Gender and organised dentistry
Liam Lynch puts forward the case for and against gender–based units within national dental associations
All countries of the EU have national dentist representative organisations (DROs), often called Dental Associations or Dental Chambers. The primary role of national DROs is to “defend the interests of individual members and the dental profession as a whole” 1.
In several countries, the representative organisation is also the official trade union for dentists. Typically, DROs have official units (often termed committees) as part of their structure to look after special interest groups among their members.
Examples of such units might be a Public Dental Surgeons Committee or a General Practitioner Committee. This article is concerned with gender based units. To avoid repetition, the focus is on women’s committees.
The case for a Women’s Committee
Fitzsimmons and Callan produced a report in 2015 called Filling the Pool: Achieving Gender Equality is Everyone’s Responsibility2. In it they note 13 factors behind gender inequality.
Organisational culture describes the internal environment of an organisation that encompasses the assumptions, beliefs and values that members both create and replicate to guide their functioning3. Healy and Kirton4 believe it makes sense for unions to pay attention to gender based issues in their organisational culture: “The feminisation of the labour market in recent decades means that there is also a business case for unions to develop and sustain gendered policies of attraction and retention [of women]”. Caiszza states that: “Unions can also support women’s leadership by providing space for them to address their issues and obstacles as union women. This can be done within training programmes, conferences, women’s committees, and networks at the local, regional and national levels.”5
With regards to the feminisation of dentistry, the conclusions of Jones, Schmitt and Woo6 are relevant: “As women move toward majority status in the labour movement, the potential for unions to contribute to a broader work family agenda can only increase.” Cobble7 argues that gender differences must be accommodated and that equality could not always be achieved by applying an identical standard of treatment to men and women. Thus, a women’s committee might support women dentists through the establishment of networks and to increase contacts of women in similar situations.
Colgan and Ledwith8 quote an activist as saying: “the women’s committee sit and look at the position ongoing in the industry and look at things that affect women”. Female role models already active may encourage women to join organisations by mentoring9. Ehrich10 synopsises the functions of mentoring to include encouragement, friendship, advice and feedback, as well as helping individuals develop a sense of competence, confidence and effectiveness. Golding11 examined the gender distribution in Royal Australian and New Zealand College of Psychiatry committees. She concludes that the college could improve equality in college committees by adopting strategies which may include the formation of women’s committees.
As leaders, or opinion formers, in organisations, there are significant differences between men and women according to Eagly and Carli12. Research regarding democratic versus autocratic leadership styles conducted by Van Engen and Willemsen13 suggests that women tend to adopt a more democratic or participative style than men. The causes of gender disparity in leadership roles in organisations are well established in the academic literature12,14,15.
There is also literature on the different manner in which males and females act on committees. For example, Steinmayr and Spinath16 found that men are more likely than women to overestimate their ability to fulfil roles with which they are unfamiliar. In addition, shyness is more socially acceptable for females, at the expense of self–confidence or assertive behaviours according to Coplan, Doey and Kingsbury17. Explanations of gender disparity in social structures must go beyond biological reasons18,19,20. Theories of gender difference suggest that women and men are motivated by different concerns when participating in allocative decision–making processes such as those engaged in by committees.
Kennedy21 suggests that women are more likely than men to be motivated by altruistic concerns and to have a preference for a universalistic solution. Men are more likely to be motivated by self–interest and prefer a competitive solution. More recent work has pointed to differences in preferences and psychological attitudes between males and females: less competitive behaviours, greater risk aversion and less bargaining attitudes in females22.
The challenges facing women on entry into a role in a representative organisation can be summarised under five headings: childcare; cash; confidence; culture; and candidate selection procedures. Each of these challenges needs to be addressed, and it is clear from experience elsewhere that a whole package of reforms is necessary23. Lovejoy and Stone24 noted, in a study of professional women, that 86 per cent of respondents cited long and inflexible work hours as significant factors in their decision to quit their organisations.
Formerly, the type of committee was often gender based. Men were preferred for membership of compensation, executive, and finance committees, and women were preferred for membership of public affairs committees25. Formal gender equality policies are often utilised to counteract this tendency. However, Mellor found no evidence of their presence in her survey of national dentist representative organisations26. To summarise this section: a women’s committee may be an environment where, particularly a newcomer, or perhaps a longstanding member of a representative organisation, may feel at home and flourish. For this reason alone it may have merit.
The case against a women’s committee
The necessity for a woman’s committee in a professional representative organisation has been questioned27. The possibility that a women’s committee encourages gender stereotyping is one problematic area. Pillay28 emphasises that gender stereotypes about women’s roles are deep–seated. Gender stereotyping has been clearly identified in the UN Convention on the Elimination of All Forms of Discrimination against Women, as something that impedes the achievement of gender equality and the empowerment of women.
Negative stereotypes hinder people’s ability to fulfil their potential by limiting choices and opportunities. They are at the root of overt and covert, direct and indirect, and recurrent gender discrimination, which adversely affects the de jure and de facto substantive equality that should be guaranteed to women in representative organisations.
Stereotypically, males are expected to act agentically with aggression and competitiveness, whereas females are expected to act communally with interpersonal sensitivity29. Babcock, Bowles and Lai30 believe that women are negatively evaluated by followers when they engage in assertive behaviour, whereas men are not. The formation of a women’s committee may, in some people’s minds, reinforce this negative stereotypical expectation of women members.
Some bodies consider it important that dentists should not be identified primarily by gender. For example, typically the registers of dentists, maintained by the competent authorities of EU states, do not explicitly identify the gender of their registrants. Many believe that female dentists should be part of the mainstream in the representative organisation and should not be marginalised into a ’Women’s Committee’. Otherwise, individual dentists may be “channelled into gender–specific portfolios, creating glass walls” 31. Recent research suggests that dentist gender is not an issue for patients when it comes down to the treatment process32. Correspondingly, the formation of a women’s committee in a DRO might not be an issue.
Prevalence of gender–based committees
Up to now, the prevalence of gender based committees in DROs has received little attention. This paper reports on a survey of the national DROs in the EU. The purpose of the survey is to establish the prevalence of gender–based committees in these organisations.
A web–based survey, utilising SurveyMonkey, of the main national DROs of the EU was carried out during December 2015 and January 2016. Twenty eight organisations, corresponding to the 28 member states of the EU, were surveyed. The DROs and their email addresses were as described in the EU Manual of European Dental Practice. An email was sent to each DRO containing a link to the survey. The survey was composed of five questions. The survey was confidential; no individual DRO was identifiable in the results.
In the web–based survey of EU national DROs, completed surveys were returned by 14 national organisations representing a 50 per cent response rate.
Q1. Does your organisation have a unit or units (e.g. a Committee, Subcommittee or Interest Group) with a membership based on gender? Examples might be a Women’s Committee or a Men’s Committee.
Twelve organisations (86 per cent) answered no and two (14 per cent) answered yes.
If the answer to Q1 was yes, they were directed to continue to Q2 and Q3. If the answer was no they were asked to skip to Q4.
Q2. Does the unit (or units) have similar powers within your organisation as other units, whose membership is not based on gender, such as, for example, general practitioner committee or specialist committee? The term powers might include voting rights, funding, size etc.
One organisation answered no and one answered yes.
Q3. Is membership of this unit (or these units) confined to one gender i.e. membership must be all males or all females?
Two organisations answered no. No organisation answered yes.
Q4. Does your organisation have plans to introduce a gender–based unit in 2016?
Thirteen organisations answered no and one organisation answered yes.
Q5. Do you have any comments on this Survey? Please write them here.
Two organisations made comments in their reply to Q5. One was: “In (…) there are more women than men working as a dentist. This can also been seen in our committees, e.g. in the Committee of Continuing Education we have 13 members (11 women and two men) and in the board of our Society we have 11 members (eight women and three men).”
The other comment was: “I would be interested to learn of your survey findings and would be pleased to assist further as you wish.”
No other comments were returned in the survey.
The response rate (50 per cent) in the web–based survey was satisfactory. Two DROs (14 per cent) said they had a gender–based sub unit in their structure. A further one DRO (7 per cent) said they were planning to introduce a gender–based unit. Both of the DROs which responded said membership of their gender–based committee was open to males and females.
There are strong arguments for and against gender based committees in dentist representative organisations. Gender–based committees are an unusual feature in the structure of the main national dentist representative organisations in the EU. Currently, few DROs plan to introduce gender–based units. Where they do occur, membership is open to male dentists and female dentists.
About the author
Liam Lynch BDS MDPH PhD is a dentist practising in Cork City, Ireland. He has more than 34 years’ experience of active involvement in publicly–funded dentistry. He lectures on the topic of healthcare fraud to MSc students in Healthcare Law and Ethics at the Royal College of Surgeons of Ireland in Dublin. He has published and lectured internationally on probity assurance systems in oral healthcare.
In 2013, he was awarded a PhD from The National University of Ireland for his thesis The Counter Practitioner Fraud in Publicly Funded Dentistry Index – A New Dental Instrument.
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