Cracking the Glass (Hospital) Ceiling: Gender Diversity in Health Care

Though women make up 75 percent of the health care workforce, and are the primary decision-makers when it comes to their families' health care needs, they are still underrepresented when it comes to leadership roles in the industry. Women are also earning bachelor's and graduate degrees, like those available through online Master of Health Administration programs, at higher rates than men, which means there will be a growing number of highly prepared female leaders available to bridge the persistent gender gap in the 21st-century world of health care. As health care organizations continue to become more complex, the need for excellent leaders is increasing, making it essential to hire and retain talented women executives in order to thrive in today’s increasingly competitive environment.

Lagging Positions—and Pay

According to a 2012 study by the American College of Healthcare Executives, women attained CEO positions at half the rate of men, and only about 26 percent of CEOs overseeing U.S. hospitals were women. Despite having nearly the same amount of experience and level of education, the female care managers surveyed in 2011 earned about 20 percent less than their male counterparts. This represents a gap comparable to prior studies in 1990, 1995, 2000 and 2006.

Rock Health, a venture fund that supports digital health startups, reported similar results in “The State of Women in Healthcare 2015," noting that "women represent only 21 percent of executives and 21 percent of board members at Fortune 500 health care companies. Of the 125 women who carry an executive title, only five serve in operating roles as COO or president. And there's only one woman CEO of a Fortune 500 health care company." However, the organization also observed that hospital diversity was slightly better: "At Thomson Reuters 100 Top Hospitals, women make up 27 percent of hospital boards, and 34 percent of leadership teams. There are 97 women that carry a C-level title at these hospitals and 10 women serve as hospital CEO."

Contributing Factors

As an indication of the slow pace of progress, it was 1995 when the Glass Ceiling Commission first identified four categories of barriers that were preventing women from advancing into senior management positions: societal, governmental, and internal business and business structural barriers. Unfortunately, many of these conditions exist today in a variety of iterations, such as:

  • The lack of flexible working arrangements to care for family.
  • The lack of comprehensive federal paid parental leave policies.
  • A persistent wage gap.
  • An inability to access informal networks that are key pipelines for promotion.
  • Lower levels of confidence and career ambition.
  • The lack of a sponsor to promote their skills and abilities with others to help them climb the organizational ladder.
  • Gender stereotypes and communication differences.

Rock Health co-founder Halle Tecco wrote that of the 400 women in health care surveyed, 96 percent of them believe gender discrimination still exists and almost half cited gender as "one of the biggest hurdles they've faced professionally." Tecco noted that these are not just one-time events, but "microinequities" that accumulate over a woman's career and create work environments that keep women from advancing.

The American College of Healthcare Executives concurs: "It is not simply one barrier at the very top, but rather myriad obstacles at many junctures. To promote gender diversity and help ensure a pool of qualified women candidates for the most senior positions, health care organizations need to look not only at policies affecting the promotion of women to the C-suite or the top leadership positions, but also at policies affecting the development and retention of female executives at every level."

Making Progress

In an effort to better understand current sentiments on gender diversity, Rock Health surveyed 50 individuals, 38 women and 12 men. Findings revealed a positive trend in how women view opportunities for career development, although some felt that gender discrimination is still an issue across all health care entities. However, of the women who identified such discrimination, 76 percent said they see equal opportunities for career development within their organizations and 95 percent "felt respected by their colleagues without having to change their behaviors to fit in."

Such positive sentiments are likely due to specific efforts that some health care systems and companies are making to close the gender gap. In Rock Health’s survey, improvements in the hiring process were the most common types of initiatives cited, including experimenting with job titles to attract a wider pool of applicants and being more specific in the recruitment search in terms of finding women executives. Other diversity initiatives cited include recognition and promotion policies, mentorship programs, and women in leadership programs.

The American College of Healthcare Executives survey, which included 806 male and female health care executives, revealed similar results, finding that many health care organizations are striving to create greater diversity at top management levels through various policies and programs. These include processes related to:

  • Structuring decision-making groups to include women.
  • Providing advancement opportunities.
  • Offering rewards to those who help address the gender imbalances in top management.
  • Recruiting a wider array of candidates.
  • Providing flexible work arrangements.
  • Helping executives accommodate the needs of their families.

In addition, many organizations had general policies in place “that encourage promotion from within the organization, tie pro-diversity initiatives to business objectives and express zero tolerance for sexual harassment,” according to the survey.

Building a Better Business

Ensuring that women have equal opportunities for senior leadership positions is not only the right thing to do, but also is good for the bottom line. There have been many studies showing the direct correlation between having female executives and experiencing positive business outcomes, including a recent global study by the Peterson Institute of International Economics of nearly 22,000 firms. It revealed that having more women in multiple high-level leadership positions led to increased organizational profitability: “When we examined the profitable firms in our sample (average net margin of 6.4%), we found that going from having no women in corporate leadership (the CEO, the board, and other C-suite positions) to a 30% female share is associated with a one-percentage-point increase in net margin — which translates to a 15% increase in profitability for a typical firm.”

As Tecco wrote, “Having a diverse team creates a positive, virtuous cycle. Companies with women CEOs outperform the stock market, and companies with women on their boards outperform male-only boards by 26 percent. Researchers even estimate that transitioning from a single-gender office to an office evenly split between men and women can be associated with a revenue gain of 41 percent.”

Looking Ahead

Even if the glass ceiling appears largely intact, researchers say we’re making progress: “Although there are still major strides to be taken, the state of gender diversity is moving in a positive direction … . With increased transparency around the topic of gender diversity and gender equality, more individuals are engaging in the conversation to encourage a positive change.”

What do you think? Are we trending in the right direction? What more can be done to advocate for women in health care, particularly leadership roles? What kinds of strategies, attitudes or legislation can help women become better represented in this growing industry? Connect with us on Twitter or Facebook and join the conversation.

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