Breaking Through Healthcare’s Glass Ceiling

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Healthcare continues to outperform many other industries in female representation at many levels. But let’s not break out the champagne just yet — at least not until more women break through the glass ceiling and into the C-suite.

Over the past decade, the number of women physicians has grown more than 43%. Unfortunately, that increase isn’t helping to close the gender gap at the leadership level. In the U.S., women lead just 20% of hospitals and a mere 4% of healthcare companies, even though nearly eight in 10 American healthcare workers are women. For women of color, the statistics are even worse: They account for nearly 20% of entry-level healthcare jobs in the U.S. and only 5% of C-suite positions.

There are good reasons to advance women physicians as leaders. Beyond providing individuals who belong to underrepresented groups with opportunities for advancement, the makeup of a leadership team plays a significant role in developing and executing strategies to achieve equity for the patients and communities that healthcare organizations serve. Patients, clinicians, and staff need to see women doctors, including those from underrepresented groups, leading other doctors.

The problem isn’t that women lack leadership skills. In fact, women performed better than men in 16 of 18 leadership categories, according to a study by consulting company Zenger Folkman. What’s holding women back is not lack of capability, but a dearth of opportunity.

Based on the research, it’s not really a problem of volume or ability — we have enough women with the skills to lead. Rather, it’s the systemic processes of developing and promoting leaders that we need to dismantle and reimagine. There are four concrete steps that we can take collectively as physician leaders to help level the playing field.

Make the business case. Several studies show that companies with women in leadership positions are more profitable than those without. An extensive study by Pepperdine University followed more than 200 Fortune 500 firms over 19 years and showed a strong correlation between promoting women to the executive suite and an 18% to 19% increase in profitability over the median Fortune 500 firm. Other research shows that companies listed on the London Stock Exchange, where at least one-third of bosses are women, have a profit margin more than 10 times greater than those without it.

Advocate for board-level engagement. Because boards of directors set the direction and strategy for an organization, they have the power to champion the hiring, mentoring, and promotion of women in the workplace. Of course, the key is to advocate for and appoint more diverse boards of directors, which brings an elevated level of interest and engagement to decisions about inclusiveness.

Encourage sponsors and mentors to raise awareness of the need for equity, inclusion, and diversity at the institutional level. It’s not enough to raise awareness of the need for more diverse leadership, or even to promote more women and people of color. The success of women, including women of color, requires intentional and intensive professional development, particularly for high-potential women and underrepresented minorities. Just as we assign metrics for success in outcomes for cancer and cardiovascular care, we need to create that kind of intentionality when developing people strategies. We need to reform institutional processes, ranging from identifying diverse hires to coaching, advancing, and promoting them.

Address unconscious biases across the organization. While nearly every Fortune 500 company now offers some version of equity, inclusiveness, and diversity training, offering such training alone is not enough. The key is to conduct company-wide surveys that invite people, under the protection of anonymity, to share how they have observed or experienced inequity and bias, and empower them to help design the solution. If possible, it’s best to conduct such a survey before implementing any new equity, inclusion, and diversity initiative so you can measure the initiative’s effectiveness.

The case for promoting women into executive, decision-making roles is strong. Organizations need to understand that more diversity at the top leads to better leadership and business outcomes. To set and stay the course will take the commitment of organizations and the persistence of the women and men who comprise them. While we’re starting to see cracks in the glass ceiling, we have a ways to go before we create a sustainable diverse leadership pipeline that shatters it.

Imelda Dacones, MD, is President and CEO of Northwest Permanente.

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