Women, Leadership & Hospital Medicine: Lean In

By  |  June 19, 2014 | 

by Dr. Rachel George MD, MBA, CPE, SFHM

It is time for women in hospital medicine to sit at the table, pursue our ambitions, and change the conversation to what we can do to transform patient care. One year ago Sheryl Sandberg, COO of Facebook, published her best-selling novel Lean In: Women, Work, and the Will to Lead encouraging women to do just that. So, what’s the buzz about? Wasn’t this all sorted out a generation ago and didn’t we get this equal rights thing figured out? We can have it all, right?

Unfortunately, that may not be the case. The United States is far behind other countries in helping women stay in the work force; America comes in last place on paid maternity leave (CNN Money), and according to a survey released by the United Nation’s labor agency, only three countries do not provide cash benefits to women during maternity leave: Oman, Papua New Guinea, and USA.

Despite the fact that women have outnumbered men on college campuses since 1988, earning a third of law degrees, and a third of medical degrees, they have not moved up to positions of prominence and power in America at the rate that should have followed. Across a broad range of fields, only 10 to 20 percent of top leadership positions are held by women. In fact, it’s now estimated that, at the current rate of change, it will take until 2085 for women to reach parity with men in leadership roles in our country.

Not only that, equal pay for equal work is still not a reality in 2014. Even among physicians, women earn 71 percent of what men earn even after controlling for age, race, hours and education. Katty Kay and Claire Shipman, authors of The Confidence Code, say that this is due to a lack of confidence. If we can teach ourselves to be more confident, then more success is just around the corner. However, women are still fearful of speaking up and advocating for themselves. Patricia Sellars in a 2011 Fortune article, “Facing up to the female power conundrum” says that this is because women face a narrower band of acceptable behavior than men do. Women can be powerful or women can be likeable; being both is difficult to do Hospital medicine is not much different from all other professions; we have a much smaller percentage of women in leadership positions than would be expected by the number of women in the profession. While Warren Buffet may find it easier having to compete with only half the human race, it means that we are not tapping into the full potential available to us to transform hospital medicine and healthcare as a whole.

So is it really about building confidence and having the willingness to “lean in?” What is our responsibility for creating a supportive and accepting culture with our employers and throughout the medical education process? What can we as hospitalists and as a professional society do to encourage women to “lean in” and participate? How can we help women stay in the hospital medicine workforce not to just survive, but thrive?

I have started a list of things that could potentially contribute to tapping into the potential of women in hospital medicine. This is just a starting point, and I invite you to add to the list below so that we can begin to think about meaningful ways to engage women in hospital medicine at a higher level:

1.  Create flexible work schedules and job sharing opportunities making it easier for anyone wanting to work part-time.

2.  Encourage those working part time to pursue leadership opportunities.

3.  Encourage women to step up (or lean in) and apply for positions of leadership in hospital committees or group management.

4.  Mentor women to help them understand and navigate the challenging world of hospital politics.

5.  Sponsor women for positions of leadership by putting their names into the hat when opportunities arise.

Dr. Rachel George MD, MBA, CPE, SFHM

Rachel George 09 2013Dr. George has been with Cogent Healthcare for nearly eight years, and serves as President of the Central Business Unit. In that role, she oversees 30 hospital medicine programs in 10 states. Cogent Healthcare is the nation’s leading private hospitalist and intensivist company, providing clinical solutions at Acute Care and Post-Acute Care facilities. She has an MBA in Healthcare Administration and is a Certified Physician Executive as well as a Senior Fellow in Hospital Medicine. She is an active member of SHM and has served on multiple committees including Leadership, Membership, and Annual Meeting. She chaired the first Women in Hospital Medicine taskforce as and has spoken extensively on the role of women in hospital medicine and women in leadership.


  1. Kimberly Bolen June 19, 2014 at 12:37 pm - Reply

    Well said.

  2. MaryEllen June 19, 2014 at 8:59 pm - Reply

    I’m a parttime Hospitalist leading a major QI project and it’s a delicate balance! I’m excited to learn more at the SHM leadership academy this fall but have to admit I was disappointed there aren’t more women on the faculty. SHM is one of many organizations without many women leaders and I hope that increases as time goes on. One of the hardest things is not having mentors who share your personal and professional struggles.

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