The doctor will see you now…

‘You wanted to become a doctor to help people and feel better at the end of your job, I think, watching them, as the nurse takes my hand. But I don’t think you do feel better at the end of the day. You look like humans have constantly disappointed you.’

– Caitlin Moran, How to Be a Woman

‘I thought I was seeing Dr Jones, is he not here?’

She is here. I’m her registrar and we share patient lists so you’re seeing me today.’

‘Damn, I was hoping to see him. Does he often let his registrar see his patients having never met them?’

She is very happy with this arrangement as I discuss all the patients with her after the clinic, and I can assure you that I am also quite competent…’

As this real exchange demonstrates, sexism is still alive and well within medicine! Just as I am astounded at their occasionally profound racism, elderly and/or demented patients often appear shocked that I am their doctor because I am a woman. Despite not wearing a uniform and carrying a stethoscope instead, having a very visible name badge, and always introducing myself as a doctor, I am still the nurse first.

But I have accepted this. I don’t like it but I have accepted it, because it represents the past and not the future. It’s not as if my peers or bosses act in a sexist manner. Women are doing well in medicine as a career, progressing within previously male-dominated fields, being treated with the respect that their seniority and experience deserves, and sharing equal opportunities to men.

Or so I thought…

The proposed new junior doctor contracts, however, plan to change that, and this shouldn’t go unnoticed. We junior doctors have many objections, most of which need to be shouted loudly at Jeremy Hunt and the policy makers but can seem somewhat selfish when compared to general unemployment levels and pay variations within other industries. Of course I’m furious that I’m facing a huge pay cut, but is that of concern to non-medics? I do worry that all of the protesting on social media and in the press might be harming the junior doctors’ cause as, by complaining about money, we risk looking like spoilt children who have thrown their toys out of the pram.

But there *are* proposed changes that should outrage everyone and there *are* plans that will have a wider implication beyond medicine, and these involve the treatment of women and the inevitable worsening gender discrimination. If implemented, the contracts are not only a huge step backwards for gender equality, but set a dangerous precedent for other industries, both in the private and public sectors. If a government approved contract can disregard previously established measures to reduce pay differences, why should anyone else bother to do any differently?

I have been struggling to write this for a while as I couldn’t concisely describe the effect of planned changes without sounding biased or pissed off…and then Buzzfeed kindly did that job for me, twice, if you’re interested in more details!

In summary, there are a lot of junior doctors! I am 30 and have been working for 5 years, but I am still a junior doctor and will be for at least another 4 years before I complete my training. Although being called a junior suggests youth and recent graduation, all doctors except GPs and consultants are described as junior doctors as we’re all still in training.

Amongst these, there are a lot of women trying to juggle career and childcare, and currently the NHS is very supportive of that choice, both with part time training and regular incremental pay increases that match full time trainees. The new contract, however, will mean that these pay rises will occur much less frequently for part time trainees. As these are mostly women, this will inevitably create a pay difference between genders that just does not exist in the current system. This is not the only blow to women within the new NHS. Pay is not protected when taking time out of training, so maternity leave further delays any pay rises. Increased working hours and changes to what counts as ‘social hours’ can only complicate child care arrangements. Women can’t even retrain in a speciality that works fewer hours as retraining risks pay cuts and further pay freezes.

Having children as a doctor is suddenly starting to look more and more like a sacrifice…

I am particularly troubled by these developments because the decision to have children is not an easy one for me. I do want a family, I really do. I want to read them stories and watch them grow and die of pride with their every achievement, but I have no strong desire for a baby. The pregnancy/baby/toddler part has absolutely no appeal. Pregnancy is kind of disgusting, birth is worse and babies are exhausting, why would I do that to myself? I struggle to talk to children, I get bored of babies quickly and, with a midwife sister and paediatrician housemate, I have heard so many horror stories that I am terrified of every part. I could easily be persuaded that having children is just not worth it.

So when changes to my career seem to discourage taking time off for children, I know that it will make me even more reluctant. My career is my shining achievement, I love my job, and there is nothing that will make me quit or leave the country to work elsewhere. I will accept the pay cuts and increased hours. I will swallow the criticisms and lies in the media. I will even ignore the eroding respect and changing attitudes towards doctors, because it’s too important and I can’t think of any job I would rather be doing. Instead, my life outside of work will have to change, and most likely not for the better.

It can be argued that woman struggle for equal pay in all industries. It can be argued that I have no right to expect my contract and benefits to stay the same in this time of austerity. But it should equally be argued that progress does not mean sinking to the lowest level. That new contract negotiations should be supporting equality. That saving money by disproportionately penalising women who choose to have children and work part time is never OK!

The gender pay gap is also a hot topic right now. Just look at the press coverage of Jennifer Lawrence’s exasperation at the pay gap in Hollywood. We are being told to fight back, and yet this is the time that the government has chosen to bring about such sweeping and outdated changes. It baffles me…

So I’m off to join the protest today. Not because of the money and not just because of the valid patient safety concerns, but because I don’t want my job to be the reason I don’t end up with the life I’ve imagined for myself. I don’t want to have to choose between a family and a financially viable career. I don’t want women to choose a different career or quit because medicine has become incompatible with family. And I don’t want anyone to think that it’s acceptable in 2015 to worsen gender pay differences or reverse the progress of the last few decades.

I just hope the right message is heard.

6 thoughts on “The doctor will see you now…

  1. Ok I’m single so maybe my opinion isn’t valid πŸ™‚ but over the years I’ve talked maternal instinct with ladies, I’ve heard ‘I get bored of babies’ then that the maternal instinct flourishes the moment she sees her own baby. Best wishes x. πŸ™‚

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  2. It’s shameful that such retrograde changes are being proposed.

    As for maternal instinct, it’s not universal. I don’t have it – I’ve never wanted kids. As a result, I’ve never had to make those hard decisions about balancing career with “family”.

    I put “family” in quotation marks because it’s code. If it literally meant family, then the conversation would involve women and men equally, because (in hetero relationships) there is one of each. But what’s really meant by “family” is pregnancy, and then care during early childhood which is somehow automatically primarily the mother’s responsibility. Where is the discussion about “paternal instinct” and men juggling career and family?

    If you had your own baby, you might fall head over heels in love with it. Or, you might not. One aspect of “femininity” is being a “good mother”, such that not aspiring to or enjoying motherhood is taken as failing at being a woman. I call bullshit. I don’t care for babies, and I too struggle to relate to young children. I don’t have the skill set to be a good parent; if I were really motivated, I could probably learn, but I’m not remotely interested. And that’s OK.

    It’s every woman’s decision to make for herself. Listen to your gut. [OK, getting off the soapbox now.]

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  3. Try talking to some independent midwives instead of hospital midwives. Or reading some homebirth stories instead of hospital ones.

    Sorry, I’m a little horrified that my comment on this very valid post is the having of children, and the first two comments are also regarding whether or not you have children as if the political import of your post is far less important than encouraging a woman who’s not sure about motherhood to have babies… sigh.

    My concern is more about how birth is managed and marketed, and while of course it’s not always a happy dreamy easy event, people seem to have forgotten that it very often can be. There’s a lot of reasons to realise that, and to modify the hospital birth system and stop giving women PTSD and lasting physical damage, etc.

    Having said that, yes, the stress and drudgery of having small children is real, while being interspersed with magical moments. I am not bored by infants, I find them amazing and great company, but the daily grind is unquestionably boring. There is PND and sleep deprivation and piles and breastfeeding kills your sex drive. There is financial stress and in my case, ASD to contend with, that ruins the picture of the nice things you anticipate. I thought I would be a great mother, and I’m not. Having wanted kids for most of my life, I now wish I hadn’t. But there are lots of people who feel the opposite, despite the piles and sleep deprivation.

    I dunno. I think the world is over populated and heading for disaster (and Politics in England, as well as everywhere else only serves to reinforce that view), we should be breeding very selectively with only the most dedicated and well balanced of potential parents who can create strong, stable, happy people. Not having children when you’re not sure about it is a really good idea.

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