International women’s day1, an annual event, this year celebrated the social, economic, cultural and political achievements of women, but this can mean different things to different people. This article follows this by examining some of the struggles women have faced fighting for equality before focusing on some of their challenges and achievements within the dental world.
Why focus on women?
As well as ‘sugar and spice and all things nice’,2 girls are made of strong stuff and been pushing for equality for generations, but are we there yet? Perhaps, men and women alike can spare a moment of thought for the ‘fairer sex’ and consider their valuable and potentially changing role in the dental world.
Sadly women still aren’t given truly equal status to men. In the UK, we continue to debate in the media about the differences in pay received between men and women, with statistics reporting as much as a 20% difference for the same jobs.2a
It isn’t just businesses, however, that have shown inequality toward women over the years. Sport and science have as well.
In rural villages in the 16th century, women would compete in sports days for prizes that ranged from dresses to cash. However, the Victorian age saw an end to this as the exertions of running were not only seen as unladylike but were also thought to affect a women’s health and fertility. This slowed down the progress of women’s involvement in competitive sports and women’s running was only introduced into the Olympics in 1928. It then stopped until 1960 because the spectators couldn’t handle seeing a sweaty female crossing the 800m finish line! Unbelievably, it wasn’t until 2008 that women’s and men’s track programmes finally reached parity.3
In the field of scientific research there are actually more women than ever before but they aren’t being published and progressing their careers as much as men. This isn’t helped by the fact that men have a nearly 4% better chance of being successful when applying for research grants in biological sciences than women.3a
How do women view generational changes?
A report, released last year by Mumsnet and Ipsos MORI, compiled the views of the various generations of women, including those of the Baby Boomers (50-69 year olds), Generation Xers (36-49 year olds), Generation Yers (15-35 year olds) and Millennials (16 and under).4
The media often position Baby Boomers as the most fortunate generation, being financially secure home owners with their own pensions, however this report revealed some telling truths with interesting, heart-felt verbatim to the opinions collected from the other groups, showing that women of every generation struggle with some of the same issues; allowing us all an insight into the personal thoughts of other generations, whether positive and negative. The results make for an interesting read and allow all women to identify with the issues of each age group, perhaps helping both men and women alike to communicate and empathise with their issues better.4
Women in dentistry
Dentistry is considered by many as a great profession for women because of its caring nature, the freedom it offers those who run their own practices and the potential flexibility to take career breaks for children, if required. This is certainly supported by the fact that now nearly 47% of dental registrants are female,5 and that it is estimated that over half of all UK dentists will be women by 2020. Currently over 50% of dental students and dentists under 35 year olds are female.6 Despite this increase, there are now only two dental specialties where women hold a significantly larger percentage of specialists then men; paediatrics and special-care dentistry.5/6
It hasn’t always been like this though, as women back in the late 1800s struggled to even train as dentists and be accepted into the male dominated teaching establishments. Lilian Lindsay became the first qualified woman dentist in Britain, graduating from Edinburgh Dental Hospital in 1895 after being refused into the London dental schools.7
It wasn’t necessarily from the lack of desire though that women didn’t become dentists, as a piece published in the BDJ in April 1914 quoting Miss Louie M. Brooks, secretary and warden of the London School of Medicine for Women, pointed out:
“It is almost the only career which has been over looked by the middle-class women of to-day who are seeking to enter professional or business life. It is the more surprising, because the field for the activities of the woman dentists is a big one, and is practically empty of competitors. At the present time there are only three women registered dentists in London, and they are called upon to deal with more patients than they can cope with. I believe there are only two in Manchester and not more than six for the rest of the United Kingdom. The desire for them among women themselves is a steadily increasing one. That is because women have reached the stage at which, while not distrusting men, they have a greater confidence in their own sex.”8
Even now, when a cross section of clinical undergraduates at the University of Bristol were asked their ‘career intentions, work-life balance and retirement plans’, 43% of respondents felt men had an advantage over women in terms of career success - mainly due to the fact that, the female students interviewed said that they intended to take time out of their career to concentrate on looking after their children and they felt that having a child would affect their career more than males.9
So have women changed the dental workforce? A paper published in the BDJ in 2014 discussed the impact of the increased number of young women in dentistry and the impact they could have on the future workforces, considering that women are more likely to take a career break and reduce their hours afterwards.10
In fact only just under half of women dentists work full-time, the remainder practice part-time with the main reason being caring for children. Because of this and further observations in the summer of 2000, the Department of Health commissioned a review to examine the need for improvements to employment opportunities for female dentists in the NHS across England. Dame Margaret Seward carried out the review, which was published in September 2001. On its publication, it was considered important for four main reasons:
It’s good to see women in ever increasing, more powerful and influential positions in the dental world, now leading from the top with a female CDO. But it continues to be a long road.
Only 32% of women dentists surveyed in the review above owned a dental practice, stating that the benefits were being able to dictate their own working hours and working environment, allowing them to run the practice how they chose and to build their own team. More recent research supports this, showing that women manage practices very differently.6
The survey showed that practice ownership did not seem to be an overriding ambition of many women dentists, with only 27% of non-practice owners saying that they would like to. Of those who said 'no', the reasons given were that they weren’t business minded or were simply happy in their current situation, as well as that owning a practice would not fit in with their family and spouse or partner's job. Many also mentioned that the paperwork, responsibility and commitment were just 'too much hassle'.6
Perhaps this is changing as, even over the last year, there seems to have been a slow increase in females or purchasing partnership with females. “Last year 14% of all of our practice purchases were to women, and over 24% of all our purchasers were to partnerships of men and women (either work or life partners). So far this year nearly 19% of all our purchases are to women, and nearly 30% to partnerships, thereby seeing a steady decrease of the solely male buyers.” said Lis Hughes, Managing Director, Frank Taylor & Associates.
Seema Sharma, who has spoken to professionals at international women’s day events at womens’ networks and sixth-form colleges has campaigned for years for women to seek out actionable career paths. She is not only a mother of two daughters and a dentist who owns a group of practices in London, but has also completed her MBA this year and runs a dental business consultancy service as well as her own charity, ‘Child Action’, which supports underprivileged children living in poorest parts of India. Seema said, “There’s that old saying – behind every man there stands a great woman. It embodies the fact that support is essential – behind every successful woman I firmly believe there is a team and an excellent infrastructure to support her".
And it’s not just the dentists who have been as industrious, since direct access hygienists and therapists can now also set up practices,11 and while it’s not very common place, many of those who wish to make the jump, successfully have. As a profession, hygienists and therapists are predominately women with 95% of the 2,700 registered therapists being female and over 96% of the nearly 6,700 hygienists.
Christina, who qualified as a hygienist in Dundee in 1982, moved to Brighton in 1994 with her three young children and set up her practice there in 2007. Christina said of her practice, “I had a vision to open a new hygiene-led oral health care clinic on the high-street, where oral health care could become both accessible and demystified.” But how did Christina do it with three young children in tow? She said, “You have to be organised and focussed and not stray from that path. I have always had a passion for my profession and it was really having my children that pushed me to achieve what I have.” Christina has also found the time to do a number of long and challenging charity walks to raise awareness and funds for mouth cancer action month.
Earlier this year specialist dental accountant Minford undertook a survey into women’s attitudes to their dental careers. Johnny Minford, Principal, said, “We found that the way female dentists approach their careers is different to men, many especially under 35 feel there is still a gender gap in the profession. Almost a quarter of women respondents indicated that they are considering leaving the profession for other than retirement reasons, such as how the practices they work in are run, and the lack of flexibility in the workplace hindering them from returning to work after having children. We know from our long experience that women can differ in the way they run and manage practices compared to men and we hoped our results would shed light on why as well as how. In my opinion this potential exodus is draining the profession of a great deal of skill, as well as robbing women of a career in which they have invested a lot of hard work”.
Childcare, as we have seen, is a huge reason that affects a women’s dental career and the discussion about joint parental responsibility, comes up time and time again. In April 2015 there was an update of the opportunity for sharing parental leave provisions, a little behind some countries in Europe. Sweden, for example, introduced it in 1974, but it is still a step forward. These new regulations for shared parental leave (SPL) mean that working couples can decide how to share their time off and pay awards.12
However, over a year on and the government is still urging Dads to consider taking up this opportunity, with the media reporting only 1% of men taking it up from a survey conducted this year. They said it was mainly due to financial affordability, lack of awareness or unwillingness by new mothers to share their maternity leave - with 55% not wanting to share what they have always known as their own leave entitlement. This is compared to 90% of men in Sweden and Norway.13
In 2015 there were a significantly greater number of 45 year olds and younger females compared to male dentists, who claimed from Dentists’ Provident for illnesses and injuries that kept them off work.
As expected, there are certain illnesses that women tend to suffer from more than men due to their biology, meaning they are statistically more likely to claim than men. The claims received in 2015 resulted in payments of over £130,000 for breast cancer and £36,000 for ovarian and cervical tumours. For gynaecological issues, including hysterectomy, miscarriage and various complications and conditions associated with pregnancy and childbirth, we paid over £35,000. This is perhaps the reason for the significantly larger percentage paid for cancer claims in women rather than men. However you will notice that there weren’t any claims from female dentist for cardiovascular diseases, occurring in previous years as well, plus less claims paid than for men for infectious and communicable diseases.
It’s perhaps now time to embrace and celebrate the differences and similarities between the sexes and support the significant and hard won successes of the women in our profession. There is however an International men’s day,13 so watch this space for a focus on the boys…
References available on request.
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