Studies have shown that fewer women than men in healthcare are promoted into leadership positions (Medscape, Mar. 29, 2019, and Laryngoscope, Sep. 18, 2019, doi: 10.1002/lary.28308).
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January 2020Furthermore, women aren’t paid the same or supported financially for research at the same levels as men (J Gen Int Med. 2018;33:966-968). One study showed that among 23 U.S. medical schools surveyed, 40% lacked programs for recruiting or promoting women (Womens Health Issues. 2017;27:374-381).
This is despite the fact that women comprise a significant portion of the healthcare workforce (Medscape, March 29, 2019). In 2018, for example, more women than men entered U.S. medical schools for the first time in history, according to the Association of American Medical Colleges.
Reasons Gender Disparities Exist
Now that men and women are more equally enrolled in medical schools, gender disparities in leadership should begin to normalize, said Joseph E. Kerschner, MD, dean of the school of medicine and professor of otolaryngology, microbiology, and immunology at the Medical College of Wisconsin in Milwaukee.
But many other reasons have been given for the existence of gender inequities in medicine. One reason is bias, whether it’s overt or unconscious. “Even seemingly small biases have an enormous impact as they accumulate,” said Jennifer A. Villwock, MD, assistant professor of otolaryngology-head and neck surgery at the University of Kansas Medical Center in Kansas City. “Recognizing the problem can actually be the easy part. It’s much more difficult to identify and implement effective solutions.”
Women may choose to delay their professional career development due to other priorities, such as being a mother or the spouse of someone with a demanding career, needing to be a primary caregiver to elderly parents, or devoting their time to a community cause, said Julie Wei, MD, division chief, pediatric otolaryngology/audiology at Nemours Children’s Hospital in Orlando, Fla. “Any desire to live our lives holistically and care for families and relationships mandates that we give up something professionally,” Dr. Wei said. “But this doesn’t have anything to do with our competency, performance, capability, or potential.”
In addition to inequity in leadership positions, many medical facilities lack services employed women need—especially as mothers—and their benefits packages don’t offer time off and the flexibility to care for children.
Cost has been used as justification for not providing the kinds of benefits women would use most often, such as maternity leave beyond the standard sick time or disability leave options that are available to all employees. “Maternity leave can place a burden on other physicians in a practice, such as having to cover for them,” said Erin O’Brien, MD, division chair of rhinology at the Mayo Clinic in Rochester, Minn. “If women work in a practice with a revenue-based compensation model, they will need to return to work quickly in order to be paid. In some practices, women may have to continue paying for overhead while they’re on leave and not earning revenue.”
Furthermore, the board mandates that otolaryngology residents may miss only six weeks of training per academic year. If they miss additional time, they may need to make it up later in residency or after graduation,” Dr. O’Brien said.
Another barrier is that there is no uniform baseline of benefits for women. For example, there is no minimum number of lactation rooms per X number of female employees, no minimum number of women’s restroom stalls per X number of women employed at a hospital, and no minimum number of paid maternity leave weeks. “The strategies and resources needed to optimize these benefits are specific to each institution,” Dr. Villwock said. “Because there is no one-size-fits-all approach, it can be difficult to know where to begin.”