Hallam-Jan-Oct13If the profession can respond to discrimination, can it not do the same for incompetency?

Twenty years ago, I had the good fortune to be paid to study this beautiful painting below as part of a PhD project. Agnolo Bronzino’s Renaissance allegory, Venus, Cupid Folly and Time, has us all pondering how much fun it must’ve been back in 1545 when Aggie was a boy.

This past month I have had cause again to gaze on its many layers for the seemingly unlikely connection with Female Genital Cosmetic Surgery (FGCS), which, growing evidence suggests, is becoming increasingly common.

The shock and awe of the statistics is not that plastic surgeons are being kept busy trying to ‘fix’ nature’s imperfections, but that the world must be full of such high anxiety that women with healthy genitals are choosing to have their labia minora incised, their clitorises snipped and their vulvas plumped because they are ashamed/horrified/dissatisfied (or all of the above) with themselves.

venus-cupid-folly-and-time-by-agnolo-bronzinoAgnolo Bronzino’s Venus Cupid Folly and TimeThis ‘body-shame’ is not a modern phenomenon. Let’s return to the Bronzino and gaze wondrously at Venus’s mons pubis as have many before us. Not a whisker to be seen, in fact nothing to see at all – and this is the Goddess of Love, the paragon of all that is beautiful, alluring, sacred and desirable.

Given that Bronzino looked to the ancient Greeks and Romans for his artistic cues, we can account for at least the past 3000 years of female body shaming and that is just among the intelligentsia. The pornography industry goes back equally as far and has influenced a much bigger audience.

Now I can feel a rolling of eyes and an itch to turn the page because some of you can sense a feminist diatribe coming and you could be right. Some good old-fashioned hard stares are in order when you are writing the leader for the annual Women’s Issue.

However, an even more dazzling feat than just another drum-beating session would be to connect this powerful picture to the culture of bullying in the profession. And also, perhaps, the Medical Board’s poorly thought-out push for revalidation.

In March last year, senior vascular surgeon Dr Gabrielle McMullin launched her book, Pathways to Gender Equality: The Role of Merit and Quotas, and told the audience: “What I tell my trainees is that, if you are approached for sex, probably the safest thing to do in terms of your career is to comply with the request.”

The irony was lost on a few, but for the vast majority it bore testament to the entrenched sexism and bullying values endorsed by the decades of silence from senior echelons of the profession. It opened a hornet’s nest that stung a few Colleges into action. RACS, pleasingly, because it was towards its fellows that the accusations were directed, were the first to conduct an inquiry and subsequently publish new guidelines.

Last month, a year on, AMA WA announced its survey of 1000 members that overwhelmingly supported the contention that bullying and sexual harassment is rife in the profession.

Has this horse at last escaped the clutches of the old boys’ network?

Let’s hope so, because if this enormous issue can be addressed maturely by the Colleges, so too can the equally painful and divisive issue of doctor competency.

Revalidation is perhaps the bluntest of instruments to keep the medical workforce practising safely. Its CME components are already part and parcel of a doctor’s professional life and no manner of exams will weed out doctors who should be retired or sacked.

However, College networks that seek to maintain the high standards of their members are in a unique position to identify poor performers and to bring them up to scratch, slide them into retirement or cancel their fellowships. This is a professional issue and not one for the bureaucrats at the Medical Board or its crazed love-child, AHPRA.

This is about equality and professionalism, not cronyism or misplaced loyalty. It’s about recognising Folly and Time’s winged chariot. There is a great opportunity here to avert an overwhelming disaster.