Where Are the Women Leaders in Medicine?
Hansa Bhargava, MD
Medicine has truly evolved over the past two decades, from the entry of health maintenance organizations and the increase in multi-physician-owned and hospital-owned practices, to innovations and the influence of artificial intelligence. Lately, of course, is the establishment of the monolith: electronic health records. With all of this, we have seen true healthcare transformation.
But one area that hasn’t changed very much is female representation in the leadership of medicine. Although women currently make up almost 50% of medical school classes nationwide, there has been and still is a true deficiency in the top ranks.[1]
When the subject of female leadership in medicine comes up, I often hear acknowledgement but then a curiosity about why this is such an important issue. There are many reasons, of course, but a very compelling one is simple: Diversity makes organizations better.
[A] diverse skillset at the top increases effectiveness of the organization, helps in recruiting a diverse group of people, and sets a tone of broad-minded thinking.
McKinsey and Company’s Women in the Workforce as well as other groups have taken a deep look at this, and the key findings are always the same.[2] More women at top levels not only can help profitability but also help a company outperform others. In medicine this is also true, because a diverse skillset at the top increases effectiveness of the organization, helps in recruiting a diverse group of people, and sets a tone of broad-minded thinking. And in medicine, this can ultimately lead to better patient care.
Change often must start from the top, which is why the study published in JAMA Internal Medicine on January 7 is important. I am a coauthor of the study (with Julie Silver and colleagues), which took a look at 43 different physician-focused medical societies over the past decade.[3]
The 39 largest of these societies were selected; they included internal medicine, pediatrics, surgery, dermatology, and cardiology, to name a few. From 2008 to 2017, men served as president of these societies more than 82% of the time, a total of 322 out of 390 years, across all of the societies and years examined. Some societies were more equitable than others, but overwhelmingly there was disparity.
Four societies (Society of Critical Care Medicine, American Society of Neuroradiology, American Psychiatric Association, and American Geriatrics Society) had the highest number of years with women at the helm as president, at 4-6 of 10 years. However, 10 medical societies had no years when they were led by a woman.
Leadership Benefits Women and Systems at Large
Representation in leadership influences medicine and physicians in many important ways. Leadership in one arena, such as a medical society, can often help an individual in their academic or administrative career too.
When I became the lead physician at one of the largest pediatric urgent cares through Children’s Healthcare of Atlanta, it allowed me opportunities to participate in systemwide hospital clinical committees and other leadership arenas. Women who are able to get a foot in such doors can often help other women move forward as well.
Women often bring different skills and talents to the table compared with men. One survey found that women were humbler and more likely to consider others’ opinions in major decisions.[4] The combination of varied viewpoints from men, women, and people of different ethnicities and backgrounds can provide the ultimate benefit to the hospital system by bringing broader perspectives to the top. Diverse representation can then propel more diversity and inclusion, helping to influence the specific medical society or hospital, and therefore medicine as a whole.
Last, and important, this may benefit patients coming to hospitals who are of different ages, genders, races, and backgrounds. The culture at the top can influence the culture of the hospital and help everyone have a better understanding of the best ways to communicate and deliver healthcare to different people effectively, thus optimizing patient care.
Diverse skillsets and a broader outlook at the top matter. Moving this needle not only will allow the entity to thrive and be adaptable, but also can contribute to healthcare agility while, as research has shown, helping to achieve a better bottom line in this ever-changing environment.
Not only is increasing women in leadership the right thing to do, but it is very much needed to benefit physicians, universities, and hospitals, and also to deliver better healthcare to patients.
