Only 15% of CEOs in the health care system are women. Here are 4 ways to change that.

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Although women make up a large portion of the health care workforce in the United States, men still hold most leadership positions in health care organizations, according to a new to study Posted in JAMA network open.

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Study details

For the study, researchers from Ohio State University collected data from 161 U.S. health systems with at least five affiliated hospitals and 108 health insurance groups with at least 0.09% of the national market, as well as the board of directors (Boards) of each organization, between the April 1 and May 31.

Using information from organizations ‘websites, the researchers determined the binary genders of organizations’ boards, along with their top eight leaders:

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  • Chief executive officer
  • Financial director
  • Chief doctor
  • CEO
  • Information Officer
  • Chief Strategy Officer
  • Marketing / Communication Officer
  • Human resources specialist

In total, the researchers identified the gender of 3,911 senior health system executives, 1,303 health insurance groups and 3,462 board members. They also identified the gender of the 31 people in managerial positions at HHS.

Main conclusions

Overall, the researchers found that about 20% to 50% of leaders among boards and leadership teams in health systems and health insurance groups were women.

It should be noted that women were more represented in lower management positions than in the highest positions. In particular, 17.5% of board chairs of health systems and 21.3% of insurance groups were women. In health systems, 15.3% of CEOs were women, while in insurance groups, 15.8% of CEOs were women.

In health systems and insurance groups, the proportion of women in most managerial positions, such as CMO, CFO and CIO, was around 20-25%. However, the percentage of women farm managers was higher: over 30% in health systems and around 40% in insurance groups.

The story was different for marketing / communications and human resources, where women held more than half of management positions. In particular, women made up 70% of human resources managers in insurance groups.

The researchers also found that female CEOs in healthcare systems were associated with a higher proportion of women on their boards or in leadership positions. Likewise, a higher proportion of women in management teams in health insurance groups was associated with an increased representation of female CEOs.

By comparison, in the majority of leadership positions in HHS, 58.1% were held by women. However, the researchers noted that there were only 31 managerial positions at the agency, compared with more than 5,000 in the health systems and insurance groups they examined.

Thoughts Go Forward – Act Now

The fact that only about 15% health systems and insurance groups are run by women is particularly dismal because health care is a female dominated industry. It should also be noted that there is a same deeper divergence in representation for women of color.

As the study notes, having a more gender diverse board and management team is critical to increasing the odds of a female CEO. But since there’s so much more at stake here, we’ve detailed four key ways (with immediate actions) to close the gap.

Four Ways to Close the Gender Gap in Health Leadership

1. Dig deep into your data and identify where there are gender gaps.

People often point out that healthcare is a female dominated industry, and it is true that 76% of all health care jobs are female, but don’t use this as an easy way out.


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Immediate action : We challenge each organization to delve into their own data and be specific about the gaps in gender representation. This is what I recommend:

  • Use your human resources data to measure baseline gender ratios for the entire organization, as well as key departments, and contrast with ratios for governing bodies (board of directors, medical executive committee, clinical consensus groups, etc.).
  • Segment the results of your annual employee engagement survey to identify differences in engagement based on gender. If possible, further segment it by clinical / non-clinical roles, tenure, age, facility, and department to identify specific areas with the greatest gender gap.
  • Use payroll data to assess the gender pay gap and rank roles with the largest gaps.

You will almost certainly find disparities – recognizing these gaps is a crucial starting point. Be intentional in building pipelines where there are gaps. Pay attention to which ranks suffer the most drops in women – if few women make it to the managerial level, for example, focus on identifying the main obstacles and biases behind that “cliff”.

Also note which departments lack representation of women in their ranks – if most women are concentrated in a few departments, this reduces the chances of women reaching leadership positions. For example, primary care nursing tends to be largely female dominated, but there can only be one CNO. To increase leadership opportunities for women, we need more women to be part of management and mid-level leadership in other departments and functions as well. This may require supporting lateral movement or exposure to move female talent around the organization.

2. Reconsider what it takes to be a “leader” in your organization.

Be aware of gender stereotypes that may appear in talent reviews. We are all prone to gender stereotypes when assessing talent, especially about subjective traits related to leadership potential (eg, ambition, assertiveness, and strategic thinking). This categorizes women into certain roles or prevents them from being considered for certain managerial positions. Often, women are expected to take on more administrative or support tasks, and they may be punished for exhibiting the same behaviors as their male peers (eg being seen as “bossy” while men are seen as decisive). As always, recognizing these harmful stereotypes is the first step towards a fairer situation.

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Executives need to challenge these stereotypes when they arise, especially during performance reviews and promotion conversations. Rather than relying on personal (and often biased) opinions, some organizations use evidence-based external talent assessments to measure leadership capacity.

Finally, to limit the risk of misinterpretation, be sure to base performance on objective and results-based performance criteria.

3. Design flexible work models and benefits to retain women throughout their careers and in leadership positions.

Women are often forced to choose between work and home, being inadvertently punished for roles outside of work, for taking maternity leave or having caregiving responsibilities. Women have always taken on more work and home care responsibilities, and this has been exacerbated by the Covid-19 pandemic. In September 2020, nearly 900,000 women left the American workforce four times more than men. And despite the movement on the division of labor at home, women are still take on the burden of family responsibilities while working during the pandemic.


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Create flexible work policies that women can leverage throughout their careers as their needs and priorities change, and consider these models just as productive as traditional arrangements. Consider work models that allow flexibility in where, when and how people work. And make sure you get solid benefits for women, such as maternity leave, childcare subsidies, and on-site childcare. We have developed resources to guide you.

Immediate action : Connect with existing employee resource groups or start focus groups to get input from employees who make up the majority of your workforce on the work models, benefits and support they feel they need to stay in your organization and move forward.

4. Prepare and be proactive about leadership roles.

Data shows that women are less likely than men to apply for positions that require more “qualifications” than they have. Organizations should not assume that women will apply for vacancies, given the history of social and structural inequalities. You need to do the necessary work to establish leadership as a legitimate path for women, invest in preparing them for these roles and encouraging them to apply. Better yet, promote women and nominate them for the candidate list without them having to ask.

Immediate action: I challenge you to immediately include two women in your list of successors for the position of CEO. Why two? Because if there is only one woman in your candidate pool, there is statistically no chance that she will be hired. Again, this action alone is not enough. Work to actively connect women to opportunities that can develop their leadership skills and relationships.

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