Gender disparities among health care leaders plague the industry, but in recent years "bright spots" have emerged in health care and other sectors that show a path forward for health care organizations to increase women's representation in leadership, Lisa Rotenstein, a resident physician at Brigham and Women's Hospital, writes in Harvard Business Review.
While women make up 80% of the health care workforce, "only a small fraction of female physicians become medical leaders," Rotenstein writes. She notes, "Currently in the [United States], only 3% of health care CEOs are women, 6% are department chairs, 9% are division chiefs, and 3% are serving as chief medical officers."
In recent years, leaders in health care and other industries have explored ways to fix this gender disparity, and those efforts "highlight four priority areas" health care organizations can focus on to close the leadership gender gap, Rotenstein writes.
"Before they can make progress, health care organizations need to see how well (or poorly) women are represented among their leadership," Rotenstein writes. Part of this process, according to Rosenstein, is getting a better understanding of female physicians' workplace experiences, and measuring how they compare to their male colleagues.
Further, Rosenstein contends, "Quantification is a key facilitator of change in addressing gender imbalance." She cites the United Kingdom's Athena Swan Charter Awards as a successful quantitative measure of how well organizations support women's advancement. The Charter Awards recognize "commitment to advancement of women in higher education and research." Institutions are awarded bronze, silver, or gold designations for adherence to the requirements. Further, institutions must earn at least a Silver award to qualify for National Institute for Health Research Funding. By quantifying organizations' progress toward gender equity, the charter has initiated structural and cultural changes, increased awareness of gender issues, and established incentives for change, Rotenstein asserts.
Recognition within an organization or field can lead to promotions, but female physicians receive major awards and recognitions less often than their male counterparts, Rotenstein writes.
To prevent gender imbalance in promotions, organizations should systematize the way they recognize physician achievements, Rotenstein says. She notes that Brigham and Women's Hospital found that systematic identification of female physicians' accomplishments can reduce the gender gap that affects women early in their careers. Organizations can use similar systematic processes when appointing physicians to committees, nominating physicians for leadership roles, or searching for new physicians.
Another reason women are often overlooked for promotions is because clinical research, a male-dominant field, is favored for promotions in medicine, Rotenstein notes. Female-dominant fields like clinical education and service or less likely to be considered for awards and other forms of recognition. But some organizations, such as Duke University, are making an effort to promote physicians with more diverse career profiles to reduce the gap.
Organizations should engage not only women but men was well to improve gender diversity in leadership, according to Rotenstein.
Targeted programs like implicit bias training have been proven to quell discriminatory beliefs and attitudes toward women in medicine, Rotsenstein writes. Dell, for instance, created the Men Advocating Real change program to engage male executive leadership in efforts toward gender diversity and equity by educating male employees on issues of unconscious bias, dominant culture, and gender role conditioning in leadership.
According to Rotenstein, Dell has been able to recruit, retain, and promote more women in male-dominant fields after implementing the program.
Women do not have enough sponsorship and career advancement opportunities, Rotenstein writes, which often means female leaders are often "overburdened with mentee requests."
To increase mentorship availability, men and women should be equally engaged in sponsoring qualified women for diverse career opportunities, Rotenstein contends. For example, she notes IBM's Technical Women Pipeline Program pairs mid- and senior-level women with executive advocates for two days to establish career advancement plans. The women check in with their mentees and others in the Pipeline Program quarterly.
Rotenstein reports that the program has resulted in an increase in IBM's retention rates for mid- and senior-level women working in technology (Rotenstein, Harvard Business Review, 10/1).
Veena Lanka, MD, Senior Director
Considering women make up 80% of the healthcare workforce, the number that actually make it into the leadership ranks (3-9%) is woefully inadequate. This gap is simply too large to be attributed to a difference in qualifications alone. We and others have repeatedly raised this question in the last decade. Yet the industry has made few motions, if any, towards improving the workplace experience of female healthcare workers, expanding their career prospects, or recognizing their contributions. Instead, we've let the present-day gender gap—a result of decades of unconscious bias and societal stereotypes—persist.
“We believe this is an issue that deserves to be every hospital leadership team's agenda.”
This is particularly surprising in light of the fact that healthcare industry tends to be ahead of most others (such as financial or legal sectors) in recognizing and addressing gender disparities among the patient communities they serve. While this is commendable, it appears tone-deaf when the gender gap within their own ranks goes unnoticed.
The solutions that are usually offered focus on coaching women to navigate the glass ceiling by leaning in and speaking up. Not only has this failed to make a significant dent in the problem, it inadvertently masks the real issue. It's time for those in positions of influence to shift the burden off the shoulders of the very group marginalized by it.
We believe this is an issue that deserves to be on every hospital leadership team's agenda since it impacts their organization's ability to engage their workforce and achieve just about every system initiative. At minimum, the gender imbalance among leadership influences:
Healthcare leaders can begin addressing this issue immediately without having to launch yet another standalone campaign (to a highly change-fatigued workforce). Here are concrete ways you can integrate the tactics highlighted by the authors into existing system priorities and initiatives:
Hospitals and health systems have never been more committed to attracting, inspiring and retaining the talent they need. Yet, with limited resources and heightened competition for talent, leaders are increasingly asking what else can be done. In this series, we’ll explore one approach that can help achieve all three objectives—building a differentiated organizational culture.
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