“I never would have had you come for an interview if I knew you were a woman.”
That’s what the head of a surgical subspecialty department told one female resident when she came in for a job interview. While overt discrimination like this has become rare in recent years, there are still many obstacles to women attaining positions of leadership in health care. Although women make up 75-80% of health care workers, they represent just 13% of health care executives.
Why is it so important to reverse these inequities? What benefits do we gain by putting more women in charge? And how can aspiring health care leaders learned from those who have blazed a trail?
In her new book, Time’s Now for Women Healthcare Leaders, Patricia Gabow, MD, MACP, former CEO of Denver Health and Lown Institute board member, answers these questions and more. As CEO of Denver Health for 20 years, Gabow transformed the struggling safety net hospital into a “national model of success,” achieving both great patient outcomes and financial stability, while staying true to the hospital’s social mission.
Gabow first lays out the case for why we need more women leaders in health care. Besides the fact that most health care workers are women, women are generally the family caretakers and make most of the health care decisions for families. Women may also have unique advantages as leaders, such as humility, relationship-building skills, thirst for challenge, ability to collaborate, and a strong desire to improve the health care system. Research on management styles and interviews with over a dozen health care executives support these assertions.
Gabow provides a comprehensive guide for women who aspire to become executives in their field, drawing on wisdom not only from her own experience, but from other health executives and aspiring leaders. For example, Google’s Chief Health Officer Karen DeSalvo offered these thoughts on dealing with her own “imposter syndrome” (doubting your own accomplishments and thinking you are a “fraud”):
"I still have it. I have had it all my life. There are some jobs I might want that I think I may. not have enough qualifications for. Then I see people in those jobs who don't have as many qualifications as I have. Women think they are not good enough. It's a voice in my head. I have to tell it to shut up."
Gabow outlines a path from clinician to executive, from “leading where you stand” (anticipating and solving problems in your current job to show leadership), to training and honing new skills, to finding a mentor or sponsor, to actually applying these skills in a leadership position. Some of these steps may involve pushing boundaries or taking risks that seem scary–but keep in mind that women generally wait much longer than men to apply for leadership positions, often because they don’t believe they are qualified. Pushing past the fear of failure can show that hearing No is still worth taking a change–or you might hear Yes! As Gabow writes, “If you want to win the lottery, you have to buy a ticket.”
However, women cannot overcome these obstacles alone; there is a great need for institutional change, Gabow writes. These changes include recognizing and measuring gender bias within the institution; providing bias training to personnel; defining processes with clear criteria for recruiting, hiring, and paying employees to avoid bias; implementing fair parental paid leave policies; and creating goals for the institution to increase the number of women in leadership positions.
Time’s Now is an important read for anyone who wants to be a health care leader, help women leaders, or contribute to a more gender-equitable health care system.