalance of the workforce in the future and men are not discouraged from entering the profession – women themselves do not inherently devalue the system, and, just as their male counterparts - have a lot to offer.
Is the diminishment of prestige following the feminisation of a workforce justified?
In 2014 Europe Economics published a report for The General Dental Council, listing gender as a risk factor for being the subject of complaints and referrals, with research and empirical evidence pointing towards men being significantly more involved in litigation than women(5). They have proposed a number of reasons for this – that men may perceive risk slightly differently to women, that the female GDPs may have a better work-life balance, and that they may also have better communication skills, which may improve their interactions with their patients. Within medicine, studies have shown female practitioners to be more likely to adhere to evidence-based practice and clinical guidelines(6). One study even found elderly patients treated by female physicians to have lower mortality and readmission rates when looked after by female doctors as compared to their male colleagues(7). Such work highlight the importance of having a diverse workforce which present a greater variety of strengths which can be taken advantage of, in order to ultimately provide the best care for our patients – who are likewise, extremely diverse.
Overall, the feminisation of dentistry does indeed need to be addressed, purely on the basis of achieving gender equality and a balanced workforce. The notion that women inherently devalue the profession’s societal standing or that their maternity leave is a negative factor should be challenged and viewed within the wider context. In addition, we should ensure that hidden inequalities such as the disparity of pay, unequal proportion of female to male specialists and lack of women in leadership roles do not go unnoticed simply due to the overall increased proportions of female GDPs.
Sources
1. Teli, Sameera. MDDUS. Gender shift – The changing face of dentistry. Weblog. [Accessed 2017 February] Available from: http://www.mddus.com/resources/resource-type/publications/soundbite/soundbite-issue-09/gender-shift-the-changing-face-of-dentistry/
2. Newton J, Buck D, Gibbons D. Workforce planning in dentistry: The impact of shorter and more varied career patterns. Community dental health. 2002 Jan 16 [cited 2017
Feb];18(4):236–41. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11789702.
3. Kemp R. Why are only 1 in 100 men taking up shared parental leave? The Telegraph. 2016 Apr 5 [cited 2017 Feb]. Available from: http://www.telegraph.co.uk/men/the-filter/why-are-only-1-in-100-men-taking-up-shared-parental-leave/.
4. 1. BBC. Women docs ‘weakening’ medicine. BBC Health. 2004 Aug 2 [cited 2017 Feb]. Available from: http://news.bbc.co.uk/1/hi/health/3527184.stm.
5. Europe Economics (2014) Risk in Dentistry. Available at: https://archive.gdc-uk.org/Newsandpublications/research/Documents/Risk%20in%20Dentistry.pdf (Accessed: 16 February 2017).
6. Baumhäkel M, Müller U, Böhm M. Influence of gender of physicians and patients on guideline-recommended treatment of chronic heart failure in a cross-sectional study. Eur J Heart Fail. 2009;11(3):299-303.
7. Tsugawa Y, Jena AB, Figueroa JF, Orav EJ, Blumenthal DM, Jha AK. Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians. JAMA Intern Med. 2017;177(2):206-213. doi:10.1001/jamainternmed.2016.7875