We read with interest Amanda Howe's response1 to the papers by Gravelle2 and Rossdale3 in February's Journal. Our own survey of all GPs in Scotland based on a relatively high response rate (67%) found that women GPs at all stages of their careers work significantly fewer hours than men.4 As importantly, they were much less likely to become involved in non-GMS educational and managerial activities (0.73 versus 1.1 sessions weekly, P<0.01) with serious consequences for the development of the speciality.
Additionally, if the Rossdale's findings on out-of-hours referrals are also mirrored in-hours then the impact on secondary care is likely to be significant.3 Empathy and communication skills are important, but so is the ability to live with risk in general practice as is the ability, under pressure, to ‘clear the decks’.
We found the median age of GPs in Scotland to be between 45 and 50 years. They were mostly male and working fulltime, as are those aged between 50 and 60 years. This ‘wave’ of full-timers is shortly to crash on the shores of retirement, with those behind them increasingly part-time. While we agree that it is very important to have women in general practice, someone will have to look after the patients 10–20 years from now. On current recruitment and retention, given the likely female work pattern and without big imports from other countries our feminised workforce will not cope with future demands.
We need to accept that we will either need to employ more doctors in primary care in the future to make up this demographically-induced shortfall, find ways of allowing women to work longer hours and partake in the full range of general practice activities, or encourage more men to consider a career in primary care.
- © British Journal of General Practice, 2007.
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