It takes a brave - or exceptionally healthy - individual to incur the wrath of over half the country's 180,000 doctors. So Dominic Lawson must have a heart of oak and cojones of steel to have broken in the Sunday Times the shock revelation that the real cause of the NHS junior doctor crisis is... oestrogen.
That's right. The ‘one sex change on the NHS nobody is talking about’ is the insidious creeping into medical life of ovaries, malign and deadly.
No branch of medicine is safe. Operations are known to have been halted - with the patient actually on the table - when the female surgeon breaks a nail. Chest compressions are being terminated mid-cardiac arrest when the junior doctor thinks her brow has started to glisten unbecomingly.
And, perhaps most alarmingly of all, every Boxing Day for the last 10 years, in-hospital mortality rates have soared by 11 per cent as female doctors desert their patients in droves, in pursuit of cheap shoes in the January sales.
Small wonder, as Mr Lawson reveals, a hidden debate is ‘raging’ within the medical profession about this grossly irresponsible ‘feminisation of medicine’. The underlying cause of last week's strike is not, it turns out, chronic NHS underfunding, inadequate workforce planning, or constant inflammatory sniping from Jeremy ‘nuclear option’ Hunt.
No, it's the women like me who are first flooding our medical schools, then popping out babies with impunity, and finally abandoning our patients for a lazy part-timer's life.
Once upon a time, all doctors were men. That changed in 1876 when, after a tenacious fight, the law was changed to prohibit the exclusion from medical schools. One hundred and forty years later, female doctors have outnumbered men for around two decades.
Yet certain commentators from both within and outside the medical establishment still seem wedded to a 1950s view of the workplace in which women should jolly well know their place. They point to the one in five unfilled placed in paediatrics, blaming women who work-part time for those gaps.
And now they claim the fundamental reason underlying the junior doctors' position is the fact that the women amongst us are reluctant to disrupt our precious family lives by working at the weekend.
Luckily, Mr Lawson's piece ignited Twitter in satirical outrage, and my hashtag, #likealadydoc, immediately went viral.
Beneath the scorn, of course, is a serious point. Deliberately conflating the increase in numbers of female doctors, with the medical profession's near-unanimous opposition to an unsafe, unfair new junior contract, is as sly as it is inaccurate.
I'm far from hostile to weekend working, already spending one in four weekends at the hospital. But I object to the pretense that we can magically provide new 'truly seven-day' weekend services without a corresponding increase in the number of doctors.
Making us work longer and harder to fulfil an election manifesto pledge might be an attractively cheap alternative - but it's downright dangerous for my patients. It's not rocket science: to make weekends work better, we need more doctors - simple.
Incidentally, Mr Lawson, I have a message for you from my husband who, as a former RAF fighter pilot, now flying civilian planes, knows a thing or two about manliness.
He notes you claim you've received ‘quite a few perplexed letters from airline pilots complaining that they don't get paid extra for flying at weekends, so why should doctors? He says in response:
1 If I worked the shifts and hours Rachel did, my fatigue would turn my plane into a lethal weapon. Junior doctors' workloads are grotesque, and subject to none of the regulations that safeguard us as pilots.
2 In modern Britain, it may surprise you to know that quite a few fathers enjoy spending time with their children at weekends too. We don't tend to pack them off with 'nanny' as may have happened in your day. We try incredibly hard to be there at weekends for our children as well, creating the kind of caring, loving, secure, home environment in which our children can flourish.
3 Next time you insult my wife in a diatribe, please do so face to face.
OK, I made the last one up. But in general, it's fair to say, military men tend not to appreciate misogynistic claptrap at their wives' expense.
One last thing, Mr Lawson, to paraphrase a former Prime Minister: when it comes to my patients' safety, this #ladydoc is not, and never will be, for turning.
Rachel Clarke is an ST2 in cardiology in Oxford. Doctors followed up with tweets against sexism in medicine under the #pinkWednesday hashtag
I agree with Rachel Clarke wholeheartedly. I especially like the point about airline pilots being protected against unsafe rotas. Why don't the BMA focus on working only safe rotas and demanding meal breaks during 12 hr shifts, canteens that open at night, and shifts that finish on time?
I think the public would find this much easier to understand, than strike action.
So girls are doing well at school, studying rather than kicking a football, or getting drunk at weekend and get a med school place. Let aside that soft skills are much appreciated by patients and colleagues and generly the changing working environment (medicine included).
If some decide to work a 80%PT job , out of 50 hours a week (considering the alleged 48weekly hours- and extra 2 for missed lunches and late finishes) that make about 38-40 hours -the hours in a normal full time job.
How dare we decide to want a life while doing medicine? I personally want more time for myself (not family related) to surf and dive! Other people have their reasons. Ultimately we sign an employment contract and not our life away! If politicians / journalists call that selfish, so what?
I would call it self caring and required to stay sane and empathic and not burn out working in a highly stressful environment- and we only live once.
The problem is not that there is no truth in what Mr Lawson said but the this problem is not only in the way overstated his case but also in the overreaction of those responding to him. The effects of the change in gender balance should be accepted and the consequent necessary changes in approach by rational discussions with both sides recognizing the pro's and con's of the past and the present
Until someone explains what this is all about in simple straightforward and dispassionate terms the kind of best guess explanation put forward by Lawson to try and clarify what this dispute is really about is going to be as good as gets. Until then both sides will be viewed with cynicism by the public at large.
It seems that it is ok to work long hours if you get overtime (the status quo) but suddenly it becomes unsafe if you are contracted to do fewer hours rostered over 7 days for a circa 10% pay rise. So is it all about cast iron guarantees on hours and if so why hasn't this been raised by the BMA ages ago in view of the current work levels?
As for the female dimension. Google images for "doctors strike uk" and you will see a large proportion of protestors are female. May just be they catch the photographer's eye. Or perhaps Lawson has a point there is a uniquely female perspective that, amongst other aspects, needs to be understood in resolving this deadlock.
Ellie: as men: we're each sorry that we don't have a uterus - because if we did, we could expect so many extra privileges.
Typical of "Lady" docs - wanting to have their cake and eat it .. ;-)
PS: I've served time with the army, and I fly planes - but does that really make me more of a "man"?
.. and what's the "man's role" - to defend his equally-capable wife who, if she were, wouldn't need any help?
Ioana Pereni - everyone only lives once; and many people work longer hours than you. What's so special about you?
Let's have a debate! ;-)
John Pearson: Hear! Hear! Hear!
Brilliant contribution and lots of information to digest. Any way, there is another group who I was involved with. These are nurses with an ambition to become a doctor but had failed to find a place in medical school. Now they some home made Patricia Hewett, sign a document that allowed them to work as doctors. Unfortunately, men like me won't tolerate shabby, unethical medical practice because we believe its our duty to protect patients, not the ones who flock their Bxxxs and tease you to crack open your nuts.
I have created the simple solution, that will help doctors like you get paid sitting at home. This will be great, cause the tool can actually make all the fat pigs who are bleeding NHS
Have you ever thought that over 50% of patients are women??
Maybe they like someone who has knowledge of female personal problems.
Like a woman??? Sure they don't want Dominic lawson delving about their private parts!!!!!!!!
As a semi retired female doctor I look back on my career with some satisfaction that I managed to combine part time working with bringing up my children. I had to choose a speciality - child psychiatry- that fitted in with htis rather than my initial preferred option of orthopaedics !! However it's been good on the whole . Doctors come from all walks of life and all genders. They have the same rights as anyone else to work the hours they want and choose the life they lead. We are not commodities but people - so stop treating us as such!