Are there really not enough seats at the table?

As advisors, our goal as a team is always to offer effective, high-yield insights. That never changes. But, when we’re lucky, we get a chance to also be innovative and forward-thinking. Some projects give us the opportunity to shape the future of healthcare. We recently came upon such an opportunity when a client asked us to completely reimagine their women’s health strategy.

Traditionally, most health systems merely think of women’s health as OB and Gyn. That approach is far too narrow – we’ve even heard of it referred to as the “bikini boundaries.” We wanted to build our strategy on a different foundation: a better understanding of who women are as healthcare consumers and how, if at all, their behaviors differ from men.

Not only do women outspend men on healthcare per capita¹, but they are more likely to use online resources to seek healthcare information². This made us curious: does gender play a role in how women select their physicians? Do women prefer female doctors?

What we found in our research was a little unexpected. Overall, the majority of patients (of all genders) don’t have any physician gender preference. But of the ones that do, the majority prefer female physicians³. This is true for both male and female patients. What is not a surprise is that the gender diversity of the physician workforce fails to match these consumer preferences.

Females only make up 36% of the total practicing physician population in the US⁴. In fact, the gender gap is even more pronounced among healthcare leadership positions, where females make up less than 10% of the leadership roles (e.g., CEOs, deans, department chairs)⁶. This disparity also applies to value. The gender pay gap averages around $36K for physicians at the start of their careers⁷ and goes up to $80K among leadership positions⁸.

Despite the discrepancy, emerging research suggests that an increased female physician presence could potentially result in better clinical and business outcomes⁹. One study found that female physicians have a 5% lower readmission risk than male physicians, and a 4% lower mortality risk than male physicians at the same hospitals ⁹. Furthermore, a survey of 200 health system executives revealed that 59% of executives believed that their businesses would be more profitable with more gender parity⁹. While the gender-based differences in physician performance have not been definitely proven, they’re certainly not discouraging.

Female representation among physicians is improving, and will continue to do so as the increasing diversity in medical schools trickles into the workforce. In fact, as of 2019, women now make up 50% of medical school matriculants⁵. But rather than waiting around for the physician supply to shift, we believe there is a case for health systems to begin to implement best practices to recruit more female physicians sooner, rather than later (i.e., after their competitors beat them to it). So, how can systems get ahead of the curve?

There’s no simple answer, though healthcare can certainly borrow tips from other industries that have faced similar challenges. While it is by no means an extensive list, here are three ways your health system can deliberately start to address the physician gender gap, if it hasn’t already.

• Internally assess your health system’s own culture to target institutional biases and understand existing recruitment barriers and retention challenges. These can be found everywhere, from the hiring process to the gender pay gap¹⁰. As you work to identify these issues, it should go without saying that you should seek feedback primarily from the female physicians in your health system.⁹ But there’s one less obvious pitfall: don’t waste this opportunity by focusing only on what is not working. Seek to truly understand the values, frustrations, and future goals of female physicians,⁹ which will serve as guideposts for developing effective strategies for recruitment and retention.
• Foster an environment that enables female-led development of a creative, robust women’s health presence in the community. These physicians’ firsthand, lived experience as women is the advantage that will enable them to identify gaps in our current system and develop unique services and programs to close them. By elevating the role of female physicians in the system on a public scale, the system walks the talk of being an environment that is supportive of women and their medical needs.
• Lastly, develop a leadership pipeline for female medical professionals early in their careers that connects and exposes them to leadership opportunities. Intrinsic gender biases – such as unequal treatment from mentors and nurses¹⁰, among others – can create a hostile environment for women in the workplace. By intentionally carving out avenues of exposure to leadership positions via mentoring, leadership shadowing, coaching, and more, women can more effectively seek leadership roles.

An earnest effort to recruit and retain more female physicians in general, and especially in leadership, is not only the socially just thing to do – it makes business sense for individual health systems, and our entire industry.

Sources:

1. The Advisory Board, “2019 Women’s Health Market Trends”, 2019.
2. NBCNews, “More People Search Health Online”, July 16, 2013.
3. YouGov, “Nearly half of women prefer being treated by a female doctor,” August 2018.
4. KFF State Health Fact, “Professionally Active Physicians by Gender”, March 2019.
5. AAMC, “Medical Students, Selected Years”, 1965–2015”, 2016.
6. Harvard Business Review, “Fixing the Gender Imbalance in Health Care Leadership”, 2018.
7. FierceHealthcare, “Gender gap averages more than $36K for physicians starting their careers, new study finds”, January 23, 2020.
8. FierceHealthcare, “Gender pay gap extends to academic medicine where female department chairs earn thousands less”, March 3, 2020.
9. The Advisory Board, “2020 Women’s Health Research”, 2020.
10. The Guardian, “Why does America still have so few female doctors?”, Jan 2018.