Nurturing Women Health Leaders: Resources, Statistics and Tips for the Next Generation
Women make the majority of health care-related decisions in the home. Management consulting firm Oliver Wyman reports that women consumers make 80% of buying and usage decisions related to their families’ health. Women also represent 65% of the workforce in the U.S. health care industry (70% worldwide, according to the World Health Organization) but only 30% of C-suite executives (executive-level managers) in health care and only 13% of CEOs.
What’s wrong with this picture?
When the Oliver Wyman researchers looked at the career paths of women who had reached the upper levels of health care management, they discovered no overt resistance from male executives to the promotion of women leaders in their field. According to Oliver Wyman, men in top leadership positions recognize the lack of women leaders and are determined to address it.
However, women had to overcome “micro-aggressions” and other subtle forms of gender discrimination, such as men’s taking credit for women’s ideas, making assumptions about women’s commitment to their jobs over family duties and misunderstanding a woman’s career aspirations.
The best way for women to overcome obstacles to earning leadership roles in health care is by building trust with top executives. The Integrative Model of Organizational Trust was developed by Roger C. Mayer and others and published in the Academy of Management Review in 1995. The model was revisited in a 2007 paper by the same authors; it breaks trust down into three dimensions:
- Ability: The person is dependable and competent and has succeeded in various projects and professional roles.
- Affinity: The person shows empathy for others, cares about their well-being and invests personally in their success.
- Integrity: The person shares with others in the team a set of values that serves as the foundation for collaborative projects.
The Integrative Model of Organizational Trust framework still serves as a reference to many organizations. But even when women health care professionals demonstrate ability, empathy and integrity, they often lack opportunity. This guide describes methods, procedures and resources that can help women health professionals become industry leaders.
Women Leaders in Health Care: Types and Characteristics
Health care leadership is evolving rapidly due to changing demographics, financial models, technology and other dynamics of the medical industry. For example, the chief diversity officer is a new leadership position that addresses the shortage of women in top health care management roles, as Modern Healthcare reports. Chief diversity officers respond to hiring disparities and promote inclusion in their organizations.
The task is formidable: A report released by executive search firm Korn Ferry states that 55% of health system executives believe women are overlooked because of their gender, yet only 24% have sponsorship programs in place designed to help women advance to leadership roles, and almost 2 in 3 describe their career development efforts as fair, poor or nonexistent.
Here is an overview of several top health leadership positions women might aim for, along with descriptions of the education and training each requires, typical salaries, and outlooks for career growth.
The primary role of hospital directors and CEOs is to devise strategies and policies that will allow the organization to achieve its goals. The U.S. Bureau of Labor Statistics (BLS) Occupational Outlook Handbook lists the following CEO duties:
- Direct and manage the company’s budgeting and financial operations.
- Establish and implement goals, policies and procedures.
- Consult with managers, staff and board members about the status of ongoing operations.
- Approve contracts and agreements.
- Identify potential cost savings and opportunities to improve performance, policies and programs.
While many CEOs have earned a Master of Business Administration, hospital directors and CEOs often hold a postgraduate nursing degree such as the Doctor of Nursing Practice. The BLS points out that medical and health services managers — positions that often serve as stepping stones to a role as hospital director/CEO — typically have a master’s degree in health administration or a related field.
According to the BLS, CEOs in health care and social assistance earned a median annual salary of $173,770 as of May 2018. The agency forecasts that employment of top executives in general will increase by 6% between 2018 and 2028, which is the average growth predicted for all occupations.
However, there will likely be “very strong competition” for CEO positions, according to the BLS, because of their high pay and prestige. Having an advanced degree and extensive managerial experience improves a candidate’s job prospects.
Chief Nursing Officer
Consolidation in the health care industry has led to the creation of massive health systems that include dozens or hundreds of individual hospitals and other facilities. The position of chief nursing officer was created to address the increasing complexity of ensuring consistent quality of care, policies and procedures across such large health care organizations.
The journal Healthcare describes chief nursing officers as leaders who are “ultimately responsible for the actions and interventions of the RN at point of care.” The position requires a dynamic personality and a record of success in reaching goals through innovative thinking, inspiring others and setting high expectations, in addition to extensive experience as a nursing executive.
To qualify for a chief nursing officer position, candidates must possess a master’s degree in nursing, as well as national certification as a nurse executive, such as the American Organization for Nursing Leadership’s Certified in Executive Nursing Practice (CENP) certification or the American Nurses Credentialing Center’s Nurse Executive-Board Certified (NE-BC) or Nurse Executive Advanced-Board Certified (NEA-BC) certification.
The position is growing in importance among health care providers because of its perception as critical for consistent nursing practices and policies across increasingly complex health care environments. According to January 2020 data from salary survey site PayScale, the average annual salary for chief nursing officers is around $128,000.
Public Health Director
Public health directors are responsible for the management of public health care programs and organizations. They manage government agencies at various levels and lead a diverse collection of health care professionals toward a set of common goals.
As the Journal of Public Health Management & Practice explains, the role entails interacting with a broad range of stakeholders and constituencies, offering policy direction to the governing board, and working with agencies throughout government whose responsibilities and activities affect public health.
Public health directors must possess the skills and education to manage several complex and technical programs simultaneously. Their role may entail planning and managing multimillion-dollar budgets, navigating politically sensitive issues, and working with legislators and other public officials to set appropriations. Public health directors must have professional expertise in specific areas of public health care, a thorough understanding of the dynamics of public health and leadership skills.
PayScale estimates the average annual salary for public health directors is around $83,000, as of January 2020. The BLS estimates that the number of jobs for all medical and health services managers will increase by 18% between 2018 and 2028. Job growth for public health directors will be driven by the need for organizations to comply with regulations relating to health care and public health in particular.
Medical/Health Services Administrator
This broad job category encompasses medical and health services managers, health care executives, and health care administrators. These professionals may be responsible for managing all aspects of a single health care facility or specific departments or specialty areas in a larger health care system.
Among the duties of health services administrators are ensuring the efficient delivery of quality care to all patients, establishing the operation’s goals and strategies, guaranteeing compliance with government regulations, managing finances, overseeing human resources, and representing the facility at investor meetings and on government boards.
Candidates for health services administrator positions should hold a master’s degree in health administration, health management, nursing, public health administration or business administration, according to the BLS. The median annual salary as of May 2018 was $99,730. The BLS forecasts that employment of health services administrators will increase by 18% between 2018 and 2028 — much faster than the projection for all occupations.
Clinical managers generally have a broader range of responsibilities that encompass both administration and the direct provision of medical care, as the resume site Job Hero explains. Clinical managers set staffing levels and hire new workers. They also conduct performance and organizational reviews, determine the operation’s budget, and devise the business plan for the facility.
Employers look for medical office experience, a thorough understanding of ethics and confidentiality, communication skills, and expertise in one or more health care specialties. As with health services administrators, employers prefer clinical manager candidates to have a master’s in health administration or a related field. Clinical managers fall in the BLS’ medical and health services manager category, which has a median annual salary of $99,730 as of May 2018.
Becoming a Health Leader: Skills, Tools and Resources
Qualifying for leadership positions in health care requires a combination of education and experience in health topics, management and organizational behavior. Women who seek to become leaders in the field will enhance their prospects by nurturing their skills in the following areas:
Emotional intelligence is one of the five core competencies identified in the Journal of Healthcare Leadership as requirements for effective leadership in health care. In particular, the goal of establishing a patient-centered facility that benefits from selfless service depends on the leader’s ability to encourage and promote emotional intelligence in the nursing staff.
Other benefits of emotional intelligence for women leaders in health care are maintaining personal balance, cultivating personal resilience, managing self, continuing personal development and developing personal awareness.
Business services vendor Coors Leadership lists the benefits of emotional intelligence for health care leaders:
- It allows health leaders to assess the emotional and psychological state of nurses and other staff, identify those who may be suffering from burnout and stress, and empathize with them.
- By knowing how to recognize and control their own emotions, health leaders can understand how their feelings can affect their decision-making.
- Emotional intelligence improves communication by allowing health leaders to understand how others are responding to them, and how clearly and completely they are responding to others.
Critical Thinking and Communication
Another component for effective health care leadership from the Journal of Healthcare Leadership is the ability to think critically and communicate clearly. Critical thinking is the ability to think analytically and conceptually when solving problems and evaluating situations. Effective communication requires the ability to manage difficult conversations and offer constructive feedback.
The International Journal of Nursing Science concludes that the ability to think critically is of utmost importance for nurse administrators because of the unique dynamics of decision-making and problem-solving in health care settings and the direct impact the skill has on ensuring positive patient outcomes.
Inspiring and Guiding Team Members
When lives are on the line, a leader’s ability to motivate a team of workers to operate as an integrated unit is imperative. Effective teamwork begins by establishing and maintaining relationships with all team members. This is accomplished by listening to and supporting individuals on the team, gaining their trust, and demonstrating an understanding of each person’s needs and motivation.
Among the qualities identified by the Journal of Healthcare Leadership in effective team leaders are decisiveness, the ability to motivate others, encouraging their contributions, and managing the performance of team members and the team as a whole. Leaders must also foster a vision within the team that serves as the groundwork for developing and implementing the team’s strategy.
Fostering Change and Innovation
Leaders in health care must guide the industry’s ongoing transformation by ensuring that staff members are able to adapt to change. They can accomplish this goal by encouraging constant improvement and innovation, as well as by being the first to adapt to changes in the health care environment from technology innovation, market conditions, or the political and regulatory environment.
The International Journal of Health Policy and Management presents eight concepts that contribute to the effective cultivation of innovation in health care settings:
- Create a psychological climate for innovation by tapping employees’ creativity and implementing ideas that fit with the organization’s values.
- Emphasize the quality of relationships by focusing on leader-member exchanges based on mutual trust and respect.
- Encourage a wider network of relationships among staff by spending “social capital” to create a culture that thrives on innovation.
- Ensure leadership clarity by soliciting team members’ perceptions about how effectively the team and its leaders are performing.
- Support reflectivity in the team, both within and outside of traditional work environments, to promote new ideas from diverse sources.
- Develop employee mindsets that put the team’s goals ahead of individuals’ aspirations.
- Implement an organizational culture that values clear communication and rewards risk-taking by individuals.
- Promote an entrepreneurial leadership style that focuses on attributes, behaviors, motivation and intellectual stimulation.
Acting With Integrity and Ethics
Binding all these leadership skills together is the need for women health care leaders to demonstrate personal integrity. A leader’s personal code of ethics combines with the professional ethical values that others witness in the leader’s actions. By being open, honest and trustworthy, health care leaders set a standard that staff members and others inside and outside the organization can emulate.
The following are among the American College of Healthcare Executives’ guidelines for creating an ethical culture in health care environments, which were last updated in November 2015:
- Promote an organizational code of ethics that clearly describes ethical guidelines and standards of behavior.
- Include in all policies and behaviors the ethical principles expressed in the organization’s code of ethics, including personnel policies, annual reports and orientation material.
- Ensure all staff members understand the standard of behavior and ethics that they are expected to uphold.
- Create a process through which staff members can raise any ethical questions or concerns they have.
- Ensure that everyone in the organization is free from harassment, coercion and discrimination.
Additional Information for Becoming a Health Leader
Despite the obstacles they must overcome, women are encouraged to prepare for and seek leadership positions in health care. Women can use the techniques described below to tackle specific issues that may arise in the workplace.
Addressing Discrimination and Pay Gaps
The Harvard Business Review identifies the three primary reasons for the dearth of women leaders in health care: implicit gender and maternal bias, systemwide policies that disadvantage women, and sexual harassment.
Researchers recommend that health care organizations implement family-friendly policies such as longer paid maternity leave and on-site childcare services to retain and promote talented women managers. They also call for measures that will mitigate sexual harassment and implicit gender bias, as well as annual systemwide salary reviews to address the continuing disparity in pay between women and men in health care professions.
Obtaining Additional Training and Education
A study conducted by the Boston Consulting Group (BCG) found that when organizations increase the diversity of their leadership teams, the result is “more and better innovation and improved financial performance.” Firms that have above-average diversity levels on their management teams reported 19% more “innovation revenue” than companies that have below-average diversity in their leadership teams. The study also determined that diversity is gaining momentum in 75% of organizations worldwide.
However, a separate BCG survey reports that diversity in leadership is lower in health care than in other industries despite the high percentage of women in the field: 77% of health care workers are women, yet of the 150 largest health care companies, only 18 have a woman serving as CEO. The BCG survey results indicate that retention and advancement are the two greatest obstacles to gender diversity in health care leadership, cited by 57% and 50% of respondents respectively.
To help improve retention rates and prepare new nurses for the career’s many challenges, women in health care may choose to pursue additional hands-on training in practical leadership skills. Programs such as the Center for Creative Leadership’s Women’s Leadership Experience cover understanding how others perceive leaders, aligning behavior with personal leadership brands and career goals, and creating and leveraging professional strategic networks.
Preparing for Future Challenges in Health Care
As the health care industry adapts to economic, political and social change, women will be at the forefront of the effort to improve the quality of care that patients receive and the effectiveness of health care services. Becker’s Hospital Review describes several of the challenges the industry faces:
- Rising health care costs
- Changing regulatory requirements
- Incorporating technological advances in medicine and health care techniques
- Ethical challenges such as misleading medical research and unethical behavior
- The shortage of training and educational opportunities
Addressing these and other challenges will require fresh perspectives and new ways of approaching potential solutions to complex problems. Women leaders are increasingly important to ensure the health care industry of the future serves all patients’ health needs as effectively and fairly as possible.
Achieving this goal is possible only by ensuring that women in health care receive the training and education to lead efforts to surmount the unknown challenges they will face in their careers.