As shown by the numbers, gender parity for women in executive leadership is a seemingly erratic shuffle of starts and stops. The record-breaking 33 female CEOs on the 2019 Fortune 500 list represent a disproportionately small 6.6 percent share. Only 24 of the CEOs on the 2018 Fortune 500 list were women—a drop of 25 percent from the previous record of 32 in 2017.
That’s despite the evidence that gender diversity isn’t just good practice, it’s also intelligent business. A 2017 study by McKinsey found that organizations positioned in the top quartile in inclusion of women on executive teams were 21 percent likelier to experience above-average profitability than companies in the fourth quartile—a 6 percent increase from the 15 percent reported in 2014.
Current data from Oliver Wyman on women in healthcare look only slightly more encouraging than the Fortune 500 list. Only 13 percent of healthcare CEOs are females. Despite headway in recent years, that’s still a deep disparity.
According to a survey of healthcare C-suite executives by Korn Ferry, nearly two-thirds of participants believe advancement opportunities for women are improving in healthcare, but more than one-half believe women are still passed over for promotions based on their gender.
That’s not because healthcare organizations don’t see the business and social necessity of women holding top positions—at least on a conscious level. Fifty-nine percent said they think their organizations would be more profitable with greater gender parity in executive leadership.
What the research portrays is an environment in which change is taking place—but not as fast as it should be.
In a field in which women represent 65 percent of the workforce and make 80 percent of purchase and usage decisions, healthcare does not have a “women in healthcare” problem, it has a “women in healthcare leadership” problem, Oliver Wyman contends.
Peering past the data, Healthcare Executive spoke with three female executives to cull their insights.
Where Are We Now? The Status of Women in Executive Roles
Issues around women in leadership—healthcare leadership included—have been cast into the spotlight as an outgrowth of the intense public focus on sexual harassment and abuse ignited by the #MeToo movement. Investigative media reports and firsthand accounts have placed a mirror on gender, with disparities in advancement opportunities for women organically becoming a part of the discussion.
Donna Padilla, managing partner and healthcare practice leader with executive search firm WittKieffer, Chicago, sees glimmers of hope that #MeToo has helped raise consciousness within the industry, but she believes much more work is needed. “I’ve been noticing more articles and awards programs highlighting the amazing things women are doing in the healthcare space,” she says. “Still, though there is a lot of conversation, I haven’t noticed a tremendous uptick in actual progress based on the data I’ve seen.”
To help healthcare organizations move forward, “What we’re asking our clients to think about now is: What are the real practices we can put in place? It’s good to talk about gender diversity and say we have a commitment to it, but how do we ensure that the pool of candidates is diverse?” Padilla says.
Josie Abboud, FACHE, president and CEO, Methodist Hospital and Methodist Women’s Hospital, Omaha, Neb., also sees gender disparities in healthcare leadership.
“Women make up most of our workforce, and women occupy many of the managerial roles in healthcare. But historically, there haven’t been a lot of women in the executive suite in our industry,” she says.
She points to notable signs of progress, including her own institution, where the entire executive leadership team, apart from the vice president of medical affairs, is currently female. In addition, in the Methodist Health System, 14 of 33 president or vice president roles are occupied by women. Abboud, who became Methodist’s first female CEO in 2018, says she feels grateful to have advanced in an organization with an exceptionally inclusive culture. She is also Filipino. “I never felt that anything held me back from seeking or being selected for a position,” she says, though she remembers one co-worker telling her that she was chosen for a position only because she wore a skirt. “That comment was unfortunate, but I knew that it did not reflect the position of our executive team, and that I was a strong candidate because of what I had accomplished in setting and achieving a strategy,” she says.
“Josie’s dedication to Methodist was evident early in her career with our organization,” says Steve Goeser, FACHE, president and CEO of Methodist Health System. “Her clinical and leadership experience in multiple areas has served her well and has proved integral in her rise to the various leadership roles within our organization. Josie is an engaging leader who builds rapport with everyone she encounters—from our physicians to our housekeepers. This practice has been vital to fulfilling our organization’s mission and culture, while also allowing us to continue to serve our community’s growing healthcare needs.”
Describing herself as an optimist, Marna P. Borgstrom, FACHE, CEO of Yale New Haven (Conn.) Hospital and Yale New Haven Health, says informal observations suggest to her that more women are occupying senior leadership roles. But, “is it enough? Is it fast enough? Probably not, given the need for diverse talent and the current level of diversity in top executive positions. But I do think we’re making progress,” she says.
Borgstrom adds that she, too, sees healthcare workforces more diverse than leadership teams but that “our leadership teams are becoming more intentionally diverse. At Yale New Haven Health, we believe strongly that a truly diverse team is synonymous with good business practices. What got us here is not going to get us there. We should embrace the fact that diversity is going to make us better performing organizations.”
That said, she adds that diversity for diversity’s sake doesn’t work because regardless of gender, race or ethnicity, a leader must be competent, a strong performer and demonstrate they are capable of working through the challenges of senior leadership.
However, when equally skilled and experienced high performers vie for the same position, diversity enhances the overall functioning of the leadership team, Borgstrom says.
“But, diversity is something we need to work at because we all operate with different levels of conscious and unconscious bias,” she says. “If you’re not bringing in a diversity of opinion, you can convince yourself you’re moving in the right direction, run into a brick wall and be very disappointed in the outcome.”
Strategies to Build Gender Equity
Padilla says unconscious bias training is one way to build a culture that supports women interested in pursuing senior leadership roles.
Based on the recognition that all people are biologically hardwired to align with others who are more like them and reject those they consider different, unconscious bias training begins by increasing awareness that these biases exist.
“There are iterations of maturity of understanding of what that is and how it’s used,” Padilla notes, “not just at
the executive level if you’re creating a pipeline of female candidates, but also at the level of ensuring that you’re not biasing unconsciously throughout the organization and possibly stifling an
environment that brings women into the leadership track.”
Some institutions are better equipped with more resources devoted to hardwiring those processes. “If they start a search, they’ll do training on what to listen for and how to word questions to avoid pitfalls when talking with people. How do we check as much of our unconscious bias as we can at the gate? I think there’s opportunity to do more of that across the whole provider space,” Padilla says.
Writing in Harvard Business Review, consultant Joelle Emerson says unconscious bias training can work but must be carefully designed with an eye on the potential fallout. For example, “raising awareness about bias can backfire when not paired with strategies for managing bias,” she says. Further, unconscious bias training “can only take an organization so far. Ultimately, it is a commitment to consistently evaluate and innovate organizational processes—including the systems that allow for bias in the first place—that will have the most sustained impact on achieving diversity goals.”
Methodist Hospital offers several leadership development programs, including Management Bootcamp 101 and a Leadership Execution Series. Though not only for women, they provide essential training for women who are interested in moving into management positions and help feed the internal pipeline of qualified female talent.
The programs offer training in important areas such as having difficult conversations with reports, confronting problematic situations, and building successful relationship and communication skills. They offer different levels of training depending on where individuals are in their careers to help them grow and succeed in their roles.
“I believe that once you have the chance to use the skills you learn in having a difficult conversation or making a difficult decision, it becomes easier for you to ‘find your words,’” notes Abboud. “However, that’s not always the case for everyone. It comes naturally to some people with experience and practice; others may need a confidence boost and role-playing to help them get there. In those cases, we offer one-on-one coaching through our employee assistance program. We also offer support for growth and development through some external programs.”
Borgstrom stresses the need to approach gender diversity with intentionality because “it’s not easy work. It’s not a sprint, it’s a marathon. Human beings tend to gravitate toward people who are easier to work with, and often, those are people who look and act like you.”
Working toward diversity must reach beyond establishing a formal diversity and inclusion program, though a formal program is an important start, Borgstrom says. “You must keep bringing people back to it. You’ll have fits and starts along the way. But you have to stick with it, because just saying you value diversity and inclusion and building language into your strategy and business plans isn’t going to get you anything other than print that says something that is often not reflected in the way you actually operate.”
At Yale New Haven Health, the intentionality Borgstrom describes manifests in the deliberateness with which leadership work groups and teams are created. When the health system examines the composition of a group, it must include women leaders and diverse participation.
“Everyone knows at all levels of leadership that this is something we expect of them,” she says. “Putting together a homogenous group is not going to get the job done in the way that we want.”
Yale New Haven Health has developed a women’s mentorship program based on Facebook COO Sheryl Sandberg’s bestselling book, Lean In. Approximately 250 women across the system have completed the program in the past five years. Participants break into groups of five or six with a mentor for each group. “It gives women a space in which to verbalize the issues and call out what may be making them feel uncomfortable or unsupported,” says Borgstrom.
The system has since expanded the program to include a group for men so they can socialize what they learn about unconscious bias, gender diversity and inclusion in work groups across the system.
Healthcare has work to do to level the playing field for women interested in rising to senior-most positions. With solid policies and programs backed by an unceasingly conscious and deliberate focus on meaningful gains, however, organizations can bring gender equity to fruition.
Susan Birk is a freelance writer based in Chicago.
Subtle Forces May Be Standing in the Way
In its 2019 report, Women in Healthcare Leadership, Oliver Wyman identifies several “hidden” influences that may perpetuate ineffective biases and behaviors and hinder women’s movement into executive slots. Among others, these include:A focus on results. Many women believe they will be judged solely on their results and impact. As a result, they may not focus enough on career planning and building affinity.
Tunnel vision. Women often build credibility as problem solvers, but this can get them labeled as not strategic enough and undermine perceptions of their leadership ability.
The confidence myth. Women healthcare executives do not lack confidence. But men view the ability to “wing it” as more acceptable, while women may rely too much on demonstrating competence.
The Value of Mentoring
“The need for increased female leadership is clear. The means by which to achieve it is not always apparent,” observes WittKieffer in Gender and Career Advancement in Healthcare, which surveyed 300 executives.Mentoring may offer a meaningful pathway.
The survey found a correlation between gender diversity and mentoring programs. Organizations with a gender-diverse leadership team were more likely to offer and encourage women to participate in mentorships. Only 8 percent of female participants in organizations with the lowest numbers of female leadership team members (25 percent or less) reported that their organizations offered a formal mentoring program, compared with 33 percent in organizations that have heavily female (75–100 percent) teams.