Several years into her hospitalist career, committee work had satisfied Sarita Satpathy, MD’s desire to positively impact patient care. Then she attended SHM’s Leadership Academy and was inspired to do more.
“I thought, ‘I want to do something and actually have a title where I can effect change,’” says Dr. Satpathy, now the hospitalist program medical director for Cogent HMG at Seton Medical Center in Daly City, Calif.
A year and a half after starting from scratch, Dr. Satpathy’s program has improved patient-care continuity, implemented 24/7 coverage, and earned buy-in from specialists, surgeons, and hospital leaders—most of whom are men.
“There aren’t as many female physician leaders, period,” says Dr. Satpathy, speaking of Seton Medical Center.
She could be talking about medicine in general.
Despite the fact that women have made up nearly half of all medical school graduates since 2005-2006 and make up 30% of the total physician population, only 16% of MD faculty at the full professor rank are female.1,2,3 Just 11% and 13% of medical school permanent deans and department chairs are women, respectively.4
Beyond academia, results from surveys conducted by the American College of Healthcare Executives show that female healthcare executives are less likely to be CEOs and chief operating officers than their male counterparts. The results also indicate that the proportion of female CEOs remained fairly stable between surveys in 1990, 1995, 2000, and 2006; the proportion of female vice presidents actually decreased.5
This reality, experts say, undercuts America’s ability to remain at the leading edge of medical research, impedes women’s health improvements, and leaves fewer role models for future generations of physicians. In looking at why female physicians are underrepresented in leadership, key issues emerge, including unconscious bias, outdated work structures, lack of sponsorship, and conflict between the biological and professional time clocks. Although not all female doctors have faced these obstacles, many of them have and still do.
But opportunities are there—especially in HM—for female doctors to step into leadership roles. The onus is on women to seize them and on institutions to create a fertile environment for diverse leadership, physician leaders say.
Leadership Obstacles
Men often are associated with leadership by virtue of a phenomenon called unconscious bias, which posits that people identify certain genders with certain roles due to subconscious cues accumulated over time, says Hannah Valantine, MD, professor of medicine and senior associate dean for diversity and leadership at the Stanford
University School of Medicine in Palo Alto, Calif.
“These biases exist in all of us in the way we evaluate women and their work, in the way we evaluate them for leadership positions and when they’re in leadership positions, and in the thought processes that they have of their own qualifications and actions,” says Molly Carnes, MD, MS, a professor of medicine and industrial and systems engineering and co-director of the Women in Science and Engineering Leadership Institute at the University of Wisconsin at Madison.
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Table 1. Median Salary for Top Healthcare Executive Positions
Bias also exists in how institutions write their job announcements, performance evaluations, and grant and award applications, Dr. Carnes explains. When such terms as “aggressive” and “risk-taking” are used, women are less likely to be seen as viable candidates, she says.
What often impedes female physicians from taking leadership roles are a lack of sponsorship and obsolete work structures that don’t reflect life in the 21st century.
“There is some thought out there that women nowadays are overmentored and undersponsored,” says Dr. Valantine, a cardiologist. “By ‘sponsored,’ we mean going that extra mile to make sure a woman is promoted into the next level of leadership and into the next level of opportunities. It’s the ‘old boys’ network,’ and, unfortunately for women, there isn’t an old girls’ network that’s as well-oiled.”