Gendered forms of othering in UK hospital medicine

Abstract

PurposeAttempts to modernise the National Health Service (NHS) in the UK involve promoting flexible approaches to work and training, restructuring postgraduate training and increasing control and scrutiny of doctors' work. However, the medical community has responded with expressed anxiety about the implications of these changes for medical professionalism and the quality of patient care. This paper aims to address these issues.Design/methodology/approachDrawing on literature on nostalgia, gender, identity and organisations, the paper explores the narratives of 20 senior NHS hospital doctors to identify ways in which doctors use nostalgia to react to organisational and professional challenges and resist modernisation and feminisation of medicine.FindingsThis paper illustrates how senior hospital doctors' nostalgic discourses of temporal commitment may be used to constitute a highly esteemed professional identity, creating a sense of personal and occupational uniqueness for senior hospital doctors, intertwined with gendered forms of othering and exclusionary practices.Practical implicationsNostalgia at first sight appears to be an innocuous social construct. However, this study illustrates the significance of nostalgia as a subversive practice of resistance with implications for women's career and identity experiences. Change initiatives that seek to tackle resistance need also to address discourses of nostalgia in the medical profession.Originality/valueThe main contribution of this study is that we illustrate how supposedly neutral discourses of nostalgia may sometimes be mobilised as devices of resistance. This study questions simplistic focus on numerical representation, such as feminisation, as indicative of modernisation and highlights the significance of exploring discourses and head counts for understanding resistance to modernisation.

Contradictions concerning care: Female surgeons' accounts of the repression and resurfacing of care in their profession

“…In the UK, as in Canada, the U.S. and Australia, more women are enrolling in medical education and the numbers of women in general practice have increased leading some to argue medicine has become more feminized at least in a numerical sense (Tsouroufli, 2015;Walsh, 2013). Along with greater flexibility in training and work patterns associated with the introduction of the working time directive in the UK, the greater presence of women in medicine has been constructed as contributing to a decline in medical professionalism, excellence and quality of care with nostalgia for 'all-hours' availability (Bolton, Muzio, & Boyd-Quinn, 2011;Özbilgin et al, 2011;Tsouroufli, 2015;Tsouroufli et al, 2011;Wallace, 2014;Walsh, 2013). Women who opt for part-time or non-hospital positions with more regular hours risk being labelled as not 'proper doctors' (Allen, 2005, p. 569 cited in Walsh, 2013Wallace, 2014;.…”

“…In many Western countries, including Australia, women in surgery remain in a numerical minority that has not substantially increased over time Tsouroufli et al, 2011;Tsouroufli, 2018aTsouroufli, , 2018bWallace, 2014;Walsh, 2013;Webster et al, 2016). Not coincidentally, its status at the top of the medical hierarchy is unchallenged and it exemplifies the detached, agentic, masculine professional ideal with its simultaneous repression of, and dependence on, care work.…”

“…Women who opt for part-time or non-hospital positions with more regular hours risk being labelled as not 'proper doctors' (Allen, 2005, p. 569 cited in Walsh, 2013Wallace, 2014;. Along with greater flexibility in training and work patterns associated with the introduction of the working time directive in the UK, the greater presence of women in medicine has been constructed as contributing to a decline in medical professionalism, excellence and quality of care with nostalgia for 'all-hours' availability (Bolton, Muzio, & Boyd-Quinn, 2011;Özbilgin et al, 2011;Tsouroufli, 2015;Tsouroufli et al, 2011;Wallace, 2014;Walsh, 2013).…”

“…Not coincidentally, its status at the top of the medical hierarchy is unchallenged and it exemplifies the detached, agentic, masculine professional ideal with its simultaneous repression of, and dependence on, care work. In many Western countries, including Australia, women in surgery remain in a numerical minority that has not substantially increased over time Tsouroufli et al, 2011;Tsouroufli, 2018aTsouroufli, , 2018bWallace, 2014;Walsh, 2013;Webster et al, 2016). Previous quantitative research of female surgeons in the US has shown they perceive being treated differently (i.e.…”

Othering of Full-Time and Volunteer Women Firefighters in the Canadian Fire Services

“…An African American lesbian may prioritise her gender, race, or sexual orientation to resist her Otherness in certain situations, but may be treated differently by individuals who are also Othered (e.g., white women) due to the intersectionality of these factors (Carby 1997;Paechter 1998;hooks 2000). Overall, Othering is a social tool used to marginalize a group and disqualify their membership into the dominant ingroup (Tsouroufli, Ozbilgin, and Smith 2011). This paper investigates Othering of women in the Canadian fire services.…”