Senior leadership positions in health care are highly coveted and highly competitive. Even though women and those who identify as women are hired in these positions more often than they were historically, there remains a substantial lack of representation in the highest positions: from 61 percent representation in manager and director roles to 32 percent at the C-suite level (and only 8 percent for women of color), according to a 2023 McKinsey & Company study using data from 2022.
“I still think women have a higher hill to climb when it comes to positioning their unique experience and expertise as being a value-add,” says Karen A. Curley, vice president of client services at The Leadership Development Group, instructor at the Harvard T.H. Chan School of Public Health, and program director for the Emerging Women Executives in Health Care program.
“Globally, I still think one of the problems is that the pipeline for leadership doesn’t have as many women, and so they’re always fighting to get on that list,” she adds.
There are also significantly higher barriers for entry that are unique to these positions and distinct from prior job requirements, like participation on boards and risk management experience. “When you look in a pool of water, you can’t see the bottom. In this case, the bottom is actually the top of the organization and your next step up. You can’t see it—it’s not clear,” says Curley. So how does one start to bridge this gap?
Filling In the Blanks: A New Strategy for a Higher-Level Health Care Position
A woman who’s in a management position may not know the skills she’s missing until she’s overlooked or rejected for a higher-level job. Many women have backgrounds or experiences that are different than their male counterparts—the pathways they’ve taken to their role may look different or “atypical” to other applicants, in other words—or may not have had the same opportunities for growth in particular areas.
As a first step, Curley notes, women need peers and mentors who can help them network and strategize what they’ll need for their next step. They also need to start having more forward-thinking conversations. “Women are great at mentoring, but I think they end up talking about situation-specific things: ‘How do I do a better job of getting the CEO to pay attention to me?’ for example, instead of, ‘How do I set myself up for the next job?'”
More importantly, female leaders need to start focusing on what they’ve done, instead of who they are. Citing the statistic that women won’t apply for a job until they’re fully qualified (in contrast to men, who more often apply even if they don’t meet every qualification), she notes, “When you’re thinking about the hiring committees, the people in the room who are generating the names on the list for leadership vacancies or new positions they’re creating don’t often ask, ‘Does anyone know anybody with (fill in the blank) skill set?’ They talk about people who have done things, accomplished goals, been in the muck, rolled up their sleeves, are good in crisis, and demonstrated what they’re looking for.”
“These accomplishments let you in the conversation and get you in the room,” she adds.
How Female Managers Can Build a Leadership Reputation for Their Next Step in Health Care
At its core, leadership reputation is a combination of tallying one’s accomplishments, highlighting oneself to the right people, and presenting one’s profile as an asset—all with a senior position in mind. “You’re always building your leadership reputation. And you have to be thinking about what goes into it if you want to be considered for that next level. What are people looking for? What gets noticed? What do you need to feature? How do you elevate yourself?” explains Curley.
She encourages the women she works with to catalog their accomplishments, both in the moment and in the context of their larger work profile, and adds that relevant experience can come from all manner of sources. “An accomplishment doesn’t have to be something at a grand scale; it could be that they kept a ‘flight risk’ employee from leaving, and that’s huge when you think about the race for talent.”
In this way, women seeking promotion can draw from their unique skill set to demonstrate their capabilities. In practice, this can range from demonstrating adaptability and nimbleness in the face of system changes to highlighting one’s emotional intelligence and unique leadership style around negotiation and conflict resolution. This work may not come easily, depending on the person, but it’s integral if they want to achieve their goals.
“Self-promotion is not a dirty word,” Curley insists.
Harvard T.H. Chan School of Public Health offers Emerging Women Executives in Health Care, a leadership development program focused on women that enhances your skills to lead complex health care organizations.
