‘A bit of a boys’ club’: Female doctors locked out of lucrative work at top hospitals

Female doctors claim a “boys’ club” at two major private hospitals is locking them out of lucrative work providing anaesthesia during childbirth, which can pay up to $10,000 a day.

A leaked analysis of rosters from St Vincent’s Private Hospital shows that male anaesthetists secured 83 per cent of obstetric shifts over an eight-month period, with their female counterparts securing just 17 per cent of available work.

At the Epworth, male anaesthetists secured 81 per cent of obstetric shifts.

The situation has prompted St Vincent’s to hire an independent third-party to audit its obstetric roster for anaesthetists, and raised broader concerns about gender imbalances in the medical profession.

Australian and New Zealand College of Anaesthetists (ANZCA) president Dr Tanya Selak said gender inequity was a systematic issue.

“While we do not know the exact circumstances behind the rostering examples highlighted, gender disparities in the provision of anaesthesia services are concerning given our focus on this issue,” she said.

While women anaesthetists secured just a fraction of the obstetric work at the two major private hospitals between August and April next year, they make up 36 per cent of ANZCA fellows and 43 per cent of trainees.

One female anaesthetist, who did not want to be identified because she feared retribution, said a group of male anaesthetists were securing the bulk of the sought-after shifts.

The medical specialists provide pain relief to women during birth by administering epidurals and spinal blocks.

“It’s a bit of a boys’ club,” said the anaesthetist, who works across the two hospitals and compiled the analysis. “If I speak out and put my name to it, I will be denied the opportunity to work on the roster.”

She said many women giving birth expected to be cared for by women.

Another anaesthetist said the tightly held roster was controlled by a small group of men.

“It is so opaque,” they said. “It is not clear how you get on the roster. It’s really questionable.”

A St Vincent’s spokeswoman said the health service was aware of concerns about its anaesthetist roster for obstetric procedures at its private hospital in Fitzroy. She said an independent audit would ensure that anaesthetists had confidence in the roster’s administration.

“We value the expertise and contribution of all anaesthetists working across our hospitals and are committed to providing a workplace that is safe, fair and inclusive,” she said.

The analysis of roster data from the two hospitals, which ran from August 21 to April 18 next year, found that women anaesthetists secured 315 of 1753 available obstetric shifts. Rosters are usually published eight months ahead.

Epworth’s director of anaesthesia and pain medicine, Dr Jane Anderson, said an eight-member committee, comprising five males and three female anaesthetists, advised on the operation of the roster.

“Epworth’s priority is ensuring women receiving obstetric care have access to appropriately qualified and experienced specialist anaesthetists at all times,” she said.

She said available opportunities on the roster were offered through an expression-of-interest process.

Anderson said the hospital looked forward to discussing the outcomes of St Vincent’s rostering review and exploring ideas to further improve gender representation.

“We will continue to strengthen female representation across anaesthesia and support equitable opportunities for appropriately qualified specialists.”

The Epworth and St Vincent’s have long shared an on-call obstetric anaesthetist roster to provide reliable coverage across both health services, which are located close to one another.

An anaesthetist involved in creating the roster defended the process in an email sent to staff last month, saying shifts at the Epworth were “allocated using a rolling system that considers both previous contributions and the number of shifts each person has received”.

“This is not personal, and I do not favour any individual,” he wrote.

He said St Vincent’s roster framework has been established long before they stepped into the role, with shifts allocated with the oversight of the medical directors and with consideration of historical roster contributions.

“[T]hose who have contributed consistently have generally been given appropriate recognition in shift allocations.”

The email said there had recently been an effort to improve the gender balance of the roster, “which had previously been heavily male-dominated”.

Aggrieved female anaesthetists are revisiting the findings of a 2010 Australian Competition and Consumer Commission investigation into anticompetitive arrangements involving anaesthetists at St Vincent’s Private Hospital Sydney.

The watchdog found that for two decades, medical specialists in the hospital’s anaesthetics department had unlawfully allocated all permanent work among themselves, in violation of the Trade Practices Act.

As a result, the hospital was required to take full responsibility for shift allocations, stripping this role from the department of anaesthetists.

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