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Minding the Gap: How Confidence Overrides Ability for Women Leading Hospitals

January 8, 2021

Empowered women empower women. And although we all know we need to close the gender gap in healthcare, this demands more than telling women to just climb the corporate ladder—it’s about creating the confidence to do so. The American Hospital Association reports that less than a third of C-suite positions are held by women. Statistically, women have the short end of the stick when it comes to the workplace—they often work harder for less money and recognition than their Caucasian male peers. However, women can beat the statistics by improving their confidence.

Behind the facts

When asked about healthcare career goals, it’s more common to hear men confidently say, “I want to be CEO” and for women to state that they, “just want to make a difference,” reports the Journal of Healthcare Management. This is where the gender gap plays a huge role when it comes to career confidence; it often doesn’t occur to women starting their careers to aim for the C-suite. The Confidence Gap by Katty Kay and Claire Shipman, authors of Womenomics, conducted various studies that demonstrate how women are less self-assured in the workplace than men. Kay and Shipman discovered that what affects women’s success was not their actual ability, but their lack of confidence in those abilities. The difference is, men with equal ability were more successful because of their extra confidence.

The Journal of Healthcare Management’s study also found a definitive gender difference in that men were less hesitant in sharing their CEO aspirations than women. The pattern they found shows that most women who begin their career journey in a clinical setting have less confidence than women who start in an administrative role. Put another way, the study shows that it’s unlikely for a woman to strive for a CEO position unless she is already an executive.

Paying the price

Men occupy between 80 to 90 percent of leadership roles in medicine. This sad truth also reflects on the depressingly skewed ratio between male and female physicians. The only fields where women dominate in medicine are pediatrics and gynecology, according to Bryn Mawr College. It is historically believed that women monopolize these fields because of society’s assumptions that women are more maternal and should focus on family and children more. This expectation acts as an uncontrollable external factor that deteriorates women’s confidence. Trying to find confidence when the odds and assumptions are against you, this contributes to burnout and frustrations with the field.

Unfortunately, another uncontrollable external factor is the persistent pay gap. CNN Business states that in 2017, female physicians earned 28 percent less than their male counterparts. That equals an average of $105,000 a year less than men. If women make a significantly amount less than their equal caliber jobs of men, why would they want to strive for more for less reward? Of course, there are endless reasons to have more diverse leadership, but the prohibitive pay gap often stands in the way. Women, it’s time to beat the statistics.

No invitation necessary

Although there are unfortunate external forces that affect women’s motivation, there are several internal things women can control as they fight for inclusion. Women tend to steer shy of the initial leap of faith that leads to the promotion or title they have been eyeing. This goes hand in hand with women who wait for “permission” to ask for more. Too often, women have a great idea but hesitate to act on it. The only difference is that men execute these thoughts and often receive recognition. Women don’t need permission to have ambition!

“If something has to be done, it needs to be done. You shouldn’t have to wait for someone to tell you. It’s about advocating for yourself and just doing. You walk, they’ll follow,” says PRC’s chief experience officer, Hope Brown.

As a leader, Brown references Lean In by Sheryl Sandberg, Chief Operating Officer of Facebook. One eye-opener Brown shared was Sandberg’s observation of a task as simple as attending a meeting. As her coworkers trickled in, she noticed the men sat down at the main table whereas the women gathered around the outside table of the table, even if the women’s titles were equal stature to the men.

“After reading that, I made sure to find my own place at the table and encourage other women to do so as well,” Brown says.

It’s important for women to not only strengthen their own confidence, but also help others who may second guess themselves. Unfortunately, women’s inaudible nature of second guessing relates back to the confidence gap. Women who underestimate themselves in their current role often miss out on other opportunities as well. A study from Hewlett Packard reports that, “men apply for a job or promotion when they meet only 60% of qualifications, but women apply only when they meet 100% of them.” As more women (and men!) encourage female coworkers to apply for promotions, the gender gap will begin to narrow.

Be in(credible)

Whether a woman’s desired title is there or not, it isn’t always the title that inspires credibility, but rather how you present yourself to the company and your coworkers. The title will come, but confidence is a choice. When working in a team, men and women can perceive credibility differently. Women tend to feel less confident in taking credit for a project than men.

“The more ‘communal teams’ organizations have, the more effective they are in the long-run, rather than looking right at the top,” says Brown. According to Brown, communal teams have good communication and teamwork. However, she also says it’s important for the team to take credit communally as well.

“After a project is complete, women often take their credibility as ‘we did that’ as opposed to a man that takes credit as ‘I did that’,” says Brown.

In many workplaces, leaderships and titles do not always go hand-in-hand. In traditional companies, especially hospitals, a title often determines who gives orders down the line. However, that doesn’t necessarily determine the strength of leadership. Anyone can give a command, but not everyone is capable of offering the proper guidance a leader should. This is an opportunity for women to become organizational leaders without needing new business cards.

“In true strong leadership, a good leader, man or woman, is the one doing things by motivating and getting people to want to do what they want them to do, not barking orders,” Brown says.

Brown’s journey to the C-suite did not start by waiting for recognition. Brown started working as the assistant to Dr. Joe M. Inguanzo, President and Chief Executive Officer of PRC. Through her tenure at PRC, she remained self-guided, as well as self-motivated. Brown recalls that about half of her workload included special projects working directly with Dr. Inguanzo. As she walked alongside him, she built trust and credibility without a fancy title, but yet, forged the leadership position she now holds.

“In non-traditional workplaces, such as PRC, people respect specific coworkers because of their relationships that are established within the company. It’s about finding the need, and creating the title,” Brown says.

PRC’s Jan Gnida, Senior Vice President of Research Operations, followed a similar journey to Brown. She established trust within the company when she started as the consultant assistant that assumed more responsibility for direct contacts with Dr. Inguanzo’s clients. Gnida started taking on more responsibility before her promotion.

“The job wasn’t changing to reflect the new title; it was the title that was changing to reflect the work I had been doing,” she said.

A deeper look

During the spring 2019 PRC Excellence in Healthcare Regional Summit in Indianapolis, Trevor Turner, MD, a Physician Coach for our Excellence Accelerator® division, spoke about his insights on creating high performing teams. He discovered that the one characteristic shared between each successful team was the presence of women. One of the main takeaways Brown keyed from Turner was that, “you can do well with a team of men and women and a team with all omen, but it appears that a team of all men seem to have less success.”

Despite social expectations and antiquated ideas, the road to achieving higher leadership positions is open for all. When women allow themselves to ditch the voice in the back of their minds saying, “I am not as good as that man,” healthcare becomes a better place. It is undeniably difficult to beat the statistics, take that leap of faith, and do so without permission. However, the reward of a successful team, a gratifying career, and one less glass ceiling in healthcare makes closing the confidence gap worth it. Women, it’s time to stop undervaluing yourself and shoot for the moon.