Intense focus on health inequities magnified by COVID-19 brought long-overdue attention to the needs of people from historically disenfranchised and diverse communities. It is clear that we cannot realize equity in healthcare without a parallel focus on diversity in the workforce, including leadership positions.
There's a diversity gap in healthcare leadership, which includes . This gap widened during the pandemic.
Across the world it has been reported that gender parity was pushed back by a during the pandemic. Nowhere is this imbalance more apparent than in the gender pay gap, the largest of which exists in healthcare among .
Then there's the disproportionate impact of burnout, stress, and anxiety on women in medicine. According to a , women physicians in 2022 reported 27% higher odds of burnout and 37% lower odds of achieving work-life balance. A National Academies of Sciences, Engineering, and Medicine cited the mental health challenges faced by women healthcare professionals, who encountered an unstable work environment during the pandemic and were often the ones at the bedside of patients dying from COVID.
To turn this tide, the voices of women physician leaders must be heard in the C-suite. Here are four steps to create a more inclusive work environment for women in medicine and empower them to become leaders.
Step 1: Build recovery strategies that include women decision makers
As health organizations rebuild from the pandemic, recovery strategies must include women physician leaders for their perspective and diversity of ideas. Research shows that women serving in any sector , particularly through their representation on corporate boards.
However, simply including women is not enough -- reaching critical mass is key. companies with at least 30% female representation on corporate boards achieve a higher level of organizational performance. Elevating the voice of women in C-suites is essential to reshape the industry while maintaining and improving care quality and outcomes.
Step 2: Recruit purposefully and creatively
Throughout my career, I've been in leadership and executive meetings in which the only other woman was the one taking notes. There's still a long path ahead to increase the voices of women leaders within physician groups, and this means recruiting with purpose.
While more women are achieving leadership roles, the path to equitable representation is not yet self-sustaining and must remain purposeful in its execution. Some women may need encouragement to apply for leadership positions. They might have an overly critical view of their own qualifications for a particular role, even if they are more than qualified and capable. They only move forward when a mentor, sponsor, or colleague encourages them to do so.
According to a recent McKinsey "" report, women leaders are switching jobs at one of the highest rates in years. As companies struggle to keep the few women leaders they have, creative ways to attract and retain talent means focusing on what women need to support their success and engagement.
Step 3: Adopt policies to support work-life balance
It was well established pre-pandemic that women shouldered a heavier burden of responsibilities at home. The pandemic added to that burden, with women carrying a greater share of caregiving responsibilities, whether for children or for elderly parents, even if both working partners were at home.
A 2022 JAMA Network Open found that physicians experiencing high levels of child-care stress had 111% greater odds of reporting anxiety and depression due to COVID-19 compared to those with a low amount of such stress. Based on a survey between April and December 2020, women had a higher rate of child-care stress (21%) compared to men (17.9%). Those higher levels of stress translated to a 63% greater likelihood of burnout, compared to a 49% rate among women with low child-care stress.
Time itself often presents a significant barrier for women considering leadership. When opportunities arise, women tend to think first about the "extra time" they'll need to take on a new role -- time they typically don't have.
Real workplace policies are needed to support women physicians' ability to balance work-life responsibilities. Empowering women to set priorities is also important; this means making it acceptable to set boundaries, while acknowledging that it is a challenge to adhere to those boundaries all the time. With this type of support, opportunities to explore leadership roles become more realistic. Ironically, it will likely take more women in the C-suite to sponsor the very policies that enable greater representation.
Step 4: Move from mentorship to sponsorship
It helps to have mentors who can guide and support women seeking leadership roles. But there's a difference between mentorship and sponsorship.
Sponsors identify opportunities for individuals while providing referrals and recommendations. Women in positions of power should support other women coming through the ranks. For example, by making sure an individual's voice is heard in settings where those in traditional positions of power might look past or "not see or hear" the woman in the room.
The Benefits of Women Physician Leaders
According to the McKinsey report mentioned above, women leaders do more to support teams and advance diversity, equity, and inclusion efforts. Employees with women managers were more likely to report that they were supported and helped over the past year. Respondents said 61% of women managers checked in on their well-being compared to 54% of male managers. Women leaders are also more likely to be allies to women of color.
Expanding gender diversity in leadership roles encourages women physicians to stay in medicine by evolving the workplace environment to reflect the communities we serve. We can eliminate healthcare disparities only if we achieve diversity of the healthcare team and leadership.
is an internal medicine physician. She serves as executive vice president and chief quality officer of The Permanente Federation.