Medscape UK Social Issues Report 2022
Healthcare access, climate change, drug use, domestic violence, racial disparities, gender discrimination, LGBTQ+ rights, and immigration/refugee issues are just some of the social issues that doctors have to deal with at work. How concerned are doctors about these issues, which is the most important, and how do doctors feel about them?
We surveyed 467 UK physicians from May to August to find out.
Medscape UK Social Issues Report 2022
Of the issues that doctors said were most important to them, healthcare access came in at the top for 2 in 5 (38%) of those taking the survey. This was followed by climate change (21%), with racial disparities and drug/substance abuse tied at 11%. Domestic violence and 'other' were tied at 6%. Immigration followed at 4%, with gender discrimination close behind at 3%. Only 1% of doctors listed LGBTQ+ rights as the most important.
Interestingly, more women felt that climate change was the most important issue (25% to 18%), while more men felt that racial disparities and drug/substance abuse was the most important (12% to 9% and 13% to 7%, respectively). Age seemed to be a factor as more doctors aged 45 and older chose healthcare access (40%) and climate change (22%), compared to those under 45 (31%, 13%, respectively).
If you grouped the top five choices together, healthcare access was amongst the top 5 for just under 9 out of 10 doctors (88%), followed by racial disparities (72%), climate change (66%), domestic violence (64), immigration/refugee policies (56%), and gender discrimination (45%). Only 1 in 5 (21%) listed substance abuse in the top 5, and only 16% said LGBTQ+ should be in the top 5.
For the top 5, gender also showed some differences as more women felt gender discrimination and domestic violence should be included (50% compared to 41% in men, 71% vs 60%, respectively), while more men felt that racial disparities were a priority (78% men to 66% women). Those 45 and older were also more likely to include climate change (70% to 59% of those <45), while younger doctors were more concerned with racial disparities (84% to 68% in those 45 and older).
Level of Concern Over Social Issues
Medscape UK Social Issues Report 2022
Level of Concern Over Social Issues
When asked about the level of concern over social issues - 'very', 'moderately', or 'not very' - differences were noticeable across gender and age. More women doctors were 'very concerned' about climate change then their male coworkers (81% vs 61%), while more men were 'not at all' or 'not very' concerned about the issue (20% vs 7%). More doctors aged under 45 were 'very concerned' about racial disparities compared to those 45+ (75% vs 57%). Younger doctors (67%) and women (66%) were also more concerned about immigration/refugee policies than those older (52%) or male (49%).
The majority of men and those older were 'not at all concerned' (45% and 39%, respectively) with gender discrimination, while the majority of women and younger doctors were 'very concerned' (57% and 58%, respectively). Domestic violence was also a subject that had more women 'very concerned' (73% vs 56% of men). Meanwhile, the majority of respondents across all ages and sexes were 'not very concerned' about LGBTQ+ rights.
Medscape UK Social Issues Report 2022
Half (50%) of doctors said they or their family had been personally affected by healthcare access. About a third had been affected by climate change (34%) and racial disparities (31%), while a quarter had been affected by gender discrimination (25%). About 1 in 5 (19%) said that neither they nor their family had been affected by any social issues. This was followed by 17% for immigration/refugee policies, 13% by drug/substance abuse, 12% by domestic violence, and 6% by LGBTQ+ rights.
Younger doctors (under 45) were more likely to be affected by racial disparities than older ones (46% vs 29%), as well as by gender discrimination (41% vs 22%) and immigration/refugee policies (28% vs 15%). Women were more likely to be personally affected by gender discrimination than men (43% vs 13%), as well as domestic violence (16% to 9%).
Six in 10 (60%) reported that social issues had affected their job or medical practice. This number was higher for women than men (70% vs 53%).
Medscape UK Social Issues Report 2022
Perhaps unsurprising given the British penchant for a 'stiff upper lip', about 4 in 10 UK doctors said they felt 'anxious' when thinking about social issues (43%), while about a third said they felt either 'stressed' (33%) or 'angry' (32%). About 1 in 10 felt 'neutral' (13%), 'optimistic' (12%), or 'no particular emotion' (9%).
On the other hand, about 4 in 10 doctors also said that they had helped raise money for or donated to a charity/organisation that aids social issues (44%). A similar number (41%) said they had not participated in any activism related to a social issue. A quarter said they had volunteered time to help people with a social issue (25%) or posted on social media about a social issue (24%). About 1 in 10 said they had attended a protest or rally about a social issue (12%). Women were a bit more likely to have attended a protest or rally (20% vs 8% in men) or to have raised money or donated to a charity (55% vs 40%), while men were more likely to have not participated at all (46% vs 31% in women).
Medscape UK Social Issues Report 2022
Almost 6 in 10 (57%) reported discussing social issues with patients. Women doctors were more likely to have these discussions than male doctors (71% vs 49%).
Four in 10 (44%) said that professional medical organisations were not doing enough to address social issues. About a third felt that these organisations were doing enough. Men and older doctors were more likely to say the latter (14% men vs 7% women; 14% doctors 45+ vs 5% doctors <45).
Over half of doctors (53%) thought the physician community was doing enough to help address disparities across gender, race, religion, sexuality, etc., while a third (31%) didn't feel enough was being done. Women and younger doctors were more likely to say that doctors were not doing enough (38% women vs 28% men and 40% doctors <45 vs 28% doctors 45+).
Medscape UK Social Issues Report 2022
A sign of current troubles in the NHS with waiting lists, more than 9 out of 10 (91%) doctors said that they had seen an increase in patients having trouble accessing medical healthcare services in the past 5 years. Of the remaining, 5% said they had not seen this, while 4% said they were "unsure".
In addition, 92% said that COVID impacted the overall quality of care. Only 5% disagreed, while 3% said they were "unsure".
Doctors overwhelmingly felt that COVID had negatively affected health care in the UK. Just under 8 out of 10 (79%) said they thought health care would be worse after the pandemic, while 1 in 10 thought it would be the same (11%) or better (10%). Women tended to be more pessimistic than men, with more women thinking it would be worse (83% to 76%) and less thinking it would improve or stay the same (18% to 24%). Younger doctors were also more pessimistic, with more thinking it would be worse (83% to 78% of those 45 and over) and less thinking it would get better after (5% to 12%).
Nine out of 10 (90%) of the doctors surveyed said they had seen an increase in patient waiting lists, with only 3% saying they had not seen this, and a further 7% saying they were "unsure". Furthermore, a majority of doctors (57%) reported that they have seen more patients turning to private medical care in the last 5 years, while 42% said they were unsure or had not seen this trend.
Medscape UK Social Issues Report 2022
More than 2 out of 3 (34%) doctors felt that the NHS model was the best for the UK. One third thought a hybrid model of private and public was the best (34%), while only 3% were in favour of moving to a completely private model. The number in favour of private-only moved up to 7% if you looked at those aged under 45.
The NHS model was especially favoured amongst women (68% vs 60% in men), and those aged 45 and older (64% to 56%). Of those that chose the hybrid model, they tended to be men (36% mean to 29% women) and under 45 (37% vs 33% in those 45 and older).
Climate Change
Medscape UK Social Issues Report 2022
Climate Change
More than 8 in 10 doctors felt 'climate is a major current threat to humanity' (84%) and that it 'needs to be a top priority for all countries' (84%). About half disagreed that the UK was doing a good job of combating climate change (49%), while slightly over half (55%) agreed that climate change is having a direct effect on their patient's health. While the majority of respondents could neither agree nor disagree whether the danger of climate change was 'overstated' - more agreed (15%) than disagreed (9%).
Racial Disparities
Medscape UK Social Issues Report 2022
Racial Disparities
More than 8 out of 10 doctors (83%) felt that there is still a need in the UK to address racial inequality, while 9% disagreed. Almost two-thirds (64%) felt that, in general, people in the UK are treated differently based on race, while 23% disagreed. Women and younger doctors felt stronger about this than men or older doctors (71% to 59%, 70% to 62%, respectively). Slightly more than half (53%) felt that great strides had been made in the UK towards fixing racial inequality, while 23% disagreed. Here, it was mostly men and older doctors that agreed (57% vs 47%, 56% vs 46%). Slightly under half (48%) felt that, in the medical field, patients are treated differently based on race, while 37% disagreed. Women and younger doctors tended to feel stronger about this (58% vs 42%, 60% vs 44%).
On a positive note, more than half (52%) of doctors said that they did not see any racial disparities at their work. About one third (33%) said they did, while 15% were 'unsure'. While men and women agreed on not seeing racial disparities at work, the majority of doctors under 45 said they had seen racial issues at work (44% 'yes' vs 37% 'no') than doctors 45 and older (58% 'no', 29% 'yes'). When asked if doctors witnessed racial disparities in the treatment of patients, about two-thirds said 'no' (63%), while about a quarter (23%) said they had, and 14% were 'unsure'.
Medscape UK Social Issues Report 2022
During the COVID pandemic, the UK allowed abortion pills to be taken at home via telemedicine. Asked if they thought this practise should continue almost half (49%) said 'yes' to it remaining at home. About one third (36%) thought abortion pills should continue to be distributed in clinics, while 14% disagreed and 19% were 'unsure'. Women felt stronger about this continuing at home than men (67% vs 37%).
Asked if the NHS should increase the use of abortion pills, almost half (49%) said 'yes' and the pills to be used 'at home', 41% also agreed, but for the pills to be distributed at hospital, while 30% did not agree. Again, women felt strongest about their use at home (65% vs 39%). Younger doctors also agreed with home use compared to older doctors (60% vs 48%).
Lastly, almost half of doctors (48%) felt that the NHS should expand access to in vitro fertilisation to patients. One-quarter (26%) disagreed, while one quarter (26%) were 'unsure'.
Immigration Laws
Medscape UK Social Issues Report 2022
Immigration Laws
With staffing shortages, many UK health workers are now immigrating from other countries. Asked what they thought of UK immigration laws, almost half (45%) of doctors said they felt they were 'too restrictive'. Similar numbers followed on if the laws were 'appropriate' (17%), 'not restrictive enough' (18%), or if they were 'unsure' (20%).
However, most also felt that 'immigrants were being denied rights that they should have' (42% agreed, 31% disagreed, 27% 'unsure')
Medscape UK Social Issues Report 2022
More than two-thirds (69%) of doctors said they did not see any disparities in medical care towards LGBTQ+ patients, while 13% said they had, and 18% were 'unsure'. Women were more likely to say they had seen disparities than men (21% vs 5%), while older doctors were more likely to say they hadn't than younger doctors (74% vs 45%).
Almost 9 in 10 doctors (87%) felt that people who identify as LGBTQ+ should have the same rights and privileges as anyone else, while only 2% disagreed. More than half (57%) felt that LGBTQ+ people experience discrimination, while 19% disagreed. Nearly half (49%) agreed that LGBTQ+ people currently have 'adequate' rights and equality, while one quarter (24%) disagreed, and 28% were 'unsure'.
Medscape UK Social Issues Report 2022
Three-quarters (76%) of doctors felt that society has greatly improved in recent years in regards to gender discrimination, but over 4 in 10 (46%) doctors disagreed that the current level of gender equality in the UK was 'acceptable'. Almost half (47%) also disagreed that, in general, women have the same opportunities as men in the UK, and 61% felt that there was still 'a long way to go' towards gender equality in the UK.
Women were more to disagree with the idea that society has improved in recent years (20% vs 7% in men), and they were also more likely to disagree that the current level of gender equality is acceptable (65% to 35%). Women were also more likely to feel that improvement was needed toward gender equality (77% vs 52%), and women were more likely to disagree that women had the same opportunities as men (62% vs 37% in men). More men felt that women had the same opportunities as them (44% vs 28% of women).
Medscape UK Social Issues Report 2022
Asked if, in the past 5 years, they or someone they knew had experienced gender discrimination in the workplace, almost half of doctors (48%) said they had from patients, 4 in 10 (41%) said they had from colleagues, while a third (35%) said they hadn't. Women and younger doctors were much more likely to report this from patients (58% vs 39% in men, 65% vs 42% in older doctors) and from colleagues (62% vs 27%, 57%, 35%, respectively).
Only about half (47%) doctors were required to complete any workplace harassment prevention training at work, whether via class or seminar (21%) or on their own time (26%). About 4 in 10 (39%) doctors said they were not required to attend any training, while 15% were 'unsure'.
Gender Discrimination in Pay
Medscape UK Social Issues Report 2022
Gender Discrimination in Pay
The majority of doctors (62%) said that they were not aware of any wage discrepancies based on gender at work. About 2 in 10 (21%) reported that they were aware of gender-based pay discrepancies, either in their current workplace (8%), previous one (8%), or both (5%). Women and younger doctors were more likely to be aware of pay discrepancies, while men and doctors 45 and older were more likely to not be (76% men vs 41% women, 66% doctors 45+ vs 48% doctors <45).
Medscape UK Social Issues Report 2022
Almost 6 out of 10 (58%) doctors felt that more needed to be done in regards to domestic violence. Women and older doctors were more likely to report this (67% women, vs 50% men; 60% doctors 45+ vs 50% doctors <45). Asked if they had ever notified the police or social services about a potential domestic violence incident involving a patient, 4 in 10 (44%) said they had, while over half (51%) had not. Women and younger doctors were more likely to have reported an incident (53% women vs 36% men; 50% doctors <45 vs 41% doctors 45+).
Less common was dealing with domestic issues amongst colleagues. Less than 1 in 10 (7%) doctors had ever notified the police or social services about a potential domestic violence incident involving a colleague.
Medscape UK Social Issues Report 2022
Asked how often doctors see patients with substance abuse issues, 8 in 10 said 'often' (43%) or 'sometimes' (39%). Only 2 in 10 said 'rarely; (15%) or 'never' (3%). Asked about the number of patients with drug/substance abuse issues during the pandemic, half (51%) said they stayed the same, while 44% felt that they had increased. Only 5% said they decreased during the pandemic. Younger doctors were more likely to say that drug issues had increased during the pandemic (58% of doctors <45 vs 40% doctors 45+).
There were mixed results when asked about what is the greatest harm caused by drug/substance abuse: 45% felt was the damage caused to the user's health, while 43% felt it was the associated crime. This was followed by loss of the user's potential (29%), financial cost to public agencies (24%), and unnecessary death (21%).
Medscape UK Social Issues Report 2022
About 2 in 10 (19%) doctors felt that drug/substance abuse was a very significant or significant problem amongst doctors, while more than half (56%) did not think it was a significant problem. More women felt it was 'somewhat significant' than men (34% vs 17%).
As to whether or not drug use had changed over the pandemic amongst physicians, more than half (56%) felt it had stayed the same, while 39% felt it had increased. Only 6% said it had decreased.
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