The lack of depth of women leaders in U.S. healthcare organizations continues to

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1 C A R E E R S Leveraging Women s Leadership Talent in Healthcare Martha C. Hauser, managing director and Southern Region healthcare practice leader, Diversified Search, Atlanta, Georgia The lack of depth of women leaders in U.S. healthcare organizations continues to be a perplexing and challenging issue given the transformation taking place in the industry. With the impending departure of the baby boom generation from the workforce and the anticipated retirement of executives who postponed their departures as a result of the recent economic downturn, a significant shortage of experienced and qualified healthcare leaders is expected at the very time the Affordable Care Act is being fully implemented. Women, who make up the majority of the workforce in healthcare organizations, are largely an untapped resource for many of the leadership gaps that will result from this trend. The research presented in this column indicates that those organizations able to provide the support and sponsorship necessary to develop women in leadership roles are most likely to have a deep leadership pipeline and reap financial value from taking such measures. Although a majority of the healthcare workforce 74% is female, women continue to be significantly underrepresented in the C-suite of healthcare organizations (Dunn, 2014). Figure 1 shows the percentage of women who hold positions in five levels of healthcare. Only 24% of senior executives 18% of hospital CEOs are women. In addition, women make up only 14% of the population of healthcare boards of directors. These statistics were the backdrop for this research study, sponsored in early 2014 by Diversified Search, in which we sought to examine the career paths of male and female executives to identify any differences in their trajectories or backgrounds that might explain why fewer women than men are prepared for senior leadership roles. The study also examined the career paths of women in senior leadership positions to look for trends and insights that might help organizations as they seek to develop a deeper footprint for women in leadership roles and advise women interested in moving into the most senior positions. ABOUT THE STUDY Diversified Search, in collaboration with the Women s Leadership Center at Kennesaw State University Coles College of Business, conducted a quantitative online survey of 282 healthcare leaders (125 men and 157 women) to identify specific 318

2 Careers FIGURE 1 Percentage of Women in Healthcare Positions Healthcare workforce 74% Mid-level officer/management 71% Executive/senior officers 54% Senior executives 24% Hospital CEOs 18% Sources: ACHE (2012), BLS (2011), EEOC (2011), AHA (2010). factors and trends that differ by gender and that influence the process of identifying, developing, retaining, and advancing healthcare talent. The real impetus for the study came from my own experience in conducting executive searches for healthcare organizations over the past 25 years. I recognized that there was a shortage of women who were ready and positioned appropriately for the most senior leadership roles, particularly CEO positions. Paying particular attention to the differences in the career paths of female executives, I observed anecdotally that many female CEOs had been named to their roles as the result of internal promotions. I began to wonder why more women were not in C-suite roles when half of the graduates of the large master of health administration programs over the past 25 years have been female. These considerations led to the decision to research the differences in career paths and trajectories. The institutions surveyed included secular not-for-profits (58%), religious not-for-profits (21%), government entities (9%), for-profit organizations (7%), and other (5%). The size of the organizations varied as well; however, nearly 40% were large, defined as those with more than 10,000 employees. The organizations represented a mix of urban, suburban, and rural locations. FINDINGS Diversified s research reveals that women and men in leadership positions come from different functional backgrounds (see Table 1). For example, data on the educational and functional backgrounds of the male and female CEOs surveyed show that 53.3% of the women had clinical (mostly nursing) backgrounds, whereas 14.3% of the male CEOs came from general administration and 35.7% were physicians. 319

3 Journal of Healthcare Management 59:5 September/October 2014 TABLE 1 Functional Background: CEOs Men Women Medicine (35.7%) Nursing (43.9%) Finance (16.7%) Medicine (9.6%) Administration (14.3%) Finance, human resources, administration (6.4% each) Furthermore, as shown in Figure 2, 54% of the women surveyed, versus almost 40% of the men, were named to a C-suite role as a result of an internal promotion, whereas 60% of the men, versus 45% of the women, were recruited into a C-suite role as an external hire. Compensation for women in the research sample was considerably lower than that for men in similar positions by an average of 35%. While this finding reflects the gender-based income disparity across many industries in the United States, the dichotomy found in this survey could be a reflection of the different backgrounds and experiences men and women bring to the position as well as the increase in compensation that usually accompanies a move to a new organization. Additionally, the study revealed that traditional barriers to leadership, such as male-entrenched cultures and a lack of consideration for work life balance, that have affected women over time are still of concern. By becoming aware of these issues and creating a culture that seeks to know the needs and wants of talented women, organizations can develop an empowered and motivated group of female leaders. FIGURE 2 Internal Versus External Hires Men 39.7% 60.3 Women % n Internal n External 320

4 Careers ENHANCING THE FEMALE LEADERSHIP PIPELINE What can organizations do to identify and nurture the careers of high-performing females in the healthcare industry? Assess the current leadership pipeline; seek to attract female talent; and focus on developing, advancing, and retaining that talent. For example, it appears from this survey that those with clinical backgrounds, whether medicine or nursing, make up a large percentage of the executives. Look to the women in medicine and nursing for high-potential performers who can be groomed and developed for C-suite roles. Offer flexibility when women require it to balance the demands of a professional and personal life, and ensure that they incur no cultural penalties for utilizing the flexibility at appropriate times. This strategy engenders organizational loyalty. Engage male leaders in the sponsorship of women in the organization. Given that the preponderance of C-suite executives is male, it is imperative that organizations engage male leaders in the development of high-potential women by serving as sponsors, mentors, and coaches. One idea to consider is including the development of gender diversity as part of the incentive compensation plan. Monitor the culture of the organization and the issues that women cite as detrimental to their careers. These may include a lack of supportive supervisors, exclusion from informal networks, a lack of senior role models, an inhospitable culture or biased attitudes, and a failure of senior leadership to help in advancement. Inviting regular feedback from women and tracking the engagement of male leaders in sponsoring high-potential women can foster a culture in which more women emerge as leaders. Develop resources to address women s specific needs. Support their involvement in professional groups, help them identify opportunities to network within the organizations, and assign mentors or sponsors to advise and endorse them. This is a two-way street talented females should not hesitate to take advantage of these programs and any coaching available to them. WHAT WOMEN CAN DO What concrete steps can women who are seeking leadership roles take to pave a pathway to senior positions? Develop and map out specific career goals. Then focus on acquiring the skills, experience, and education needed for leadership positions and organizational advancement. Discuss career aspirations with influencers in the organization (human resources, supervisors, colleagues) who can be of help in career advancement efforts. Take on high-risk/high-reward projects or roles in the organization. Be vocal and clear about your willingness to assume broad promotional opportunities. 321

5 Journal of Healthcare Management 59:5 September/October 2014 Examine the organization to determine what factors influence promotional opportunities in the culture. Discuss career options with family, if appropriate, and be clear as to whether relocation is an option for career advancement. If so, pursue that option with focus. Research all available organizational resources offered, and use them. Maintain visibility in appropriate professional organizations related to your career aspirations. Develop a strong professional network, and tap your personal network as well, for professional development and visibility. Find a mentor or sponsor inside the organization. Even when the hospital or health system has no formal mentoring program, it is extremely beneficial for women to find mentors who are willing to sponsor females at the C-suite level, where the women may not have a voice. In the absence of an internal sponsor, they should find someone outside of their current organization, male or female, perhaps a former boss or someone who is respected professionally. CONCLUSION Research from Catalyst (2012) and other distinguished entities, such as Harvard Business School (e.g., Eagley, 2013), has consistently shown that organizations that recognize and follow through on the issues expressed by women in Diversified s study can reap great benefits. For example, as the governance of an organization becomes broader and more diverse, the thinking becomes more creative and the bottom line strengthens. Unfortunately, many companies lag in diversifying the governing board, either remaining satisfied with the status quo of a traditional male governance system or adopting diversity as a token effort. The benefits of developing women leaders in healthcare and other industries are just beginning to be recognized, both in the enhanced decision making of diverse leadership teams and in the financial outcomes associated with a broader talent pool. REFERENCES American College of Healthcare Executives (ACHE). (2012, December). A comparison of the career attainments of men and women healthcare executives. Retrieved from /pubs/research/2012-gender-report-final.pdf American Hospital Association (AHA). (2010). Strategies for leadership: Does your hospital reflect the community it serves? Chicago, IL: Author. Catalyst. (2012, November 29). First step: Engaging men. Retrieved from /knowledge/first-step-engaging-men Dunn, L. (2014, April 24). Women s executive leadership still lags, and it matters more in healthcare than other industries. The daily beat blog. Retrieved from review.com/healthcare-blog/women-s-executive-leadership-still-lags-and-it-matter-more-in -healthcare-than-other-industries.html Eagley, A. H. (2013). Women as leaders: Leadership style versus leaders values and attitudes. In Gender & work: Challenging conventional wisdom (Harvard Business School research symposium). Retrieved from -symposium/documents/eagly.pdf U.S. Bureau of Labor Statistics (BLS). (2011, March). Women at work. Retrieved from U.S. Equal Employment Opportunity Commission (EEOC) Employer information report for hospitals Washington, DC: Author. 322

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