Who cares where the doctors are? The expectation of mobility and its effect on health outcomes

Brewster, Liz; Lambert, Michael; Shelton, Cliff

doi:10.1111/1467-9566.13480

Cited by 3 publications

(1 citation statement)

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“…Flexibility is used here then as a shorthand for the service and training demands on doctors to move around, and capacity for doctors to adapt to the needs of the health service in terms of their location, working hours and demands on their time regardless their personal life events and circumstances. 13 What has not been previously recognised is how this need to be flexible, particularly during training, affects access to opportunities such as higher prestige specialisms. As will be explored, we therefore frame 'flexibility' in terms of place/location, career stage, and specialism/specialisation.…”

Section: Introductionmentioning

confidence: 99%

Gender, flexibility and workforce in the NHS: A qualitative study

Chekar,

Brewster,

Lambert

et al. 2024

Health Planning & Management

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Data from the General Medical Council show that the number of female doctors registered to practise in the UK continues to grow at a faster rate than the number of male doctors. Our research critically discusses the impact of this gender‐based shift, considering how models of medical training are still ill‐suited to supporting equity and inclusivity within the workforce, with particular impacts for women despite this gender shift. Drawing on data from our research project Mapping underdoctored areas: the impact of medical training pathways on NHS workforce distribution and health inequalities, this paper explores the experiences of doctors working in the NHS, considering how policies around workforce and beyond have impacted people's willingness and ability to continue in their chosen career path. There is clear evidence that women are underrepresented in some specialties such as surgery, and at different career stages including in senior leadership roles, and our research focuses on the structural factors that contribute to reinforcing these under‐representations. Medical education and training are known to be formative points in doctors' lives, with long‐lasting impacts for NHS service provision. By understanding in detail how these pathways inadvertently shape where doctors live and work, we will be able to consider how best to change existing systems to provide patients with timely and appropriate access to healthcare. We take a cross‐disciplinary theoretical approach, bringing historical, spatiotemporal and sociological insights to healthcare problems. Here, we draw on our first 50 interviews with practising doctors employed in the NHS in areas that struggle to recruit and retain doctors, and explore the gendered nature of career biographies. We also pay attention to the ways in which doctors carve their own career pathways out of, or despite of, personal and professional disruptions.

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Section: Introductionmentioning

confidence: 99%

Gender, flexibility and workforce in the NHS: A qualitative study

Chekar,

Brewster,

Lambert

et al. 2024

Health Planning & Management

Self Cite

View full text Add to dashboard Cite

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Who cares where the doctors are? The expectation of mobility and its effect on health outcomes

Brewster

Lambert

Shelton

2022

Sociology Health & Illness

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Doctors are typically portrayed as active agents in their work lives. However, this paper argues that this construction of agency ignores the effects of the healthcare structures that constrain choice, which in turn affects population health outcomes. Medical training pathways, regional boundaries, and rationalisation all have a long-lasting impact on the provision of healthcare. Using a mobilities lens to examine the movement of doctors, this paper examines how the expectation of movement built into training programmes perpetuates unequal access to healthcare. Long waiting times, poor care quality and lack of preventative care all perpetuate health inequalities; as one of the socio-economic determinants, access to healthcare affects health outcomes.

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