Down with the masters in lab coats

It’s time male scientists stopped hogging all the power in experimentation, funding and research and

Scientific research requires many skills and no one has them all. It needs dreamers, pedants and leaders. It needs an environment where everything is open to questioning, and this can only happen when people don't all come from the same place and point of view. Just as science needs more people from diverse cultural backgrounds, it needs more women.

There are reasons for optimism: more girls are taking A-levels in the sciences and more of them are carrying on to do undergraduate and higher degrees in scientific fields. Yet, as young female scientists reach their mid-twenties, the numbers begin to drop. It's a vicious circle - without mentors in the subject, young people are far less likely to sign up.

In 2002, I led a team writing a report on women in science for the government, which exposed the difficulties in attracting more women into the field and then keeping them there. Sadly, the situation remains unchanged and it won't improve until there is proper investment. The new government has yet to tackle fully the question of provision for scientific research. It's a worrying silence. And the lack of funding raises many challenges that affect women in particular.

Having children hugely limits a woman's progress in any profession. A female scientist in her mid-twenties who wants a family is faced with a difficult choice. She can delay getting pregnant, which will mean waiting until she is beyond her biological optimum. In science, you might, if you are lucky, get tenure in your mid-thirties. On the other hand, those who take time out to have children in their twenties miss the crucial postdoctoral phase of their career when a scientist is first knowledgeable enough to have her own ideas and be proficient in the lab. When women who have children in their twenties return to their career, they find their male peers have published extensively. A new parent will only struggle in such a competitive field.

In 2002, I proposed making ring-fenced fellowships available to scientists who are also their children's primary carer. It wouldn't be sexist - the awards would be open to men, too. Then, the government put a pathetically small sum of money into the scheme. I would like to see similar fellowships available now. There are already schemes that work along these lines, such as the awards given out by the Daphne Jackson Trust and L'Oréal's Women in Science fellowships, which I am involved in. But even for the L'Oréal award - worth £15,000 each - there are about 200 applications for just four or five bursaries. Getting funding should not be as unlikely as winning the Lottery. But things will continue to be this way until the government puts in some serious money.

A few steps would help women in any profession. British institutions could learn from their French counterparts, some of which have crèches on site. Then there are more science-specific solutions. Job-sharing couldn't work for a research scientist, but employing technicians to complete some of the more routine work and collect data would make it possible for mothers to spend more time at home.

Unusual pressures

Above all, we need a change of culture. Think of it like the change in attitudes to fur coats. When I was growing up, ladies wore mink coats. These coats have never been the subject of legislation, but if you saw someone wearing one today, you would do a double-take. The media can play a part in portraying female scientists as good role models - using them as commentators, for example.

The mindset of male scientists also needs a bit of work. I often go to meetings and see a middle-aged senior scientist with an entourage of attractive young female graduates. On the one hand, you think: "Look at all the young women in science!" But the power lies with the male, senior scientist, like a magus with his handmaidens.

Women scientists face unusual pressures at every stage of their working life, even when they are quite senior. By then, they would be all too well aware that they are carrying the torch for women. Yet, it is at this time that they may meet particular antagonism. When someone capable and advanced in their career looks different from the norm, people feel insecure.

Over the years, women have been encouraged to make men look good and not to be too pushy. But scientific research is like a painting - it's your project, your baby. If two scientists are doing an experiment, they will have different interpretations of the results and they will see different priorities. Within a few weeks, they could be doing very different types of research, because, while the techniques are impartial, the planning and interpretation are very personal.

It's not that women need to become aggressive and arrogant; it would be very nice if men stopped being like that. But an upbeat attitude can be helpful, especially at a time of dire fin­ancial straits. There are little things scientists can do in their sector to make a difference.

For example, an initiative I'm launching, called Screening the Mind, will raise funds for research into how science and technology affect the way people think and learn, especially children. There are two aims. One is to encourage debate, but the other is to get funds for research. Ultimately, all the goodwill and cultural change is no substitute for hard cash.

Susan Greenfield is professor of pharmacology at Oxford University.

This article first appeared in the 16 August 2010 issue of the New Statesman, The war against science

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Want to know how you really behave as a doctor? Watch yourself on video

There is nothing quite like watching oneself at work to spur development – and videos can help us understand patients, too.

One of the most useful tools I have as a GP trainer is my video camera. Periodically, and always with patients’ permission, I place it in the corner of my registrar’s room. We then look through their consultations together during a tutorial.

There is nothing quite like watching oneself at work to spur development. One of my trainees – a lovely guy called Nick – was appalled to find that he wheeled his chair closer and closer to the patient as he narrowed down the diagnosis with a series of questions. It was entirely unconscious, but somewhat intimidating, and he never repeated it once he’d seen the recording. Whether it’s spending half the consultation staring at the computer screen, or slipping into baffling technospeak, or parroting “OK” after every comment a patient makes, we all have unhelpful mannerisms of which we are blithely unaware.

Videos are a great way of understanding how patients communicate, too. Another registrar, Anthony, had spent several years as a rheumatologist before switching to general practice, so when consulted by Yvette he felt on familiar ground. She began by saying she thought she had carpal tunnel syndrome. Anthony confirmed the diagnosis with some clinical tests, then went on to establish the impact it was having on Yvette’s life. Her sleep was disturbed every night, and she was no longer able to pick up and carry her young children. Her desperation for a swift cure came across loud and clear.

The consultation then ran into difficulty. There are three things that can help CTS: wrist splints, steroid injections and surgery to release the nerve. Splints are usually the preferred first option because they carry no risk of complications, and are inexpensive to the NHS. We watched as Anthony tried to explain this. Yvette kept raising objections, and even though Anthony did his best to address her concerns, it was clear she remained unconvinced.

The problem for Anthony, as for many doctors, is that much medical training still reflects an era when patients relied heavily on professionals for health information. Today, most will have consulted with Dr Google before presenting to their GP. Sometimes this will have stoked unfounded fears – pretty much any symptom just might be an indication of cancer – and our task then is to put things in proper context. But frequently, as with Yvette, patients have not only worked out what is wrong, they also have firm ideas what to do about it.

We played the video through again, and I highlighted the numerous subtle cues that Yvette had offered. Like many patients, she was reticent about stating outright what she wanted, but the information was there in what she did and didn’t say, and in how she responded to Anthony’s suggestions. By the time we’d finished analysing their exchanges, Anthony could see that Yvette had already decided against splints as being too cumbersome and taking too long to work. For her, a steroid injection was the quickest and surest way to obtain relief.

Competing considerations must be weighed in any “shared” decision between a doctor and patient. Autonomy – the ability for a patient to determine their own care – is of prime importance, but it isn’t unrestricted. The balance between doing good and doing harm, of which doctors sometimes have a far clearer appreciation, has to be factored in. Then there are questions of equity and fairness: within a finite NHS budget, doctors have a duty to prioritise the most cost-effective treatments. For the NHS and for Yvette, going straight for surgery wouldn’t have been right – nor did she want it – but a steroid injection is both low-cost and low-risk, and Anthony could see he’d missed the chance to maximise her autonomy.

The lessons he learned from the video had a powerful impact on him, and from that day on he became much more adept at achieving truly shared decisions with his patients.

This article first appeared in the 01 October 2015 issue of the New Statesman, The Tory tide