On my way home from Scotland, I had a moment to watch a movie while my daughter was caught up in the encore adventures of Moana. I stumbled upon Hidden Figures, the story of the African American women at NASA who helped launch John Glenn into space, relaunching the nation’s space program. These women were true heroes and patriots – they lived in a man’s world and a white world, and they still managed to overcome and lead when needed. Yet, their story was “hidden” from the public until years later when popularized into this screenplay. On the plane, I realized I needed a fresh take to start my women in medicine webinar for this month’s American Medical Association Women in Medicine webinar. Instead of exploring the ‘leaky pipeline’ resulting in 1 in 5 professors who are female, I wondered whether were there hidden figures – women leaders among us who we don’t see.
Turns out I wasn’t the only one who stumbled upon this. Harvard researcher Dr. Julie Silver raised the question about invisible women leaders when reviewing quotes in magazines like Modern Healthcare or Forbes. Moreover, her research demonstrates that for many professional society awards, 0% are awarded to women! This is happening in specialties that had nearly even proportions of women and men in practice, such as dermatology and rehab medicine. Last month, I was dumbfounded when I saw a full-page NYT ad of Top Surgeons by Castle Connolly featuring 16 surgeons, all male.
— Vinny Arora MD (@FutureDocs) August 19, 2017
While Castle Connolly does name female top doctors and market ad opportunities to women and men, I learned that only men sign up for the ads. While this itself raises more questions, the optics remain problematic – women doctors are hidden. Regardless of the venue, we must do a better job profiling our female leaders. In addition, it is important to recognize that female leaders face well-documented and somewhat controversial challenges that require careful thought:
- Stereotype Threat: Some of the original research on stereotype threat done in college students showed that before a math test if women are told that the test will expose gender differences such as men do better at math, girls will do worse AND boys will do better. The threat of stereotypes is that women can internalize them and hamper their progress. The good news is that education on stereotype threat apparently helps.
- Imposter Syndrome: Even highly successful people apparently suffer from the fear that they are not deserving of their success, but it is much worse in women than in men. You are always conquering the little voice in your head telling you that you are not good enough.
- Discrimination and Bias: This is probably where the most stunning data lies and suggests bias starts early. Just ask Tamika Cross. A recent paper looking at maternal discrimination among the Physician Moms Group (PMG) Facebook group members revealed 4 of 5 reporting discrimination, either due to being a woman, a mom or both.
- The Likability Penalty: This somewhat controversial theory espoused by female icon Sheryl Sandberg of Facebook/Lean In fame posits that women face penalties for exhibiting confidence and assertiveness, characteristics necessary for leadership but go against the female archetype. We have found evidence of likability penalties in attending evaluations of female residents who struggle to find the right balance between being assertive and overly confident.
- Queen Bees: One of the most polarizing ideas is that women who make it to the top in very rigid patriarchal leadership styles end up actively trying to keep other women out, perhaps due to concerns that there is only room for one woman at the top or that other women should have to suffer as much as they did.
So what are the solutions for women seeking leadership? As noted in a recent Harvard Business Review, leaders require both an internal leadership identity (which can help overcome stereotype thread and imposter syndrome) as well as a strong sense of purpose (or a reason to lead). Given those thoughts, here are my suggestions for female leaders:
- Craft a legacy statement: This sounds strange for someone not on their death bed, but the idea is to start with the end in mind. What do you want your impact to be? Use that statement to measure your current activities and guide your decision-making. Time is limited, especially for women physicians with many competing obligations so a legacy statement can help you focus your activities to the high impact ones likely to succeed.
- Get sponsorship and coaching: While mentorship is often used, sponsorship can help overcome the well documented gap that women often face in which they are less likely to be nominated for honorifics.
- Find your posse: Since female leaders face a likability penalty, finding a posse or support group is critical. This could be at work, at home or online. Social media has made it easy to join large posses, like the 65,000+ strong Physician Moms Group on Facebook. Even in that space, however, you can often find a group who shares similar issues.
- Use your voice to lead: While this may sound uncomfortable, women leaders use their voice to speak up. Recent examples include #DoctorsSpeakOut and truth heroes like Dr. Jen Gunter who takes on Goop’s alternative facts about health.
- Amplify other female voices: As Obama female staffers wrote, they used a deliberate process of amplification to repeat and attribute comments made by other women. Not only do they get farther working together, it unhides the women. Twitter is often used to amplify other women’s voices – ranging from #ThisIsWhatADoctorLooksLike #ILookLikeASurgeon and #NYerORchallenge.
I recently sat down with the American Medical Association to discuss challenging bias in the workplace and creating a culture of solidarity.
Lastly, I am thrilled to highlight that women hospitalist leaders are very visible in the healthcare community and SHM: this year, the course director for Hospital Medicine 2018, a physician editor of The Hospitalist, 5 board members and the president-elect are all women! Add this to the fact that SHM’s membership comprises 40 percent women, and it’s not hard to discern that both hospital medicine and SHM provide women leaders with a clear pathway to career advancement. Together, we can ensure more women leaders stay front and center, visible and respected.
Vineet Arora MD, MPP is Director of GME Clinical Learning Environment and Assistant Dean for Scholarship and Discovery at the University of Chicago Pritzker School of Medicine. Dr. Arora’s scholarly work has focused on resident duty hours, patient handoffs, sleep, and quality and safety of hospital care. She is the recipient of the SHM Excellence in Hospital Medicine Research Award in 2007. Her work has appeared in numerous journals, including JAMA and the Annals of Internal Medicine, and has received coverage from the New York Times, CNN, and US News & World Report. She was selected as ACP Hospitalist Magazine’s Top Hospitalist in 2009 and by HealthLeaders Magazine as one of 20 who make healthcare better in 2011. She has testified to the Institute of Medicine on resident duty hours and to Congress about increasing medical student debt and the primary care crisis. As an academic hospitalist, she supervises medical residents and students caring for hospitalized patients.
Dr. Arora is an avid social media user, and serves as Deputy Social Media Editor to the Jounral of Hospital Medicine, helping to maintain its Twitter feed and Facebook presence. She blogs about her experiences at http://www.FutureDocsblog.com and actively tweets at @futuredocs.