Strategies for Recognizing and Eliminating Gender Bias in Healthcare

INTRODUCTION

Why is it that I have been the only woman in the boardroom so many times in my 30-year career? I have held four chief executive officer roles, served as chair of the board of two organizations, and participated in leadership roles in federal healthcare policy, consulting, and healthcare industry innovation. In most of those roles, the majority of people in the other leadership positions were men. In the third decade of the 21st century the fact that I am a woman in the C-suite and boardroom should not be remarkable, but unfortunately it frequently is.

I wrote this book to explore why so few women have had the experience of holding executive leadership positions and, I hope, to provide some insight into how we can change the persistent problem of gender inequality in healthcare leadership. I have drawn on my personal experiences, but also those of other women healthcare leaders, four whom I profile in the book.

Looking back in time at women in leadership roles in powerful patriarchal societies who were exceptions in their historical contexts, I wanted to identify traits and behaviors that explain their exceptionalism, but I also attempted to defy the constraints that make exceptionalism the only pathway to female empowerment. Although I have drawn liberally from the wells of both feminist historians and traditional critical thinkers, I have also explored the topic through the quantitative social research underway currently, whose post-pandemic iteration is demonstrating the damage gender discrimination plays in health inequity worldwide.

Many readers may find this to be a strange book because of its juxtaposition of personal anecdotes, copiously footnoted data points, feminist Jungian psychology, and extensive quotations from all over the intellectual landscape. Gender inequality is one of humankind’s most wicked problems to solve, so, from that point of view, I feel no shame in how I have drawn on the writings of great thinkers with whom I have engaged, whether they are currently out of fashion or not.

You will see what I am alluding to by the end of chapter one, where you will go on a whirlwind journey of statistical and quantitative information on the state of gender leadership variance, with reference to analyses of scores of social scientists, before ending with Jungian psychology as a reference point for understanding the complex patriarchal building codes that have left us with glass ceilings and sticky floors.

The book will just get weirder from there, but if you stick with me, by the final chapter, we will have set up nicely some tactics for repairing the structural damage caused by the wicked problem.

One potential critique of this book may be that its focus on the unique problems of women in healthcare leadership does not take into account the perspective of non-binary gendered voices, nor adequately elaborate the more complex discriminatory challenges faced by non-white people in healthcare professions.

As a white, cis-gendered woman (contemporary identity phrasing I am still getting used to), I have written through the limited lens of my own experience. When data are available, however, I have tried to supply information in the text that differentiates the experiences of other groups of people who are impacted by discriminatory biases and barriers to leadership. Diversity, equity, and inclusion should be very robustly designed into our cultural and organizational objectives. By starting with misogyny, a discriminatory practice that spans all cultures and historical timeframes, I hope my approach can be useful in that broader DEI design process.

I want to make it clear up front that this book is not written from the perspective that the behaviors and experiences that I personally have lived should be a roadmap for others to follow. Rather, I believe women from all types of backgrounds and experiences should have ample opportunity to fill leadership roles in healthcare; understanding why and how that does not happen are crucial steps in remedying the situation.

When half of the world’s population is excluded from full participation in leadership, power, and influence, everybody suffers. We simply do not have the time nor the luxury to settle for patriarchy anymore. In a world facing ecological destruction from climate change, nuclear annihilation from ongoing worldwide wars and conflict, unprecedented mass killings from gun violence, and the assault on women’s rights across cultures, we need the hearts and minds of women involved in solving these problems equally with men.

As a healthcare professional, I will address this through the lens of healthcare leadership inequality, because that is the space I know best. But the tactics I lay out in chapter eight can be cross disciplinary, and I challenge all of us to move from the constrictions of nouns to the power of verbs; actions, not archetypes, are what will yield us full agency.

Excerpted from Strategies for Recognizing and Eliminating Gender Bias for Healthcare Leaders by Grace E. Terrell, MD, MMM, CPE, FACP, FACPE.