Closing the Gap in Healthcare Leadership: Interview with OHSU's Susan Hedlund
Next time you take a trip to the doctor’s office, take a closer look at the staff. You will notice that most healthcare professionals are female. This phenomenon shouldn’t come as much of a surprise. Caregiving is a trait typically ascribed to women’s roles both at home and at work. According to a survey from Rock Health, women spend more than twice as much time informally caregiving for household members than men. Also, 77 percent—more than three-fourths—of the U.S. healthcare workforce is female.
However, while healthcare is an undoubtedly female-dominated industry, women are not being represented proportionally on healthcare companies’ executive teams. According to a report from Oliver Wyman, women make up only one-third of senior leaders at healthcare companies and only 13 percent of the industry’s CEOs. In fact, not a single woman holds the role of CEO of a Fortune 500 healthcare company.
And women in the industry don’t anticipate this trend to turn around anytime soon. In the same survey from Rock Health, almost half of respondents said they think it will take at least 25 years or longer until gender parity is a reality in the industry. Unfortunately, if historical data is an accurate indicator, they’re right. In 2017, only 22.6 percent of healthcare company board members were female, a mere 1.6 percent increase since 2015. At that rate, the industry won’t see gender equality on healthcare boards until 2049.
These statistics are troubling, not just because of the disproportionate percentage of women on executive boards—which is on par with other industries’ representation at around 20 percent—but because, unlike other industries, healthcare is overwhelmingly female-dominated.
So, why isn’t this being reflected proportionately farther up the leadership ladder?
Meet the Expert: Susan Hedlund, MSW, Director of Patient/Family Support Services at OHSU
Susan Hedlund has been a leader in patient/family support services at the Oregon Health & Science University (OHSU) Knight Cancer Institute for eight years, but her experience in the field of social work in oncology goes back 30 years. She began her career by earning a bachelor’s degree at University of California, Davis, and continued on to the MSW at Portland State University.
Hedlund now specializes in the development and provision of psychosocial support services for people with cancer and their loved ones at hospitals at OHSU. She’s taken on leadership roles like director of the cancer counseling program at Cancer Care Resources and director of the Palliative Care Program in Hospice and Palliative Care of Washington County.
Like many accomplished managers, Susan Hedlund stepped up to the plate when the circumstances called for it. She said that she first began to take on administrative leadership roles while teaching a class at the School of Social Work at Portland State University. From there, she was tapped for leadership roles in other capacities, like at the national volunteer organization she was involved with, the Association of Oncology Social Work, where she was eventually elected president and earned an award in leadership excellence.
As a longtime member of the healthcare industry, Hedlund has seen gender disparity in healthcare and witnessed it begin to evolve in a positive direction. “It used to be very male-dominated when it came to both leadership and physicians themselves,” she said.
But at her place of work, OHSU—one of Oregon’s most revered medical centers and its only academic health center—there are tangible improvements being made. At present, four out of eight of the executive leadership roles are held by women. “It’s a big deal,” Hedlund said. “As more and more women are in male dominated fields, we’re seeing more women in leadership roles as well. I think we’re really seeing it change.”
As of 2018, OHSU has more women in executive leadership roles than ever before, including historically male-occupied roles like chief medical officer and dean of the School of Medicine.
While some institutions are taking the initiative to bridge the gap, there is still a long way to go before we see gender parity reflected in statistics. To help build the momentum of this progress, it’s important for healthcare community members and prospective women leaders in healthcare to understand what is at the heart of this statistical paradox.
Obstacles for Women in Healthcare Leadership
There is no simple explanation for the gender disparity in healthcare leadership. The reality is that the barriers women face are multi-faceted.
Some suggest that the goal of raising children may steer young female professionals away from pursuing early leadership training. Women may perceive they have to make a choice between family and career, which is perpetuated by our society’s insufficient support for mothers, such as maternity leave and other childcare benefits. This perception may be especially true for people in executive positions, who are held to a high level of performance at work. This ingrained belief results in fewer women at executive tables further down the line in their careers.
Then, there’s the potential fear of public perception. Since women with nurturing and caring qualities are looked upon favorably in our society, many women are carrying the believe that the pursuit of a leadership role will be looked upon as selfish, overly ambitious, or cold and calculating. So, a fear of disapproval from family, community members, and coworkers could also be dissuading such potential leaders from reaching for the ladder.
Research supports that these lingering old-school belief systems are perpetuated by a lack of representation. According to the U.S. National Library of Medicine, women in academic medicine face greater challenges finding mentors than men. If young women in the field don’t have female role models in positions of administrative power, they will be subconsciously discouraged from pursuing similar roles themselves.
This cultural context feeds into a phenomenon you’ve probably heard of: imposter syndrome. It’s a term that was coined by clinical psychologists Pauline Clance and Suzanne Imes in the 1970s, describing a pattern of behavior in which individuals doubt their own accomplishments and hold an internal fear of being exposed as a fraud. While this term can be used in a gender-neutral context, it is largely associated with the female experience in the professional world. In essence, many of the obstacles that women face in pursuing leadership roles are psychological, rooted in intangible societal expectations for female behavior that are still lingering from centuries past.
This condition plagues even the most prominent female leaders. Hedlund says that she experienced this feeling herself when she first started taking on leadership roles in the field.
“At first, I was reluctant to speak up, but I found I was sometimes the most knowledgeable in the room,” she said. “I was in a meeting with a bunch of guys and finally decided to speak up. I realized that people were listening to what I had to say and valued my opinion.”
Hedlund laughed and admitted that even now, the imposter syndrome creeps up from time to time, but that she has learned to push past it. “It comes down to ego—I think it requires ego strength, which is different than being egotistical,” she said. “You have to have the confidence to sit at the big table with the big guys and speak up.”
The Value That Women Bring to Leadership
In learning to define her own leadership style, Hedlund discovered that her natural empathy and thoughtfulness were not a weakness, but a strength. She views leadership as an opportunity to support others, which has led to her department’s zero turnover-rate since she’s been onboard.
“I view management as how you keep the daily operations going, while I think what’s more interesting about leadership is that it has to do with the bigger picture and having a vision,” she said.
“I believe compassion and humility are characteristics that women typically possess a little bit more automatically than men just from the way we’re socialized,” she continued. “The ability to build relationships with people helps you be a good counselor, build good relationships with clients, and also, be a leader. Part of what has helped me be successful is being respectful.”
Hedlund’s ideology is one that has lended success to other female leaders in the industry. Nancy Howell Agee, president and CEO of the Virginia-based Carilion Clinic, a not-for-profit health institution, is another advocate of the importance of women in healthcare leadership roles.
“Healthcare is powered by women,” Howell Agee said. “It seems to me that women are particularly good at relationship building and that’s a real strength. There is a whole notion of [women] leading others so that others can achieve… It is a role that is somewhat natural, at least for me, and I think for women in general.”
So, the idea is not for women to go against their natural propensity toward inclusiveness and sensitivity to others, but to use it to foster better synergy in teams, and ultimately, to better accomplish business objectives.
“Once we have this great diversity of people in leadership roles, it will make such a difference in what we’re trying to achieve,” Howell Agee added. “Be authentic, be yourself. Don’t try to be something that you’re not.”
How Women Can Persevere
While seasoned industry pros like Hedlund and Howell Agee have mastered their own leadership styles, coming into one’s own is easier said than done for the industry’s fledgling female leaders.
So, what steps can women who want to pioneer a change in gender parity follow for themselves?
Seek mentorship from women you look up to. You can thwart the effects of the underrepresentation of female leaders in the industry by seeking out a trusted advisor that you can turn to for tailored career advice. It will be inestimably beneficial as you navigate the beginning of your career and plan for the future.
Identify your strengths and weaknesses to fight imposter syndrome. For Hedlund, one of her perceived weaknesses was public speaking, but since her first presentation some 30 years ago, she hasn’t shied away from the challenge and has seen each request for her to speak publicly as an opportunity for growth. Her openness toward addressing her weaker areas has been instrumental to her success and helped her battle the imposter syndrome phenomenon.
Don’t compare yourself to others. Forbes says that setting goals based on your own progress is an important measuring stick rather than looking at your colleagues or competitors. This way, you won’t be discouraged by others’ successes, allowing you to keep moving up the ranks at your own pace.
Align your own path to the strategic direction of the organization. Harvard Business Review advises that in order to rise within an organization, it is imperative to understand its goals and objectives. “It’s knowing the culture and what the administration values and how to speak their language,” Helund explains.
Realize that your own thinking may be the biggest obstacle holding you back. This may be the most important tip on the list. Make sure you are aware of your own thoughts about yourself and your attitude’s effect on your performance. “Part of it is developing the skills, but part of it is trusting your voice and knowing its value,” Hedlund said.
How Organizations Can Promote Women’s Success
The value that women bring to the healthcare industry is already so powerful, but imagine if they held more positions in high leadership within these organizations. If you are in a position as a top-level administrator, there’s a lot you can do top-down to create an environment that encourages women to pursue vertical career growth.
Dive into the plethora of resources available online that can help educate you on how to create an environment that promotes female success in healthcare. One example is the new nonprofit initiative Time’s Up Healthcare, which aims to bring gender equality to industry. Another is the Harvard T.H. Chan School of Public Health leadership program, Emerging Women Executives in Health Care, which examines obstacles that women face in the industry.