Family Practice Vol. 16, No. 3, 322
© Oxford University Press 1999
Book Reviews |
Sex and medicine: gender, power and authority in the medical profession.
Clinical Research Fellow, Department of Primary Care and General Practice, University of Birmingham
R Pringle. (250 pages, £14.95 paperback, £40.00 hardback.) Cambridge University Press, 1998. ISBN 0-521-57812-4, paperback, 0-521-57093-X, hardback.
As Gwyneth Paltrow et al. amusingly demonstrated in "Shakespeare in Love" women who wanted to act in Elizabethan times were faced with a concrete ceiling. Four hundred years later, as numerous head counts demonstrate,1 some sort of ceiling, continues to be a topic of relevance to women in medicine. Taking a far broader view than confining herself to promotion prospects, Rosemary Pringle, Professor of Women's Studies in Brisbane, sets out to analyse the role of women in medicine in this work.
Professor Pringle conducted 150 semi-structured life history interviews with women doctors (50 in Britain, 100 in Australia) in the early 1990s. She also interviewed 50 men, conducted focus groups with nurses and spent time as an observer of doctors at work. She has distilled this field work into chapters devoted to individual specialities, which include general practice, surgery, anaesthesia and psychiatry. In addition, there is a fascinating chapter reviewing the history of women's struggle to gain entry to medicine, and sections on doctor–nurse relations and doctors and women's health movement.
The result is a readable account of women's experience as members of the medical profession. In particular I found the review of feminist critiques of childbirth, and the relationship between midwives and obstetricians enlightening. Within the narrative there are many reminders of the breath-taking pace of change in UK practice in recent years. One illustration being the reference to (recently abandoned) GP fundholding, or the statement that assistants don't need to be vocationally trained in general practice – which is no longer the case for new applicants in the UK.
In the chapter on "The power of gynaecology" there is a discussion of examples of incompetence by gynaecologists, which have been witnessed by the interviewees. The examples chosen are those related by a single informant who graduated in the late 1930s. Sadly, as recent GMC hearings illustrate2 this continues to be a live issue for the medical profession.
As a female GP working both as a clinical assistant in the inner city and in an academic department of primary care I was particularly interested in the comments on part time work. Professor Pringle is explicit at the outset that she has taken a deconstructionist view. However, with respect to the reported view of the UK female physicians, who felt that part time work was in conflict with medical excellence, I should have been interested in a more detailed exploration of ways to challenge this perspective.
References
1
Kvaener KJ, Aasland OG, Botten GS. Female medical leadership: cross sectional study. Br Med J 1999; 318: 91–94.
2
Dyer C. Gynaecologist showed "lack of care judgment". Br Med J 1998; 317: 965.
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