The main barrier for women’s medical career advancement is the role conflict they encounter, which includes career breaks, child-care and difficulties in combining professional and family demands (Dumelow C. and Griffiths S. , 1995; Miller and Clark, 2008). The BMA states that the most frequently-cited reason for female doctors (76%) to leave general practice is due to family responsibilities (Miller and Clark, 2008). Another study indicates that women are significantly more likely to believe that they hold a disproportionate burden of family and home responsibilities (Lantz and Maryland, 2008).
Having a family, or other domestic commitments, were regarded as a disruption of daily working life (Dumelow C. and Griffiths S. , 1995) and accordingly, most women who reached a senior grade in their profession were likely to be childless and were even less likely to be married than men (Miller and Clark, 2008). According to a female respondent in the Dumelow and Griffiths (1995) study, “the route (medical consultant career) is structured in a way that favors men and male attitudes. You need a good wife to support you, which most women don’t have.
” (Miller and Clark, 2008). A study in 2004, by Arnetz and von Vultee, indicated that the higher rates of absenteeism observed in female physicians were not only because of family-related incidents, but also because of higher occupational stress. Low influence and authority capabilities at work, due to gender discrimination and ongoing restructuring of the healthcare sector, were reported as important factors that fostered an unhealthy work environment, consequently increasing the rate of absenteeism for female physicians.
Men are more prone to become chemists, physicians and computer scientists and women are more likely to be employed as biologists, technicians, pharmacists or nurses (Joy, 2006). This is mainly due to the gender attributes that are associated with these fields. A study conducted by the American College of Healthcare Executives (ACHE) interviewed 743 respondents of both genders, asking them to describe the positive attributes that played a key role in career advancement (Weil and Mattis, 2003). Interestingly, both genders were in accordance that traditionally-male attributes were critical in determining career success.
Consequently, it was determined that both sexes favored male superiors. A possible underlying cause of this apparent lack of self-confidence may be due to the fact that “women have internalized a second-class attitude that they have been encouraged to assume” (Appelbaum, 2003). Women’s attitude towards leadership plays a key role in predicting “group assessed leader emergence” (Appelbaum, 2003). Leadership styles are especially important in influencing promotion to executive positions (Lantz and Maryland, 2008).
Women’s leadership style is often categorized as transformational and charismatic, motivating and inspiring workers to contribute towards organizational goals. Conversely, men’s leadership approach is often classified as transactional, allowing for the monitoring of employee performance, intervening when necessary and rewarding solid performance. People are generally less threatened by a leader who is emotive, personable and an inspiration towards others. While some typical female attributes include modesty, cooperation and emotiveness, the male characteristics embrace assertiveness, stability and independence.
Previous researches have shown mounting evidence of gender differences in the physicians’ practices and behaviors (Francescutti and Rondeau, 2006). Their research consisted of surveying over 400 Canadian emergency physicians and found that female physicians engage in a more counseling behavior with their patients than their male counterparts. In 1990, Cann and Siegfried determined that effective leaders should have the flexibility to engage in both stereotypical masculine and feminine associated behaviors: most optimal models of leadership assume a need for both employee-oriented and task-oriented behavior (Hopkins, O’Neil at el.
, 2006). However, most leadership models assume masculine-dominant characteristics (Fernandes and Cabral-Cardoso, 2003). In order for them to be successful and to “escalate the ranks”, it is implied that women should adopt these leadership styles (Rigg and Sparrow, 1994; Trinidad and Normore, 2004). Another significant barrier was identified in a study that examined the findings of a national survey of healthcare executives (Weil, 2003); the (short) amount of time women spent within the organization.
Results indicated that a longer time spent in the company should be sufficient to induce several cracks in the healthcare’s glass ceiling. However, CEOs that responded to that same survey indicated that in fact, the time factor played a limited role in establishing women’s advancement; time cannot be an accurate remedy when the main barrier for career advancement was due to a lack of “line experience and significant management. ” In their surveys of 140 women in the healthcare field, Hopkins, O’Neil and Bilimoria discovered that women’s individual strategies for success in this field are related to access and competence.
These women have been excluded from the networks and work experiences that would enhance their possibility for advancement, and consequently, they try to compensate by demonstrating their qualifications of competence and exceptional abilities of performance. However, these circumstances will not change until “the doors of accessibilities and the structure of opportunities for organizational advancement will open for women in the healthcare industry” (Hopkins, O’neil and Bilimoria, 2006).
Many studies have suggested that there is a lack of female mentors and that the importance of a mentoring relationship has been neglected, as critical as it is (Lantz and Maryland, 2008). Women at senior hospital and consultants grades can be great role models for the rest of the women in the medical profession (Williams and Cantillon, 2000; Joy, 2006). William and Cantillion’s (2000) research also states that it is important for female students to work and meet with female surgical specialists and consultants because 70% of female students were reluctant to pursue a surgical specialty since surgery is considered a male dominant area.
Despite the fact that this classical vertical hierarchal model still exists between physicians, nursing itself does not have a defined hierarchical power. Even top-level nurses have narrowly defined authority restricted to nursing issues (Weil and Mattis, 2003). The glass ceiling that exists is not only present due to the influence of general management, which has successfully sought to establish itself and continues to do so by dominating and controlling nursing, but also due to nursing’s attempt to move away from its “assistantship” to medicine and physicians (Tracey, 2006).
Following the conduction of semi-structured interviews with 50 directors of nursing, it was concluded that nursing needed to confront the power imbalance by examining its own behaviors; “the reality is neither medicine nor general management, individually or collectively, are going to share or devolve power and influence nursing” (Tracey, 2006). Breaking the Glass Ceiling in Healthcare Despite widespread awareness of the existence of the glass ceiling in healthcare, current action and policy recommendations are severely lacking.
Witt and Keiffer reported (2002) a set of recommendations for enhancing diversity in the talent pool of future leaders. Weil and Mattis (2001) developed a detailed focused set of recommendations, including “avoiding career interruptions of six months or more”, all reinforcing the notion that women must make more sacrifices in order to attain top leadership. Yet the majority of today’s recommendations put forth do not sound like concrete strategies: they are unrealistic and simplistic.
Another approach that has been implemented in healthcare is affirmative action, which involves proactive employment practices whose object is to prevent discrimination. (Weil and Mattis, 2003) Research studies in the US have recently shown that 45% of men said that affirmative action was no longer needed, as opposed to the 55% of women that believed it was crucial in breaking the glass ceiling (Weil, 2003).
Although considered fair when designed to identify and eliminate barriers hidden in employment systems, it can also be viewed as “unfair when candidates are given preference over others with similar qualifications”, consequently making it unpopular with a majority of healthcare professionals (Weil, 2003). Numerous women attempt to balance the busy demands of work and family constraints (Lantz and Maryland, 2008) with the career structure of the medical profession, that expects long working hours and defines career success and achievement as being stereotypically masculine (Miller and Clark,2008).
Some research state that there is a need for more part-time, flexible training and working schemes to help women overcome the difficulties of combining a medical career with family life (Williams and Cantillion, 2000). Yet in order to be treated as equals to men, should women expect an organization to be accommodating to their needs? “And, what can be done to address discrimination, segregation and barriers to female career progression within the medical profession? ” (Miller and Clark, 2008).
In their analysis of longitudinal data (1963-1996) of female hospital doctors, McManus and Sporston (2000) concluded that there is no glass ceiling for female medical practitioners and state that in general, there is no overall disproportionate promotion of women. Their analysis of data show that the recruitment patterns are related to the low proportion of women in senior hospital levels. There are three main obstacles that have been successful in preventing women from gaining recognition from upper-hand management: CEOs, boards, recruiters.
Therefore, a good recruitment model is needed. In a study where he examined the relationship between 108 senior leaders and 325 of their subordinates in a diverse number of organizations, Groves (2005) suggests that organizations shouldn’t rely solely on interviews to select or promote senior managers but rather utilize social and emotional skill levels as selection criteria. Moreover, it is clearly evident that the optimal approach in organizations should include a transformational approach underpinned by a transactional philosophy.
Yet several studies have suggested that when women do display some male attributes, they are looked upon in a negative light, due to the fact that they have “stepped outside their roles” (Arnetz, 2004). In fact, Neubert and Palmer correctly warned against this “strategy of proclaiming the virtues of competitive advantage of ‘feminine management’ as it may reinforce gender stereotypes. ” Although barriers must be moved in order to break the glass ceiling, women as a minority must not be promoted as the “reverse discrimination” suggests (Weil and Mattis, 2003).
The answer to the above questions might lie in the rapid growth in the last decade of female medical students (McManus and Sporston, 2000) and in the increased rate of female medical graduates (Miller and Clark, 2008). With the feminization of the medical field, these issues will have to be addressed thoroughly (Miller and Clark, 2008) and will be reflected in the future as more women progress in hospital and surgical specialties (McManus and Sporston, 2000).
Throughout the past several years, women have been able to gain entry into almost every field dominated by men. Recent statistics portray that women remain underrepresented in senior management positions in academia and healthcare, despite them constituting a large percentage in both fields. Having ‘knocked up against the glass ceiling’ for numerous years, yet not having been able to break it implies that there still remain a series of obstinate barriers preventing the advancement of women’s careers.
Previous research has shown that transformational and charismatic leadership associated with females “positively affects net profit margin, stock value, top management team motivation and cohesion, and follower perceptions of leadership effectiveness” (Groves, 2005). The real issue in leadership lies in selecting the right person with the appropriate skills and qualities to ensure effectiveness and success within the institutes. “The integration of women in leadership roles is not a matter of ‘fitting in’ the traditional models, but ‘giving in’ the opportunities for them to practice their own leadership styles.
” (Trinidad and Normore, 2005). Some women “dared to break the mold” by utilizing feminine leadership behaviors and styles “as silent cries for social justice and a place of their own in organizations. ” (Trinidad and Normore, 2005). In reality, behaviors and styles associated with female attributes are not as socially accepted as we would like to believe due to the fact that most organizations primarily comprise of men. Consequently, most women choose to adopt the styles of successful male leaders (Appelbaum and Shapiro, 1993).
Conversely, instead of being acknowledged as good managers when using this particular style, women are labeled as “bossy” and “pushy” (Davidson and Cooper, 1992). On the other hand, when women embrace a “female-oriented” management style, they are perceived as being ineffective (Ragins et al. , 1998). Due to this “lose-lose situation” in male-oriented organizations, women cannot become “one of the boys” (Rosener, 1990) and are often excluded from decision meetings as well as assigned to lower levels projects with restricted visibility, thus creating the “invisible-woman syndrome” (Janet Cooper Jackson, 2001).
Although some women have “made it” to a certain extent in their career, it cannot be disregarded that they face wage gap due to gender discrimination. A new trend in leadership has emerged over the past several years; it is described as being genderless, incorporating attributes from both sexes. This current movement is derived from “the fact that women’s styles are not at all likely to be less effective” (Appelbaum, 2003). Rather, a successful leader is one that adopts the interpersonal attributes of females with the task oriented characteristics of males.
The healthcare and education industries need to recognize the importance of the presence of women in their institutions. This should start in teachings in educational institutes and will only be possible if affluent males in those fields start taking steps towards the elimination of this gender gap. Male-dominated hospital boards should be required to recognize obstacles that deter them from passing high level responsibilities on to their female counterparts.
Simultaneously, females should take proactive action by attempting to gain further experience, expanding their networks and becoming more visible outside their institutions. Despite the numerous studies that have been conducted over the past several years, there have been varying results in the leader succession literature. This is due to the fact that several studies have utilized only short-term performance measures and have not examined long-term performance effects on succession. Furthermore, the majority of the data in the studies mentioned was collected prior to 2005.
It is imperative that new data be studied in order to reassess the developments that have taken place in regards to the glass ceiling. Moreover, most of the collected data are from self-selected samples, where it is highly likely that respondents’ answers may be skewed as a result of personal motives. In addition, a women-only sample provides no other points to compare with. Many have questioned whether more of an effort should be made in order to increase the number of women in senior management positions.
This decision has a crucial and direct impact on our society; “should senior executives embrace the liberal idea of individual achievement and freedom to act according to one’s individual conscience or should they pursue a strategy that corrects the injustices of the past? “(Powers 2001, as quoted by Weil) “While it is true that more women now than ever before are slowly chiseling through the glass barrier to take on leadership positions, one can hardly claim to hear glass ceilings shattering around us” (Cubillo and Brown, 2003).