clash of minds & norms: women leaders in healthcare applied...

Clash of Minds & Norms: Women Leaders in Healthcare

Applied Project

APRJ-699

Vanessa Alexis

November 30, 2014

Supervisor: Dr. Angela Workman-Stark

Word count: 13,303

alexisv-APRJ-699-a1 November 30, 2014

2 Table of Contents

Abstract ............................................................................................................................................................ 4

Introduction ..................................................................................................................................................... 6

Research Questions and Method ..................................................................................................................... 9

Research Questions ...................................................................................................................................... 9

Method....................................................................................................................................................... 10

Literature Review ........................................................................................................................................... 11

Workforce Stats .......................................................................................................................................... 11

Educational Stats ........................................................................................................................................ 16

Trends ........................................................................................................................................................ 19

What are the barriers which prevent females from occupying senior leadership roles? ............................... 22

Culture ........................................................................................................................................................ 22

Biases...................................................................................................................................................... 25

Glass Ceiling Affect ................................................................................................................................. 30

Glass Wall Affect..................................................................................................................................... 32

Semantics ............................................................................................................................................... 32

Queen Bee Syndrome ............................................................................................................................. 34

Stereotypes ............................................................................................................................................ 37

Gender Diversity Leaders ........................................................................................................................... 40

Royal Bank of Canada (RBC) ................................................................................................................... 41

Citigroup Financials ................................................................................................................................ 42

Catalyst ................................................................................................................................................... 43

What changes can be done to increase the percentage of women in leadership positions? ............ 44

Recommendations ......................................................................................................................................... 46

Limitations ...................................................................................................................................................... 54

Conclusion ...................................................................................................................................................... 56

Appendix ........................................................................................................................................................ 58

Appendix 1 ................................................................................................................................................. 58

Appendix 2 ................................................................................................................................................. 59

Appendix 3 ................................................................................................................................................. 60

Appendix 4 ................................................................................................................................................. 60


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Appendix 5 ................................................................................................................................................. 61

Appendix 6 ................................................................................................................................................. 61

Appendix 7 ................................................................................................................................................. 62

Appendix 8 ................................................................................................................................................. 64

Appendix 9 ................................................................................................................................................. 65

References: .................................................................................................................................................... 67


4

Abstract Gender inequality is a systematic issue which permeates the work culture of every

industry. Although there has been a number of studies and literature throughout the

decades from the feminists, sociological and organizational theories, little advancement

has occurred to rectify gender imbalance. Gender discrimination still persists in work

environments today; the discrimination translates into salary disparity up to 50% difference

to their male counterpart. There is only 3-4% globally of women in executive positions.

The purpose of this research was to uncover any changes, persisting factors and/or

challenges within the healthcare sector which negatively impact women leaders. This

analysis investigated barriers women leaders’ encountered working within the healthcare

system. There were two key questions used throughout to maintain a focal interest in

critically analyzing the barriers. These two questions were: 1. What are the barriers which

prevent females from occupying senior leadership roles within healthcare? 2. What

changes can be made to increase the percentage of women in leadership positions? This

conceptual paper utilized a systematic review methodology to draw from a multitude of

quantitative studies based on the content relevant to women in leadership.

Recommendations to address the barriers encountered by women leaders within the

healthcare system and across industries are as follows: 1. Government Ministries (Labour

& Health and Long-Term Care) work collaboratively with women leaders within the field to

develop educational tools for gender diversity implementation, mandatory awareness, and

educational programs in order to establish best practices. 2. Government and health

organizations develop stringent human resources policies to support and reinforce women

in their career navigation and journey for sustained leadership success through


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regulations, formalized networks and mentorship programs. 3. Develop equitable

succession planning structures within each healthcare establishment. 4. Government

department responsible for (GBA)-‘Gender Based Analysis’ and ‘Women in Canada’ data

collection as well as healthcare organizations to work in collaboration to develop provincial

performance metrics and a balanced scorecard with gender diversity as one of the key

performance indicators which will be monitored and reported on annually.


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Introduction With all the impressive advances and remarkable breakthroughs within healthcare;

healthcare still remains one of the most unresponsive to gender equality and lags behind

most industries in areas of women’s access to leadership positions and forums.

Historically, healthcare has been founded on the medical model which is derived from a

patriarchal and hierarchical construct, where the culture is skewed towards sustaining the

male gender’s position, status and power (Evans, 2003). Within healthcare, women

executives represent 4% of the global leaders who face common barriers in establishing

key networks, enabling autonomy to exercise their authority within their senior capacity, to

sit at and be respected in decision making tables (Evans, 2003). The disparity does not

just occur in overall executive positions but also in compensation, where there is an

average of 35% and up to 50% gap found between male and female salaries.

Gender inequality is not specific to any geographical area, industry or sector but

rather, it is a universal dilemma across all industries which has not been properly

addressed or prioritized with high importance to see any positive significant statistical

change (Heller, Stepp, & Thompson, 2011) (Gilmartin & D'Aunno, 2005). In 2007, the USA

Government Accountability department found that within a decade, women managers only

increased by 1% (Heller, Stepp, & Thompson, 2011). Although this analysis was intended

to speak to barriers women leaders experience within healthcare; the findings determined

that challenges for women leaders are indeed universal barriers. Thus, this analysis

addressed the subject matter broadly and inclusive to all industries.


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Why is gender diversity of grave importance? Gender inequalities are universal in

nature and taint opportunities for all women leaders across all industries. Women are

neither leveraged for their talents nor recognized for the skills, which is perplexing as

women have the lowest volumes of leadership positions, over 70% in health provider

positions but overall women have the highest market share, higher earning power and

higher post graduate volumes. Also, due to the upcoming wave of baby boomers who will

be retiring in the near future; there are forecasts identifying critical levels of shortages for

skilled professionals to replenish the workforce. Currently within the marketplace, women

leaders are underutilized, marginalized and not a consideration to address or resolve the

anticipated deficit of skilled professionals within the workforce. Research has found that

on a global perspective, women have the highest market share, highest consumer

spending which accounts for approximately $28 trillion but despite these pervasive facts,

employed women are an untapped and unrealized economic opportunity. In reviewing and

comparing professions by number of females to males, there are studies which have found

a direct correlation to corporation that endorse gender diverse work groups resulting in

positive outcomes such as; an increase up to 10% higher (ROE) Return on Equity, 48%

increase of output and 70% growth in stock prices (Patel & Buiting, 2013).

Within the commonwealth countries alone, by 2009, females earned $13 trillion,

which is a combined GDP times two, of both China and India. By 2014, it is forecasted

women’s earning power will increase to $18 trillion (Patel & Buiting, 2013).


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(Silverstein & Sayre, 2009)

The earning power is not the only element of increase, academically; at a Masters

level, there are a higher number of enrollments and graduates by females at 60% versus

males at 40%. Within Canada there it is anticipated for the next three decades females

and males’ population will be stable in and around 50.4% for females. Based on the

demographical trends of population, market share, and education; these trends should

translate to encompass a diverse representation of corporate leadership (Patel & Buiting,

2013). With projected statistics indicating an increase of female prominence in the market

share, it would be wise for corporations to be proactive and modify business strategies to

include assertive gender diversity initiatives to strive for an optimum balance of female to

male employee leadership quotas. It is not only wise, but crucial for corporation’s

competitive advantage and the marketplace’s replenishments of skill labour in the coming

decades.


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The analysis of barriers women leaders experience further led to ascertain how

culture impacts women’s ability to attain and sustain leadership positions. Culture was

then compartmentalized into six subcategories which affect women leaders in their ability

to advance in their expertise, sector or industry. The six subcategories are; biases, glass

ceiling, glass wall affect, semantics, queen bee syndrome, and stereotypes.

Research Questions and Method There were two questions addressed in this conceptual paper to identify barriers

which impede women in attaining leadership roles. Barriers were the focal point of this

analysis which further directed the investigation of women leaders in healthcare and

across industries. There was a broad evaluation to determine, trends over time, in terms

of occupational changes, changes in income, females residing in senior manager

positions in comparison to their counterpart. There were further evaluations conducted of

best practices by corporations, who have successfully implemented gender diversity

programs to address women leadership challenges and extract elements which would be

crucial in assisting as well as managing gender inequality in the healthcare sector.

Research Questions

1. What are the barriers which prevent females from occupying senior leadership

roles within healthcare?

2. What changes can be made to increase the percentage of women in leadership

positions?


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Method This report utilized existing studies and articles on women in leadership which

provided context to support the meta-analysis of this conceptual paper. The analysis was

derived from a systematic review of quantitative evidence taken from the healthcare

sector and various industries, feminist as well as sociological approach to identify salient

points creating barriers such as gender biases and stereotypes. The research included

gleaning several articles based on the significance of gender oppression, leadership

inequalities and social norms which perpetuate the biases preventing increase of women

leaders as well as their ability to sustained success within their roles. Unfortunately, due

to the nominal articles written on women leaders within the healthcare sector; this

investigation required broadening the scope of interest to include all sectors using

secondary data to support the analysis. The trending data used the following time

parameter, 1990- 2013. The investigations included other sectors as a comparative in

similarities as well as differences to extract progressive and action oriented approaches in

rectifying the gender disequilibrium.


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Literature Review The following subsections; workforce stats, educational stats and trends across

industries provide a backdrop in understanding where women stand within the marketplace

in terms of total number of women who currently reside in senior roles, total number of

females versus males with higher levels of education, and what the female educational

pipeline translates into for employment opportunities and future economic activity. This

analysis evaluates the impact that culture has on women leaders in healthcare and across

the board in all industries. Culture is further broken down into six prominent themes,

(biases, glass ceiling affect, glass wall affect, semantics, queen bee syndrome, and

stereotyping) which drive and perpetuate barriers preventing women leaders from attaining

and sustaining senior management positions.

Workforce Stats

(Sherwin, Strategy:Why Women Are More Effective Leaders Than Men, 2014)

Research states there are nominal numbers of females in higher level positions,

particularly at a CEO level. Worldwide research compiled has found there are only 3%-

4% of women presiding at a CEO level. Globally, statistics highlight women are


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significantly under-represented in senior leadership as per the following percentages and

table:

16% of overall directorships in North America

9% of those roles in Europe

2% in Asia (Heller, Stepp, & Thompson, 2011).

(Caranci, Preston, & LaBelle, 2013)

The above table captures the top 15 industrialized economies showing only 1% of

women sit on Board of Director with Canada positioned 6th place in 2009 then dropped to

13th in 2011. Firms that do have a generous female membership on their Corporate

Governance have found a positive correlation with increased productivity, better ethical

conduct and decreased bankruptcies by 20% of (Patel & Buiting, 2013).


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In two, two year studies conducted by McKinsey and Company, both findings

determined, firms with gender diverse management teams exceeded industry averages in

Return on Equity, EBIT and growth of stock prices (McKinsey & Company: Women Matter,

2007).

(McKinsey & Company: Women Matter, 2007)


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Currently in the marketplace, across industries, there has been an increase of

females working in non-traditional occupations. Despite an increase of females entering

into non-traditional positions, this has not altered the leadership ratio between genders,

particularly in well-established patriarchal sectors. The norm across industries, healthcare

included, women still remain under-represented in senior role capacities and on Board of

Director Memberships and Governance bodies (Latz & Arbor, 2008). Here are a few

pervasive facts within the healthcare industry:

Women are underrepresented with only 31% residing at a senior level and

13% on Board of Directors (Government of Canada: Statistics Canada, 2014) (Caranci,

Preston, & LaBelle, 2013)

Women leaders are faced with a precarious underlying fact; their roles do not

inherently secure one’s job nor determine job longevity

Micro-inequities across industries vary, women’s income ranging from 9-50%

salary disparity opposed to male incomes (Government of Canada: Statistics

Canada, 2014)


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Pervasive gender insensitivity that leads to cumulative disadvantages, such

as the availability of fewer mentors, unconscious institutionalized sexism

which undermine women’s self-confidence and productivity (Morahan, Rosen,

Richman, & Gleason, 2011) (Richman, Morahan, Cohen, & McDade, 2001).

The women’s movement was initially fueled by solidarity of females in the 1800’s

who challenged the patriarchal systems which for decades suppressed women’s rights and

made them an invisible gender to be seen and not heard. The 1970’s civil rights movement

ignited women to band together in order to abolish restrictions preventing women in certain

roles and pursuing higher learning, such as enrolling into medical school. The healthcare

sector is under the category of ‘Service Producing Industry’ which is the 4th largest industry

in Canada and second to the Trades sector in the total number of employees. Healthcare

has one of the highest female service providers within industries at 78%. In 2009,

Statistics Canada reported 0.3 females worked in a senior role capacity versus males at

0.6 in leadership roles Appendix 2. Research indicates 70% of females access the

healthcare system with a disproportionate number of women leaders who have very little

input to add to or affect change in the evolution of healthcare services for the same gender

(Government of Canada: Statistics Canada, 2014). In a sixteen year survey conducted by

(ACHE)-American College of Healthcare Executives; concluded women were most likely to

attain department head positions, whereas their counterpart filled positions such as CEO,

COO, President and Vice President (Latz & Arbor, 2008). A 2005 survey conducted,

sought to determine if there would be a change to the gender inequality within an

establishment that was progressive and considered within the Top 100 Hospitals (Latz &


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Arbor, 2008). The findings proved that despite the embracement of medical and

technological advancements, 24% of women held chief administrator roles, 30% of the

hospital did not employ females in chief positions and 34% of the facilities only employed

one female chief administrator (Latz & Arbor, 2008). Out of the top 100 USA hospitals in

2005, there were only 15 female CEO’s (Latz & Arbor, 2008).

(Evans, 2003)

As the core focus of healthcare is the well-being of its constituents; it is essential

that in moving forward, there be a fair ratio of representation of users to providers. The

healthcare industry must objectively address gender barriers in order break down rigid

structures which prevent the transformation and evolution into an equal opportunity sector.

To resolve the timeless and universal gender disparity of the lack of women leaders; there

requires re-calibration of each working culture through the integration and reinforcement of

gender diversity (Ibarra, Ely, & Kolb, 2013).

Educational Stats Catalyst reported that from 2010-2011, 34.5% of Canadian women were accredited

with an MBA. In the USA, there was a marginal difference, with a reported 36.8% of


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women who earned an MBA (Catalyst, 2014). In 2012, the UK found there were twice as

many females than males enrolled in undergraduate programs. The increase of female

university students is producing an upward trend that will have dissatisfying outcomes for

the prospective female graduates. The increased number of female graduates will be

disproportionate to the number of available employment positions and senior vacancies. In

a European study, it is forecasted, 2005-2035, women in Spain will experience a 53% gap

between female graduates and vacant executive committee positions (McKinsey &

Company: Women Matter, 2007). The trajectory for female graduates in Sweden is slightly

less with a projected 39% disparity between female graduates and available management

positions (McKinsey & Company: Women Matter, 2007). A USA study determined more

women achieved a higher level of academic degrees than men; but this did not translate

into a higher ratio of employment.

“Women are highly represented in the pipeline of talent coming out of academic

institutions. They are achieving higher-level degrees at greater representation than

men in the U.S., 16 and in some instances, worldwide” (Heller, Stepp, & Thompson,

pg.5, 2011)


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(Heller, Stepp, & Thompson, 2011)


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Trends

(Chanavat & Ramden, 2014)

Global trends indicate that Asia Pacific and EMEA are further ahead than the

America’s in terms of implementation and compliance of gender diversity regulations.

Global firms which pave the path in gender diversity are located in India, Australia, Korea,

Norway, Finland, Sweden, UK and France (Caranci, Preston, & LaBelle, 2013) (Chanavat

& Ramden, 2014). All the above stated countries surpass Canada in gender diversity due

to their countries regulations linked to financial consequence in non-regulatory adherence.

France established a bylaw in 2011 stating by 2017, each company which employs 500

and greater employees must have a minimum board membership of 40% women

(Chanavat & Ramden, 2014). UK has regulated transparency by enforcing governance

codes to annually evaluate and report on the diversity policies. Albeit slow in

advancements, across industries, 2009 - 2013, trends were marginal at 7% improvement

within female board inclusion (Chanavat & Ramden, 2014). Research found companies

that implemented gender diversity programs reported less internal controversies (Chanavat

& Ramden, 2014).


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Other pertinent trends “according to McKinsey & Company, 2010 global survey and

a Berkeley WEF report states concerns over workforce shortages which affect the overall

number of skilled labour available to replenish top positions. The economic instability as

well as the future anticipated work force shortage due to baby boomers reaching

retirement age is a crisis that requires a new manner of thinking and conducting business.

Globally, by 2030, there is an anticipated workforce shortage that will cost the world GDP

$10 trillion (Gregoire, 2014). In the UK, there is a 2040 forecasts pointing towards a

workforce shortage of $24 million. Looking at the work force shortage on a provincial

scope, Ontario is currently facing an annual deficit of $24 billion on lost economic

opportunity and $3.7 billion annually in potential tax revenue (The Ontario WorkForce

Shortage Coallition , 2014). For the marketplace to be better equipped, corporations need

to be globally agile and competitive through accessing and utilizing female talent in

addressing the pending work force shortage crisis. There are many economists and 72%

survey respondents who feel strongly, that there is a relationship between diversity and a

firm’s financial success (McKinsey & Company: Women Matter, 2007).



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In addition to the above trends, there is a significant shift in the labour market,

where women are increasingly enrolling in post-secondary studies and working in non-

traditional occupations such as: “sales, marketing and advertising managers; physical

science professionals; technical occupations in architecture, drafting, surveying and

mapping; managers in engineering, architecture, science and information systems; police

officers and fire-fighters” (Government of Canada: Statistics Canada, 2014). The

conundrum with the non-traditional occupation is the lack of formal definitions or rationales

which identifies or stipulates a gender to a non-traditional job. In this day and age, it would

be illogical to make claims as to a position is out of a female’s realm of possibilities.

However, with that being said, women have crossed all employment boundaries within the

last three decades, with an approximate 6% in 1991 increasing to 11% in 2007

(Government of Canada: Statistics Canada, 2014).

(Government of Canada: Statistics Canada, 2014)


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What are the barriers which prevent females from occupying senior

leadership roles?

The lack of advancement for women in leadership roles can be attributed to cultural,

biases, queen bee syndrome, stereotyping and a lack of formal policies which support

diversity in hiring practices, succession planning and neutral gender work environments.

Corporate structures are the architectural design created by men to benefit their ideals and

gender blueprint (McKinsey & Company: Women Matter, 2007). Strategic Human

Resources provides the foundation when identifying characteristics of a leader.

“Leadership is defined as the capacity to influence others to work together, to achieve a

constructive purpose, and required to make the system work as a system” (Dickson, 2008).

A leader encompasses a multitude of skills and characteristics necessary to achieve

objectives. The key talent required in a leadership role is interpersonal skills; one must

have the ability to interconnect with others in order to influence, guide and reach

organizational goals (Lam, 2010). With leadership qualities clearly defined, limitations are

ambiguous in terms of what a leader ought to do versus what a leader can actually do in

their role (Gilmartin & D'Aunno, 2005).

Culture Culture is a strong component as to why women have not advanced further in

attaining and sustaining senior leadership positions. The semantics within a culture is the

metamorphosis of ideologies and value driven precepts which form our language and

conceptual assumptions. How does culture affect women and their ability to become

leaders within the healthcare industry? The healthcare industry is a mirror reflection of the


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cultural ideologies in terms of the high saturation of female service providers oppose to

their counterpart.

Culture is defined as “integrated patterns of human knowledge, beliefs, and

behaviours that depend upon the capacity for learning and transmitting knowledge to

succeeding generations” (Merriam Webster Dictionary, 2014). Culture plays a pivotal role

in the breeding of women for better and for worse. Culture has the ability to hinder or

promote character, leadership development and establish opportunities for leadership

positions. Within a culture, there are value systems and stereotypical type casts which

form paradigms filtering into organizational pipelines (Sherwin, Strategy: Why Women

Vanish As They Move Up The Career Ladder, 2014). For centuries, inherent gender

biases plagued our society and stifled the story creation of each great potential female

leader. “The discrepancy in men and women career paths are so thoroughly reinforced by

everything from early rearing, union sponsored training programs and to the tax structure--

that there is little prospect for rapid change” (Wiggins, 1991). Cultural perception,

language and value systems, significantly affected the perpetual oppression of women

leaders in healthcare. Perception is grounded on assumptions, expectations which are

embedded into norms and in our colloquialism (Kellerman & Rhode, 2007). Many women

do not recognize nor do they differentiate between leadership and authority; therefore the

roles are presumed the same. However, there is a difference between the two; women are

innately inclined as leaders but suppressed in attaining senior leadership positions.

The following 6-D Hofstede model provides a cultural comparison between Canada,

and two countries which excel in gender diversity, Norway and France. Appendix 9


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provides a detailed evaluation of Canada’s culture using 6 indicators; power distance,

individualism, masculinity, uncertainty avoidance, pragmatism, and indulgences (6-D

Model, 2014) Appendix 9. Canada has scored the highest out of the three comparative

countries in three of the indicators; individualism, indulgences and masculinity (6-D Model,

2014). The Hofstede’s generalized assessment on Canada and its ‘individualism’ indicator

score of 80 indicates “in the business world, employees are expected to be self-reliant and

display initiative. In terms of work, hiring and promotion decisions they are more apt to be

determined by merit” (6-D Model, 2014). With regards to the Masculinity indicator, Canada

scored 52, highest of the three countries and considered along the moderate masculine

dimension. The moderate scale of masculinity is defined as “Canadians strive to attain high

standards of performance in both work and play (sports), the overall cultural tone is more

subdued with respect to achievement, success and winning” (6-D Model, 2014). The

indulgence indicator score for Canada is 68 and therefore the culture is considered

indulgent with less control on desires and impulses (6-D Model, 2014). The last indicator

that should be mentioned is ‘pragmatism’; Canada scored 36, one point higher than

Norway. Canada’s level of pragmatism in the culture is considered normative in that there

is “strong concern with establishing the absolute truth, exhibit great respect for traditions, a

relatively small propensity to save for the future, and a focus on achieving quick results” (6-

D Model, 2014).


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(6-D Model, 2014)

Biases

Our society is littered with anchoring biases also known as focalism. “Anchoring

biases or focalism is a term used in psychology to describe the common human tendency

to rely too heavily, or anchor, on one trait or piece of information when making decisions”

(Science Daily, 2014). Metaphorically, focalism can be the blood line driving biases which

negatively impact women and preventing their advancements into leadership roles.

Research has proved that habitual gender biases can disrupt women’s learning pathway

through the loss of potential experience, development of fortitude, establishing mentor

relationships, and honing necessary skills for a sound repertoire of capabilities (Ibarra, Ely,

& Kolb, 2013). In earlier times, disciplines such as social sciences, physiology, and

neurology influenced and embedded many of societal misguided assumptions regarding

the differences between male and female competencies (Eagly, 2013). Gender inequality

is alive and strong within the working landscape. Perhaps the overarching male


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dominance causes females to succumb and fall prey to archaic stereotype due to the lack

of females in leadership positions. Perhaps, this is why millennium women dismiss the

facts and assumes society and marketplace has changed their views of women. In one

ACHE- American College of Healthcare Executives, attitudinal survey, there were very

bewildering findings regarding the perspective of gender equity and treatment within the

workplace. The attitudinal questionnaire was dispersed to both men and women with

results from both genders with a large percentage of responses stating, there was fairness

within their establishments in the management of gender equality. This finding is contrary

to the decades of information and data which supports rampant female inequalities on

many levels across industries.

(Latz & Arbor, 2008)


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There is one science that could provide some advances and clarity in

what is required to move forward and increase women leaders that are Feminist

Epistemology.

“Feminist Epistemology studies the ways in which gender does and ought

to influence our conceptions of knowledge, the knowing subject, and

practices of inquiry and justification. It identifies ways in which dominant

conceptions and practices of knowledge attribution, acquisition, and

justification systematically disadvantage women and other subordinated

groups, and strives to reform these conceptions and practices so that they

serve the interests of these groups” (Wuthrich, pg.1, 2010).

The female epistemology suggests the lack of experiential diverseness inhibits

female’s ability to create the necessary anecdotal platforms to enable the development of

confidence in which to seek success through independence and economic power

(Kellerman & Rhode, 2007). For centuries, inherent gender biases plagued our society

and stifled the story creation of each great potential female leader. Research has proved

that habitual gender biases can disrupt a women’s learning pathway through the loss of

potential experience and development of fortitude, establishing mentor relationship, and

honing necessary skills for a sound repertoire of capabilities (Ibarra, Ely, & Kolb, 2013).

Without the anecdotal foundation, how then does a woman separate success stories from

his-story to her-story?


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INSEAD’s report concur that leadership development is linked to leadership identity,

meaning one must relate to and identify with a leader persona (Patel & Buiting, 2013). If

there are minimal women leaders for role models; how then does a female create this

representation or relate to leadership when the majority of top authority positions are held

by males? How does one envision something rare and an anomaly? To expand more into

female leadership characteristics; the trait theory will be utilized to ascertain how traits can

infringe on women’s ability to climb the corporate healthcare ladder as well as own the

character and position. The perceived notion of what a leader looks or acts like is all

encapsulated into the leadership persona. Women have had to use the creative portion of

their brain to envision themselves in a top role? Is this an easy task? No, it is unfamiliar

and difficult with regards to behaviourisms. The expected male leadership traits are:

“assertive, independent, forceful, unemotional, aggressive, and logical” (Kellerman &

Rhode, 2007). Women’s attributes consist of ‘dependent, subjective, passive and

emotional” but there are no specific leadership traits aligned to a female (Kellerman &

Rhode, 2007). Therefore, women must formulate an adaptive persona to override the

current deficiency of female leaders. Gender theorists have conceded gender issues as

part and parcel of the organizational theory. The theorists feel the organizational

methodology can further obtain hypotheses for possible reconciliation of the gender

disparities.

Both the gender approach and organizational theory have brought to the forefront

maladaptive work environments which are not conducive for women’s advancements

(Styhre & Eriksson-Zetterquist, 2008). The pervasive nature of gender oppression across


29

industries and within healthcare, affects female managers in their ability to advance in their

career and be on par with their counterparts. The disparity of both career advancement

and pay has been subject to notable debates towards change, but alas to one’s dismay,

not much has changed to diminish the patriarchal structure, the formable gap in pay,

position title, and power status. The majority of leadership positions attained by women are

token positions, with little regard for their contributions, decision making, authority,

autonomy to act within the job specification, respect of one’s position and the ability to

conduct and succeed in one’s position. The following is a verbatim statement expressed

by a female physician: “I do not have any authority” (Conrad, et al., 2010). A 2008 survey

finding concluded the top issues for women leaders were; the hierarchal work structure,

women felt “uninformed of major decisions which directly affected their work area, and not

included as an active participant in the decision making processes” (Conrad, et al., 2010).

The quantitative responses from female interviewees were an overwhelming feeling of

helplessness in their roles, which negatively affect their psyche, as well as their ability to

perform to their full potential (Conrad, et al., 2010). Other important findings from the 2008

study were women felt leadership appointments were more than often conducted in

private, behind closed doors, projecting a sense of ambivalence due to the lack of

transparency and non-compliance with human resources protocols (Conrad, et al., 2010).

There was an interesting element to the 2008 study, in that if the chair of the board was

‘supportive’ in obtaining staff feedback; they were more likely to openly seek employee

input, resulting in staff feeling included in the decision making process (Conrad, et al.,

2010). The opposite would occur when decisions were kept at the top hierarchy level,

resulting in staff feeling invisible, ostracized, and not included in the decision making


30

process. Another finding identified a study which some women leaders felt that in order to

be respected by all peers (men and women) they must assume a perceived male trait in

managing staff, adopting a brash, patronizing and authoritarian management style

(Conrad, et al., 2010). The aforementioned only confirms how culture and leaders

influence the style of leadership and level of power each female employee will have

available to them within their position (Conrad, et al., 2010).

Glass Ceiling Affect

The Glass ceiling affect, was initially proposed in 1977 to describe women who

aspired to be leaders and faced an invisible barrier which prevented them from acquiring

senior leadership positions. The glass ceiling phenomenon was more prevalent in the

healthcare sector than in any other, due to the relationship between male superiors and

female subordinates, which separated and reinforced male and female assumed roles

(Gilmartin & D'Aunno, 2005). The initial theorists, Nickerson et al, research was to

determine the rate of promotion for women in healthcare and within the academic medical

field (Carnes, Morrissey, & Geller, 2008). The Nickerson et al’s research identified there

were nominal number of females appointed to a higher senior position. Those who were in

leadership roles lacked fewer institutional resources to ensure success in their capacity as

opposed to males (Carnes, Morrissey, & Geller, 2008). The glass ceiling concept could

explain the lethargic pace of improvements for women leaders in healthcare (Carnes,

Morrissey, & Geller, 2008). Prior to adopting the glass ceiling theory for the medical

profession, there was a proposed theory to encapsulate what women in the medical field

were experiencing ,which was the ‘sticky floor theory’ but this theory did not last and was

soon overturned by the glass ceiling theory. Relative across the medical field, the glass


31

ceiling was symbolic of women looking up and visually unable to find a suitable role model

internally as well as externally to provide reference and support in dealing with such

volatility and gender variance within the field (Carnes, Morrissey, & Geller, 2008). Despite

the earlier advancements for women in healthcare, women were given token positions as

clinicians and educators recognized as ‘institutional housekeepers’ (Carnes, Morrissey, &

Geller, 2008). In addition to the trivial female positions, women have encountered

continued gender discrimination, income disparity and on the job sexual harassment

(Carnes, Morrissey, & Geller, 2008). Alternatively, one must consider the hierarchal work

structure and how this impacts women and men in terms of power, hierarchy of power as

well as how they interpret between the two (Conrad, et al., 2010). Are the power struggles

women encounter related to perceived differences between women and men? Are the

differences directed towards an individual or an entire gender? Are the imbedded

differences, due to the low number of women in senior positions who lack numbers to

challenge the norms and move forward toward advancements (Conrad, et al., 2010)?

More in-depth analysis is required and research must continue to investigate this complex

societal issue. Gender inequalities cannot be answered with one response or with one

methodology; it may require a hybrid model. The perpetuity of the above is consequential

to the tension between men, societal norms that are ingrained gender biases.

(Morahan, Rosen, Richman, & Gleason, pg.3, 2011)


32 Glass Wall Affect

The glass wall affect is similar to glass ceiling in that the inference of the barrier are

both invisible. The glass wall affect differs in that the invisible blockage is an encasing of

cultural female biases surrounding women’s competencies and stereotypical roles (Styhre

& Eriksson-Zetterquist, 2008). The glass barrier impacts women’s ability to attain senior

authoritative roles which are commonly held by men in gendered work environments

(Styhre & Eriksson-Zetterquist, 2008). However, there are other theorists who assert

gender inequality is more representative of a labyrinth than a glass ceiling or wall due to

the complexity and myriad of factors which convolute and increase impasses in career

navigation to attaining senior roles with authority (Eagly, 2013) (Heller, Stepp, & Thompson,

2011). The labyrinth is indicative of the unknown women face throughout their career

journey. This is why it is imperative for women leaders to re-ignite the interests in further

investigation and solutioning into the challenges faced by women in leadership roles today,

forecast what issues could impede them in the future, to better prepare and counter the

hindrances.

Whichever theory one leans towards, gender biases are formidable consequences

of our culture which negatively impact women’s progression within organizations and

society.

Semantics

Another component that is important in understanding the complexities of women’s

disparities, compared to their counterparts, is the comprehension of semantics. Semantics

define and frame our assumptions as well as create our expectations of what it means to

be a leader or what it encompasses (Gilmartin & D'Aunno, 2005). Could both genders


33

have the opposite or same definition and competency interpretation of a leader? It has

been noted that one of the issues pertaining to the concept of leadership is that it is not

well defined, particularly amongst leadership groups. The ambiguity surrounding the

leadership role is due to the range of behaviours and competencies that could impact as

well as affect the departmental team and/or individual employee’s output. Therefore, the

multiplicities of assumptions surrounding what a leader is will account for and be

contributing factors in the plight of women in leadership roles. In terms of semantics within

the medical field, leadership becomes diluted and more dictated and heavily influenced by

the aura of male dominance. The medical field by profession was pre-eminently a male

vocation where male physicians typically were and still are the ruling force within the field,

manipulating and controlling the system to their pleasing (Gilmartin & D'Aunno, 2005).

Unfortunately, the stagnancy and low advancement of women leaders within the

marketplace can be attributed to the diminishing women leadership studies over time since

the mid 90’s. The decrease of studies is due to the low priority within the field, the overall

cost factor and researcher’s lack of enthusiasm in investigating the myriad of

idiosyncrasies and social norms particularly within healthcare (Gilmartin & D'Aunno, 2005).

However, with that being said, empirical studies conducted to date, support that the

healthcare sector could further advance in gender biases through the progressive findings

under the organizational theory (Gilmartin & D'Aunno, 2005). This optimistic empirical

study claims that healthcare is not vastly different from any other sector and can be

assessed as well as theories proposed for establishing organizational leadership

behaviours (Gilmartin & D'Aunno, 2005). The identified differences which may slightly

separate this field from other sectors are the tension and pressure points which impact


34

healthcare and no other sector. The healthcare system is susceptible to the external

volatility of demand, decreased government funding, extreme pressure to reduce

operational costs whilst simultaneously improving access to quality of care. These types of

tension and pressure points within the healthcare system place gender discrimination of

women leaders on a lesser priority for discussion and change.

Queen Bee Syndrome

In addition to the myriad of challenges women encounter, they are also prone to the

“queen bee syndrome” where female superiors take on an extreme alpha persona and

stance to which neither assists nor support other women in their career journey.

“The term "queen bee syndrome" was coined in the 1970s, following a study led by

researchers at the University of Michigan— Graham Staines, Toby Epstein

Jayaratne and Carol Tavris —who examined promotion rates and the impact of the

women's movement on the workplace. They found that women who achieved

success in male-dominated environments were at times likely to oppose the rise of

other women and obsessed with maintaining their authority. Far from nurturing the

growth of younger female talent, they push aside possible competitors by chipping

away at their self-confidence or undermining their professional standing. It is a trend

thick with irony: The very women who have complained for decades about unequal

treatment now perpetuate many of the same problems by turning on their own”

(Drexler, 2013).

Oddly, in the last 2 years there has been some renouncement of the ‘queen bee

syndrome’ stating that today’s women do support each other and that the hyper-

competitiveness that was noted in previous eras is no longer relevant. However, stating


35

that the queen bee syndrome is non-existent and non-relevant is disillusionment and far

from the actual occurrences and interactions between women. There may be in fact a

small percentage of women, who are more than willing to assist and support their fellow

females in their career journey, but that is not the norm. One must not sugar coat the

convoluted issues which contribute to the difficulties of aspiring women leaders. The

prevalent existence of hyper-competitiveness in daily interactions and relationship

exchange between women is more common of an occurrence than not. Perhaps, the

female millenniums may be dismissive to the queen bee syndrome as a direct result of

their higher level of confidence than older cohorts, but this assessment underestimates the

challenges one faces and thereby ill prepares the female millenniums for the harsh realities

of the business world. Within the psychology field, studies have proven that the ‘queen

bee syndrome’ is alive and well, creating much havoc and undue stress for junior women

leaders.

“A 2007 survey of 1,000 American workers released by the San Francisco-based

Employment Law Alliance found that 45% of respondents had been bullied at the

office—verbal abuse, job sabotage, misuse of authority, deliberate destruction of

relationships—and that 40% of the reported bullies were women. In 2010, the

Workplace Bullying Institute, a national education and advocacy group, reported

that female bullies directed their hostilities toward other women 80% of the time—up

9% since 2007. Male bullies, by contrast, were generally equal-opportunity

tormentors. A 2011 survey of 1,000 working women by the American Management

Association found that 95% of them believed they were undermined by another

woman at some point in their careers” (Drexler, 2013).


36

There are no differences within healthcare, all females are exposed at any given time

unprovoked animosity from a female leader. The following statement was from a female

faculty member who solidifies the lack of same gender support due to identifying male

traits with power and authority.

“In order to be in a position of power and leadership in the authoritarian-style

structure, one must dehumanize (female, physician, left) and ‘out-macho the guys

(female, Ph.D., left)” (Conrad, et al., pg.5, 2010).

It has also been determined by further research, millennium women do possess a

higher confidence and assertiveness level than earlier cohorts, and equal to their

counterparts. However, female millenniums quickly learn the harsh realities of gender

discrimination and are ill equipped to deal with such inequalities and the lack of resolution

resulting in many young leaders eventually opting to leave their industries due to their

negative experiences. The following verbatim statements were extracted from a

quantitative survey to explain why women were disenchanted with their work situation and

left their field:

“Lack of collegiality with their department and chair

Lower salary compared to their counterparts

Lack of promotion and tenure process,

Lack of institutional recognition and support

Lack autonomy

Increased stress and perceived isolation

Time constraints and intrinsic component of the work” (Horn, 2014)


37

Research has found that this very disenchantment to women’s workplace or field is directly

caused by females personalizing and internalizing their negative experiences and equating

those experiences as personal inadequacies. The research indicates the younger cohorts

who view the systemic issues as personal, fail to appropriately assess the issues in its

entirety. Issues of queen bee syndrome and failure to advance in the corporate ladder are

not individual, but rather a universal and societal issue (Manwaring, 2014).

Stereotypes

Stereotyping is a non-rational process of labelling people or things which have

similar characteristics. The pervasive nature of gender oppression throughout industries

has the same commonality as within healthcare which affects female managers in their

ability to advance in their career and to be par with their counterpart. Assumptions such as

women’s ambition level being lower than men’s due to the double burden syndrome of

taxing family commitments is as false as their inability to perform and produce the same

level of output as their counterpart (Patel & Buiting, 2013). To delve into creating a female

leadership character; the trait theory will be utilized to ascertain how much the concept of

traits infringe on women’s ability to climb the corporate health ladder as well as own the

character and position. The perceived notion of what a leader looks or acts like is all

encapsulated into the leadership persona. A study from Catalyst sums up the age old

stereotypical assumption in the following statement; "women leaders take care, men

leaders take charge” (Riggio, 2010). The feminist approach has significantly increased the

female knowledge bar with regards to the oppression and factors that contribute to the

suppression. However, the feminist movement and the knowledge collected have not

been properly leveraged to the betterment of women leaders.


38

The current realities of the today’s work environment were captured and summarized in

2010 Mercer survey of 540 USA firms:

USA companies were eight times more likely to not take any action to develop

women than to take strong action,

70% reported not having a strategy for developing women into leadership positions

43% of respondents did not offer any programs targeted to develop women

leaders,

5% of respondents offered robust programs” (Heller, Stepp, & Thompson, pg. 4

2010)

There are some theorists, such as Neubert and Palmer, who caution against

developing female specific management programs. They caution against further

segregation which emphasizes as well as reinforces gender biases (Latz & Arbor, 2008).

However, one may debate this cautionary clause, because it may very well perpetuate the

oppression and lag within the healthcare system and across industries. Doing nothing is

far more severe than doing something toward repairing this pervasive unbalance (Latz &

Arbor, 2008).

The healthcare industry is heavily laden with women in supportive roles rather than

leadership positions with full authority. The very title of the industry precedes an onerous

burden naturally inclined toward the female gender. The female is culturally preordained to

the prescribed role of caregiver, care bearer, nurturer and so on. Women are bred to buy

into an archaic stereotype due to the lack of females in positions with full authority. Can

anyone at any given time recite names of women in leadership positions with authority in


39

healthcare? This is not an easy task and may stump many. So, if there are few and far

between as role models, then how does a female create this representation when the

majority of top authority positions are held by males? How does one envision something

rare and an anomaly? The expected male leadership traits are: “assertive, independent,

forceful, unemotional, aggressive, and logical” (Kellerman & Rhode, 2007). There are no

known women’s leadership traits but attributes which consists of ‘dependent, subjective,

passive and emotional” (Kellerman & Rhode, 2007). A 2003 study found that there was

an opportunity within healthcare to adopt the usage of the transformational leadership style

albeit the study found a stronger correlation to less educated level staff than to the

professional (Gilmartin & D'Aunno, 2005). Studies from 1987-1996 found that medical staff

interpreted a leader as possessing the following; ‘healthy, hard-working, objective,

communicative, facilitating the exchange of ideas, giving, creative, high energy, vision and

mission oriented’ (Gilmartin & D'Aunno, 2005). Between the two studies, there could be

some similarities, but again this all dependent on the semantics. It is interesting in that the

medical professionals were not enticed by the transformational leader profile but yet many

of the qualities identified above are well aligned with the transformation leader.

The disparity of both career advancement and pay has been subject to notable

debates towards change, unfortunately, there still continues a gap which signifies

hierarchal and power status. The disparity of income within healthcare where the same

survey concluded that with all things being equal in education, experience and length of

work experience that in 1990, men’s earning were 17% higher than women (Latz & Arbor,


40

2008). In 2006, the ACHE survey determined men’s earning power increased further

widening the gap to 29% (Latz & Arbor, 2008).

(Latz & Arbor, 2008)

Research on professional groups have concluded women not only must work twice

as hard to prove their competency, but in promotion evaluation, they face increased biases

being judged in terms of perceived work cycle, impact and output (Patel & Buiting, 2013).

Research has further determined that women and men can utilize the identical strategies

for career advancements, with men reaping the rewards of of career advancement

strategies and women seeing very little reward and recognition in promotion or pay

(Manwaring, 2014).

Gender Diversity Leaders When comparing other industries statistics with healthcare, there are true exemplary

business organizations who lead by example through inclusion of gender diversity into their

business strategy as well as being transparent and reporting on overall progress. The

following three companies presented are gender diversity leaders that promote gender


41

leadership and equilibrium with purposeful strategies to close the gap: (RBC) Royal Bank

of Canada, Citigroup Financial and Catalyst. Appendix 6

Royal Bank of Canada (RBC)

Royal Bank of Canada (RBC) has a legacy of gender milestones dating back to

1902. This financial corporation is a trailblazer in gender diversity and pace setter and

champion for female inclusion in the marketplace. RBC can speak with pride of their

contributions in the advancement of women to roles in management such as, Vice Chair,

Chief Financial Officer and board of director memberships (Diversity and Inclusion, 1995-

2014). Before gender diversity became the business jargon of latest marketing scheme,

RBC was creating, developing and implementing processes and programs which made a

difference to lessen the disparity between female and male employees. In 1994, Royal

Bank of Canada was comprised of 75% female workers (Diversity and Inclusion, 1995-

2014). RBC was paving the pathway by implementing; equal employment opportunity

program, establishing Diversity Business Council mandated to reduce the gender disparity,

equity processes, appointing female executives, developing specialized training programs

for women, established one of the first chapters of ‘RWoman’ in Ontario with subsequent

global chapters thereafter and sponsors women studies in capital markets in order to

increase female volumes within the industry (Diversity and Inclusion, 1995-2014). RBC is

a business that has had an incredible team to see beyond and above barriers as well as

strive purposefully to bridge the gender gap. Perhaps, this is why the following statement

can be made with such ease: “We are a group of companies where a shared sense of

belonging and purpose, coupled with high standards for doing the right thing for our


42

employees, our clients and our communities, has withstood the test of time” (Diversity and

Inclusion, 1995-2014).

Citigroup Financials

Mike Corbat, Citigroup’s CEO, makes one statement that conveys his level of

understanding of their constituents and collective make-up. “As the global bank, diversity is

part of our DNA at Citi. Having a workforce as diverse as the clients and communities we

serve is a business imperative for us” (Citi Diversity Annual Report 2013, 2014). Citi

group has one decade, 1994-2014, under their belt as a seasoned diversity practioners.

Citi’s poignant diversity statements has gender power words littered throughout the 2013

annual report. Words to express what and why diversity is and can do, such as; diverse

workforce reflects our global customers, provides competitive advantage, inclusive, global

impact support progress etc… (Citi Diversity Annual Report 2013, 2014). What makes this

company different and confident of their diversity agenda? Citi Corporate has developed

policies, a woman program and a dedicated diversity committee which is fully supported by

their executives and board of directors. Citi Corporation has incorporated diversity into

their business strategy; its not just an addage or after thought but a well designed and

established program which is interwoven into their corporate culture. A few of Citi

Corporation’s accolades are: 80% positive employee diversity perspective; recipient of a

perfect score, 100%, on the Human Rights Campaign Equity Index; trained 600 women in

their women advancement program, 25% female board membership, and an award winner

of UK’s maternity/paternity program (Citi Diversity Annual Report 2013, 2014). Citi

Corporation’s transparency in terms of one challenge encountered due to their stance and

implementation of the diversity program is; “balancing respect for local customs, values


43

and legislations with our priniciples as a company that views diversity as a business

imperative” (Citi Diversity Annual Report 2013, 2014).

Catalyst

Catalyst is most appropriate name for this business, that signifies a firm that

authentically is an agent of change, provoking the environment to change through

research, studies, and educational tools (Catalyst, 2014). Catalyst’s vision, mission and

values are dedicated to: “Changing workplaces, changing lives, expanding opportunities

for women and business, connecting, engaging, inspiring and impacting” (Cataylst Inc.,

2014). Catalyst is a global non-profit researching organization, driven to explore the work

environment, and the interactions of factors and elements which contribute to the myriad of

challenges impeding women in business. Catalyst not only studies the exclusivity of

barriers but it seeks inclusivity through progressive solutions in overcoming the hindrances

women encounter in their work environments. Catalyst is “dedicated to creating more

inclusive workplaces where employees representing every dimension of diversity can

thrive” (Cataylst Inc., 2014). This firm’s core capabilities are; research, events and

services. Research permits Catalyst to comprehend the complex nature of the

marketplace and “empowers businesses to turn these challenges into competitive

opportunities, using data-driven, scientific approaches to pinpoint and address the causes

of talent management gaps” (Cataylst Inc., 2014). Catalyst events are a mode to extend

and share information discovered in the business world, create learning forums to

stimulate change, “inspire action, and advance our transformative vision of changing

workplaces and changing lives” (Cataylst Inc., 2014). Catalyst has a very creative array of

services to keep check on the pulse of the marketplace through data. Catalyst offers “The


44

Speakers Bureau which consists of an expert panel from the research and global member

services group” (Catalyst, 2014). This firm provides supports and referral services to

women seeking board appointments through their ‘Corporate Board Services-CBS’

(Cataylst Inc., 2014). Catalyst also offers a consulting service to women who seek

diagnostic assessment in order to provide an intrinsic insight as well as an external lens to

ascertain opportunities for advancement and employment sustainability (Cataylst Inc.,

2014).

What changes can be done to increase the percentage of women in leadership

positions?

The above left chart provides a visual representation of the nominal changes

women leaders have experienced within most industries, with zero value indicating no

change to the landscape. However, the upward trend depicts a synergized effort should all

bodies (government, industries particularly patriarchal sectors such as healthcare

establishments and women leaders) work collaboratively towards designing or modifying

0

5

10

15

20

25

30

1900 2000 2016 2020

Womencollaboration& networkdevelopment

Industry

Gov't

Government Policies

Women Collaboration &

Network establishments

Hospital Facility Policies


45

work environments to be more inclusive and conducive for growth and increase to women

leaders.

(Manwaring, 2014)

In today marketplace, there is a lack of proponents in establishing a common voice

to invoke changes within the healthcare and across industries. Therefore, it is imperative

to create a network in support of change in the industry’s landscape as well as lobby for

municipalities to create mandated attendance training and program development to

assertively address gender disparities.

Both government and hospital establishments should be accountable for developing

and implementing i.e. fair act work policy which promotes inclusivity within a harmonious

environment where gender diversity is the normative and majority group complement. The

government department would be wise to develop standard definitions which will be

universally utilized across the system to remove inconsistencies in semantics and promote

reporting indicators for monitoring purposes. Once the definitions and standards are

established, the government department should create a resource package to assist

corporations in disseminating, incorporating and implementing gender equality/diversity


46

policies. To ensure catalytic progress, the government should develop a balanced

scorecard that will be a mandated reporting objective for each healthcare establishment.

In order to counter gender biases within healthcare, it is imperative to first create a

gender neutral work environment which fosters equality, embraces change and

advancement of all employees. Human resources will be leveraged as a key partner in

implementing the culture shift within facilities through the development of HR policies and

monitoring progress. It is highly recommended all efforts which promote gender equality

endeavours made transparent by developing human resources policies which reinforce the

progress but also incorporate the progress as performance measure as well as report

these successes in the establishment’s annual reports. By healthcare establishments

removing the invisible barriers, tensions and disparity between genders and replace it with,

i.e. fair act work policy, the environment becomes open, agile and responsive to a gender

neutral work environment.

The healthcare leadership composition should be as diverse as their users and

insomuch that the 70% women who utilize the healthcare system, women leader

population should reflect a reasonable number of senior management with authority, to be

active participants in the healthcare system, and be able to vet through the potential

changes necessary for an evolving healthcare system.

Recommendations The following recommendations are developed to assertively address the

pervasiveness of inequity and disparity of leadership positions between women and men in

healthcare and across industries.


47

“Unless the composition of the decision making bodies in the health care structure

changes substantially to reflect both the sex and class composition of the producers

of the health care sector, no real changes will take place to benefit the majority of

the women in the health care sector (Wiggins, pg.2, 1991)”.

Due to the propensity of cultural biases which permeate the workforce walls of our

healthcare system, both the government and sector should adopt the following to counter

gender inequality:

Government’s Accountability

Knowledge is a powerful tool to counter gender inequality issues and open up forums

for discussion in a productive and progressive manner.

1. Develop a mass media campaign and proclaim one day/per year a day of Women’s

advancement

2. Develop a balanced scorecard within healthcare should include gender equality and

diversity as an indicators and reportable measures linked to funding methodology

Data will be used to monitor the progression of gender diversity in

senior positions with authority

3. Establish an award for the best corporation promoting equality in hiring practices,

advancement for women, mentorship programs and succession planning


48

4. Implement a workforce diversity policy which is mandated for each corporation to

submit the senior leadership complement on an annual balanced scorecard

5. Calibrate and create a fluid interface with adequate supporting mechanisms

(resources packages, reporting objectives, network forums etc…) between

government and the healthcare system

6. Create sponsorship programs and educational tools to support the development of

progressive movement and action which will combat gender inequality

“Sponsorship programs: According to McKinsey & Company (2010),

mentor/sponsorship programs are one of the most important practices for

yielding positive gender diversity effects. Organization need to know and

understand the difference between mentors and sponsors. Although

mentorships that emerge naturally are difficult and timely to foster, they are

more effective than forced, formal mentorship programs, hosting informal

career discussions is a good way to start building informal, organic mentor

relationships” (Heller, Stepp, & Thompson, pg. 15, 2011)

Healthcare establishments Accountability

7. Neutralizing the work environment so it is gender neutral

8. Industry sectors invest in women’s leadership programs which include mentoring

and succession planning for roles with authority

9. Complete and submit an annual Gender Diversity balanced scorecard

10. Establish a neutral succession planning program with equally weighted candidates

11. Implement mandatory educational e-courses for all employees on Gender Diversity


49

o Attendance and course completion will be linked to an annual performance

evaluation

o Develop Employee Resource Groups (ERGs) to support women who aspire

to be leaders and those who reside in leadership positions. There has been

much success when ERG values are reflected in the establishment’s

business strategies. The ERG will have increased success if the

membership consists of a mandatory male head of department and a rotating

male employee attendee to combat gender bias. The ERG’s include senior

sponsorship to expand the networking connections beyond their

establishment to encourage collaboration and best practices in striving for

excellence in not only patient care but in employer to employee and

employee to employee interaction.

o Ensure women candidates for leadership roles possess the necessary skills

as reflected in the following chart:

(Martin & Chermak, 2014)


50

12. Increase gender diversity awareness and provide education with the objective to

transform and weave diversity into the fabric of the work culture

13. Include gender diversity into the vision and business strategy of the facility which is

inclusive and homogenous and can accomplish recalibrating the current state of

the work culture

14. Create equal job opportunities, hiring practices as well as succession planning for

women

15. Create career support programs which assist in career navigation to combat and

improve the retention level of women leaders in healthcare

o “Adopt a new leadership model: If organizations want to stay competitive,

they can’t continue to use one transactional leadership model. It is clear that

forcing women to adapt to this male-dominated leadership style in order to

advance has proven ineffective. As the competitive climate changes,

companies must adopt a new leadership model that incorporates the more

effective transformational, female-dominant leadership attributes. (Heller,

Stepp, & Thompson, pg. 13, 2011)”

16. Address inequity in the workplace, particularly in the healthcare industry, to provide

optimum progress that is reflective of the progressive and diverse health related

initiatives. The healthcare system should be as diverse as the users and insomuch

that the 70% women who do utilize the healthcare system should have choices that

have been vetted by the same gender


51

17. Business strategies should incorporate a holistic approach on gender equality,

career navigation and communication to ensure there is adequate stakeholder buy-

in

18. Develop a progressive leadership model that incorporates effective

transformational and female-dominant leadership attributes with a mandatory

inclusive participation of both genders (Heller, Stepp, & Thompson, 2011)

19. An ideal work environment will encourage indifference towards sex, respect the

mind without acknowledgment of gender and work in unison, synergizing thoughts,

and actions.

Female Leaders

It is imperative for women leaders to band together, recognizing that not only do

they play a pivotal role to the imbalance in the current work environments but, women play

a crucial role towards advocating change for women leaders and proposing that all

healthcare establishments adopt a gender neutral work environment.

20. NEW Initiative - In collaboration with human resource and employee objectives,

there should be equal gender ratio of succession candidates with the successful

candidate chosen on merit, skill, competencies and not by gender


52

21. Women leaders within the healthcare establishments will be the key persons to

initiate and monitor female candidates for leadership programs, this will be included

as an annual performance objective for all female leaders

22. Women leaders will be paired with a junior candidate within their establishments for

mentoring support to guide trainees through the labyrinth in identifying goals and

quantifying successes (Horn, 2014). All success will be celebrated and reported to

indicate progress as well as to ensure there is alignment with pre-approved

indicators

23. The pre-approved indicators will be submitted by the key women leaders and

government (Ministry of labour and Ministry of Health) for monitoring and tracking

progress of the this initiative

o All status reports will be compiled and merged into a larger data warehouse

for report generation

By maintaining the data within the ministry level this will ensure suffice

information to direct policy makers in creating appropriate future

programs for women leaders as well as sustain their success and

therefore balancing and recalibrating the healthcare landscape

24. Contributing factors perpetuating challenges and barriers faced by aspiring women leaders

Lack of cohesiveness and inability to work as a group striving for

advancement within healthcare

Hyper-competitiveness between women creating the queen bee syndrome

and preventing female networking


53

Examples of formalized networks advocating for change and combatting challenges faced by women

Organization & collaborative effort of all bodies to support and promote

networking events for women leaders such as:

o “Participants in the 2010 CAHRS working group identified practices

inside their organizations targeted at providing more networking

opportunities for women. One example was a women’s summit—a

panel discussion about networking with women holding top global

positions in the organization” (Heller, Stepp, & Thompson, pg.15, 201)

Educational forums for the advancement of women leaders i.e. Executive

Leadership Academic Medicine (ELAM)-Leadership Continuum Model below

depicts the progressive phases and flow a woman leader moves through with

each increased leadership responsibility with the caveat that the candidate

be visible for promotion (Morahan, Rosen, Richman, & Gleason, 2011). This

model identifies the entry level through to the senior level leadership

recognizing the need for a hybrid approach to enable flexibility for the

individual and institution (Morahan, Rosen, Richman, & Gleason, 2011).

Some of the training provided involves conflict resolution, negotiation,

strategic financing etc… (Horn, 2014).


54

(Morahan, Rosen, Richman, & Gleason, 2011)

o (ELAM) was developed as a much needed women’s leadership

intervention to compensate for the ineffectiveness of the pipeline

model. The goal of the program was to increase the number of

women leaders and to ensure their sustainability within their senior

leadership roles through targetted training (Morahan, Rosen,

Richman, & Gleason, 2011) Appendix 1

First two phases address creating equal distribution of

opportunites

Third and fourth phases address visibility and assessing as well

as changing the work culture (Morahan, Rosen, Richman, &

Gleason, 2011)

Limitations Although the feminist approach is a great advocate and realm of information, it has

not propelled women forward in the cause or increase of women in senior roles with

authority. During the analysis there were notable limitations encountered with one that was


55

more prominent than the others, which was the lack of current studies beyond the early

90’s. The lack of studies may delineate the value and impact of this analysis. Other

limitations faced were:

Almost non-existence breadth and depth of information of women leaders in

healthcare

Lack of masses of women leaders in healthcare to support the level of importance

in pursuit of a resolution of this issue

Gender biases cause and effect are heavily engraved and interwoven so tightly into

the semantics of everyday interactions

The lack of acknowledgement that gender inequality exist within senior levels

The lack of industry representation therefore, lacking a common voice to incite

momentum, advancements and best practices within the industry


56


Conclusion Gender inequality is a systematic issue that cannot be dealt with on an individual

basis but rather must be addressed as a collective. Little advancement has occurred in

increasing women leaders and the persistence of suppressing females from advancing in

their careers which has become the norm in work societies. The normative society is

derived from perpetuating cultural oppression and marginalization within patriarchal work

cultures. Why is this quest for gender equality so important? It is vital, not only for those

women currently in leadership roles, but for the future females who may aspire and

endeavour to strive to be more. If gender equality is not addressed and theories of

solutions not proposed, this could very well diminish women’s pursuit of senior roles by

future cohorts. What is required for the advancement of women into leadership with

authority positions? This matter must be brought to the forefront, address what was and is

still supressing factors. Education is one of the key tools in combatting gender biases and


57

to better equip female millenniums to decipher oppressive patterns and be able to

successfully manage to overcome barriers. In addition, it is imperative for the development

of forums and networks in order to drive commitment and action in a unified manner

seeking change for the betterment of all women striving to attain leadership roles with

authority.

“Ignoring leadership without authority does an enormous disservice to the distributed

intelligences that make a society adaptive and able to thrive over time” (Kellerman &

Rhode, 2007).


58

Appendix

Appendix 1

(Morahan, Rosen, Richman, & Gleason, 2011)


59

Appendix 2



60

Appendix 3


Appendix 4



61

Appendix 5

Appendix 6

http://www.rbc.com/diversity/pdf/2009-2011Diversity_Blueprint_Report_Card.pdf

http://www.rbc.com/diversity/pdf/2009-2011Diversity_Blueprint_Report_Card.pdf


62

Appendix 7

Read the press release announcing our 2014 winners, issued on February 10, 2014.

Read the 2014 announcement, published in the February 10, 2014 of the Report on

Business section of The Globe and Mail.

Our detailed 2014 Reasons for Selection are now available online. Click below to read why each employer was selected.

(in alphabetical order*)

Accenture Inc.

Agrium Inc.

BC Hydro

BDC / Business Development Bank of Canada

Boeing Canada Operations Limited

British Columbia Institute of Technology / BCIT

Cameco Corporation

CAMH / Centre for Addiction and Mental Health

Canada Mortgage and Housing Corporation / CMHC

Cargill Limited

CIBC

Corus Entertainment Inc.

Dalhousie University

Dentons Canada LLP

Edmonton, City of

Enbridge Inc.

ENMAX Corporation

Ernst & Young LLP

Health Canada / Santé Canada

Home Depot of Canada Inc.

Jazz Aviation LP

KPMG LLP

Loblaw Companies Limited

Manitoba Hydro

http://www.newswire.ca/en/story/1302795/the-year-s-most-inspiring-workplace-inclusiveness-stories-canada-s-best-diversity-employers-for-2014-announced-today

http://www.theglobeandmail.com/partners/advcanadasbestdiversity0214/

http://www.eluta.ca/jobs-at-accenture#diversity:diversity-more

http://www.eluta.ca/jobs-at-agrium#diversity:diversity-more

http://www.eluta.ca/jobs-at-bc-hydro#diversity:diversity-more

http://www.eluta.ca/jobs-at-bdc#diversity:diversity-more

http://www.eluta.ca/jobs-at-boeing-canada#diversity:diversity-more

http://www.eluta.ca/jobs-at-bcit#diversity:diversity-more

http://www.eluta.ca/jobs-at-cameco#diversity:diversity-more

http://www.eluta.ca/jobs-at-centre-for-addiction-and-mental-health#diversity:diversity-more

http://www.eluta.ca/jobs-at-cmhc#diversity:diversity-more

http://www.eluta.ca/jobs-at-cargill#diversity:diversity-more

http://www.eluta.ca/jobs-at-cibc#diversity:diversity-more

http://www.eluta.ca/jobs-at-corus-entertainment#diversity:diversity-more

http://www.eluta.ca/jobs-at-dalhousie-university#diversity:diversity-more

http://www.eluta.ca/jobs-at-dentons#diversity:diversity-more

http://www.eluta.ca/jobs-at-city-of-edmonton#diversity:diversity-more

http://www.eluta.ca/jobs-at-enbridge#diversity:diversity-more

http://www.eluta.ca/jobs-at-enmax#diversity:diversity-more

http://www.eluta.ca/jobs-at-ernst-young#diversity:diversity-more

http://www.eluta.ca/jobs-at-health-canada#diversity:diversity-more

http://www.eluta.ca/jobs-at-home-depot#diversity:diversity-more

http://www.eluta.ca/jobs-at-jazz-aviation#diversity:diversity-more

http://www.eluta.ca/jobs-at-kpmg#diversity:diversity-more

http://www.eluta.ca/jobs-at-loblaws#diversity:diversity-more

http://www.eluta.ca/jobs-at-manitoba-hydro#diversity:diversity-more


63

Manitoba, Government of

McCarthy Tétrault LLP

Mount Sinai Hospital

National Bank Financial Group

Newalta Corporation

Northwest Territories, Government of the

Ontario Public Service / OPS

Ottawa, City of

Procter & Gamble Inc.

PWC / PricewaterhouseCoopers LLP

RBC

Rogers Communications Inc.

Saskatchewan Government Insurance / SGI

Saskatoon, City of

SaskPower

SaskTel

Shaw Communications Inc.

Shell Canada Limited

Sodexo Canada Ltd.

StandardAero

Stikeman Elliott LLP

Surrey, City of

TD Bank Group

TELUS Corporation

University of Toronto

University of Victoria

Vancouver Island Health Authority / VIHA

William Osler Health System

WorleyParsons Canada Services Ltd.

Xerox Canada Inc.

YMCA of Greater Toronto

http://www.eluta.ca/jobs-at-manitoba-government#diversity:diversity-more

http://www.eluta.ca/jobs-at-mccarthy-tetrault#diversity:diversity-more

http://www.eluta.ca/jobs-at-mount-sinai-hospital#diversity:diversity-more

http://www.eluta.ca/jobs-at-national-bank#diversity:diversity-more

http://www.eluta.ca/jobs-at-newalta#diversity:diversity-more

http://www.eluta.ca/jobs-at-nwt-government#diversity:diversity-more

http://www.eluta.ca/jobs-at-ontario-government#diversity:diversity-more

http://www.eluta.ca/jobs-at-city-of-ottawa#diversity:diversity-more

http://www.eluta.ca/jobs-at-procter-%26-gamble#diversity:diversity-more

http://www.eluta.ca/jobs-at-pwc#diversity:diversity-more

http://www.eluta.ca/jobs-at-rbc#diversity:diversity-more

http://www.eluta.ca/jobs-at-rogers-communications#diversity:diversity-more

http://www.eluta.ca/jobs-at-sgi#diversity:diversity-more

http://www.eluta.ca/jobs-at-city-of-saskatoon#diversity:diversity-more

http://www.eluta.ca/jobs-at-saskpower#diversity:diversity-more

http://www.eluta.ca/jobs-at-sasktel#diversity:diversity-more

http://www.eluta.ca/jobs-at-shaw#diversity:diversity-more

http://www.eluta.ca/jobs-at-shell#diversity:diversity-more

http://www.eluta.ca/jobs-at-sodexo#diversity:diversity-more

http://www.eluta.ca/jobs-at-standardaero#diversity:diversity-more

http://www.eluta.ca/jobs-at-stikeman-elliott#diversity:diversity-more

http://www.eluta.ca/jobs-at-city-of-surrey#diversity:diversity-more

http://www.eluta.ca/jobs-at-td-bank#diversity:diversity-more

http://www.eluta.ca/jobs-at-telus#diversity:diversity-more

http://www.eluta.ca/jobs-at-university-of-toronto#diversity:diversity-more

http://www.eluta.ca/jobs-at-university-of-victoria#diversity:diversity-more

http://www.eluta.ca/jobs-at-viha#diversity:diversity-more

http://www.eluta.ca/jobs-at-william-osler-health-centre#diversity:diversity-more

http://www.eluta.ca/jobs-at-worleyparsons#diversity:diversity-more

http://www.eluta.ca/jobs-at-xerox#diversity:diversity-more

http://www.eluta.ca/jobs-at-ymca-of-greater-toronto#diversity:diversity-more


64

Appendix 8 Top 50 USA Diversity Companies


65

Appendix 9 What about Canada?

If we explore the Canadian culture through the lens of the 6-D Model, we can get a good overview of the deep drivers of Canadian culture relative to other world cultures. Power distance

This dimension deals with the fact that all individuals in societies are not equal – it expresses the attitude of the culture towards these inequalities amongst us. Power distance is defined as the extent to which the less powerful members of institutions and organisations within a country expect and accept that power is distributed unequally. It has to do with the fact that a society’s inequality is endorsed by the followers as much as by the leaders. With a score of 39 on this dimension, Canadian culture is marked by interdependence among its inhabitants and there is value placed on egalitarianism. This is also reflected by the lack of overt status and/or class distinctions in society. Typical of other cultures with a low score on this dimension, hierarchy in Canadian organisations is established for convenience, superiors are always accessible and managers rely on individual employees and teams for their expertise. It is customary for managers and staff members to consult one another and to share information freely. With respect to communication, Canadians value a straightforward exchange of information.

Individualism

The fundamental issue addressed by this dimension is the degree of interdependence a society maintains among its members. It has to do with whether people´s self-image is defined in terms of “I” or “We”. In Individualist societies people are supposed to look after themselves and their direct family only. In Collectivist societies people belong to ‘in groups’ that take care of them in exchange for loyalty. Canada scores 80 on this dimension (its highest dimension score) and can be characterized as an individualistic culture. Similar to its American neighbor to the south, this translates into a loosely-knit society in which the expectation is that people look after themselves and their immediate families. Similarly, in the business world, employees are expected to be self-reliant and display initiative. Also, within the exchange-based world of work, hiring and promotion decisions are based merit or evidence of what one has done or can do.

Masculinity

A high score (masculine) on this dimension indicates that the society will be driven by competition, achievement and success, with success being defined by the “winner” or “best-in-the-field.” This value system starts in school and continues throughout one’s life – both in work and leisure pursuits.

A low score (feminine) on the dimension means that the dominant values in society are caring for others and quality of life. A feminine society is one where quality of life is the sign of success and standing out from the crowd is not admirable. The fundamental issue here is what motivates people, wanting to be the best (masculine) or liking what you do (feminine). Canada scores 52 on this dimension and can be characterized as a moderately “masculine” society. While Canadians strive to attain high standards of performance in both work and play (sports), the overall cultural tone is more subdued with respect to achievement, success and winning, when compared to the US. Similarly, Canadians also tend to have a work-life balance and are likely to take time to enjoy personal pursuits, family gatherings and life in general. This is not to say that Canadians are not hard workers. As a general rule, Canadians strive to attain high standards of performance in all endeavors.


66 Uncertainty avoidance The dimension Uncertainty Avoidance has to do with the way that a society deals with the fact that the future can never be known: should we try to control the future or just let it happen? This ambiguity brings with it anxiety and different cultures have learnt to deal with this anxiety in different ways. The extent to which the members of a culture feel threatened by ambiguous or unknown situations and have created beliefs and institutions that try to avoid these is reflected in the UAI score. The Canadian score on this dimension is 48 and Canadian culture is more “uncertainty accepting.” This is indicative of the easy acceptance of new ideas, innovative products and a willingness to try something new or different, whether it pertains to technology, business practices, or consumer products. Canadians are also tolerant of ideas or opinions from anyone and allow the freedom of expression. At the same time, Canadian culture is not rules-oriented and Canadians tend to be less emotionally expressive than cultures scoring higher on this dimension. Pragmatism

This dimension describes how every society has to maintain some links with its own past while dealing with the challenges of the present and future, and societies prioritise these two existential goals differently. Normative societies who score low on this dimension, for example, prefer to maintain time-honoured traditions and norms while viewing societal change with suspicion. Those with a culture which scores high, on the other hand, take a more pragmatic approach: they encourage thrift and efforts in modern education as a way to prepare for the future.

Canada scores 36 in this dimension, marking it as a normative society. People in such societies have a strong concern with establishing the absolute Truth; they are normative in their thinking. They exhibit great respect for traditions, a relatively small propensity to save for the future, and a focus on achieving quick results.

Indulgence

One challenge that confronts humanity, now and in the past, is the degree to which little children are socialized. Without socialization we do not become “human”. This dimension is defined as the extent to which people try to control their desires and impulses, based on the way they were raised. Relatively weak control is called “indulgence” and relatively strong control is called “restraint”. Cultures can, therefore, be described as indulgent or restrained.

The high score of 68 in this dimension means that Canadian culture is classified as indulgent. People in societies classified by a high score in indulgence generally exhibit a willingness to realise their impulses and desires with regard to enjoying life and having fun. They possess a positive attitude and have a tendency towards optimism. In addition, they place a higher degree of importance on leisure time, act as they please and spend money as they wish.

NOTE: While the above descriptions apply to Canadian culture overall, one will likely find subtle differences between Anglophone Canadians and Francophone Canadians (the Province of Quebec.) Compared with their Anglophone counterparts, French-Canadians can be more formal, hierarchical, moderately relationship focused, and more emotionally expressive. The scores for Quebec are as follows: pdi 54; idv 73; mas 45; uai 60


67

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