- Email: [email protected]
Women and leadership in health care: the journey to authenticity and power
BOOK REVIEW
Women and Leadership in Health Care: The Journey to Authenticity and Power Catherine Robinson-Walker, Published by Jossey-Bass/1999/227 pp/ $44.00
Jannette Collins, MD, MEd This is a three-part book focusing on the key challenges of gender in health care; specific skills and behaviors that can help women excel in today’s challenging and demanding environment; and gender as it relates to leadership, aging, and stages of maturity. It is targeted at health care clinicians, executives, managers, healers, support personnel, and providers in all leadership roles who are called on to make decisions of import for and with the patients and resources on their watches. Robinson-Walker emphasizes that “many women are sure to find affinity with the female voices in the book, but men too will hear stories that bear witness to their own lives and callings.” She is the executive director of the Academy for Healthcare Quality, a collaborative venture of the Joint Commission on Accreditation of Healthcare Organizations and five leading universities throughout the United States. The book is based on interviews with participating leaders from the 1997 Gender and Leadership in Healthcare Study (GLHS). Robinson-Walker reports that as of 1999, women were not present in senior management positions to the extent expected, given that 85% of U.S. health care workers are female. This is not expected to change simply because more women are entering the pipeline. By the late 1970s and early 1980s, women were found in significant numbers in graduate programs in health administration. Yet today, they have not attained the levels of leadership that their male counterparts have, and as they age, female health care executives continue to experience lower career attainments compared with men. So-called feminine values of responsibility, connection, and inclusion are quite different from the traits of the
competitive, rugged individual or lonehero model of leadership we have traditionally revered. “Women are more likely to strive for consensus and less likely to be autocratic in approaches to problem solving.” Women don’t want to appear better than other women, because this violates their egalitarian sensibilities. What is important to women is connection and similarity rather than difference. A number of GLHS contributors commented on the impact of low self-esteem among women in health care settings: “She consistently doubts herself even when she performs at consistently high levels. . .criticism can immobilize her.” The book makes the point that women feel that they have to know at least 75% of a job before they are even willing to apply for it, whereas men don’t feel that they have to know even 50%. Women seem to demonstrate loyalty through attachment to emotions such as grudges. One GLHS participant commented, “Women personalize and don’t get over their losses easily. Women don’t lose as gracefully as men. They can carry the hurt longer than men.” I would have liked the author to comment on why this might be so. Is it because when women are wronged, they are not afforded apologies or other recognition of fault on the part of the wrongdoers? Is it different for men? What is the explanation for women reacting differently than men when they experience losses? How should women channel their resentment? It is well established that there are custom, language, and dialect differences between the sexes. Men generally communicate to fulfill task functions, and women normally communicate to fulfill the social-emotional function. Women need to be in constant communication to preserve feelings of
© 2004 American College of Radiology 0091-2182/04/$30.00 ● DOI 10.1016/j.jacr.2004.01.007
trust. This is important for women, for much of their perceived success and fulfillment at work is based on trust. Women who don’t conform to these “rules of talk” can be viewed with suspicion by other women. Body language contains gender-coded messages, based on the premise that “the more space you occupy, the more power you have.” The male body position is one leg up, ankle across the other knee forming an A, with the hands behind the head. Or men will put one arm across the next guy’s chair. RobinsonWalker calls this behavior “puffing.” Female body language is quite different. Women are taught not to cross their legs in this manner, to fold their arms, and to assume smaller spaces. This type of body position equals the statement “It’s okay to push me over.” Suggestions for managing the “glass ceiling” include actively grooming women for top-level positions and providing flexibility in job structure (e.g., offering shared leadership positions). Individuals who experience extensive mentoring report more promotions and higher incomes. Mentors of the most successful women in health care organizations seem to be men. Men who say that they are comfortable working with women are secure in their positions, have high self-esteem, and often have professional wives or daughters who are pursuing careers. Research has shown that women are more caring and empathetic but are seen as less competent than men. Robinson-Walker outlines tips for overcoming this stereotype: simply be competent; indicate a mastery of fact and detail (e.g., demonstrate knowledge at an encyclopedic level); be organized, disciplined, and methodical (being messy implies a lack of expertise); don’t rely on prepared notes or read a speech; carefully endorse oneself personally (noting awards, degrees, and achievements); use language that is authoritative, definitive, well organized, and embodied in short sentences (avoiding breaks in the voice, high pitch, and too many “uhs” and “ahs”); and never say, “I’m not an expert.” This book touches on a number of 293
294 Book Review
issues that will stimulate self-reflection and perhaps raise more questions than it answers. It would serve well as a
springboard for women’s group discussions. Better yet, a joint discussion of the book between male and female
health care providers would facilitate a more uniform understanding of gender issues.
Jannette Collins, MD, MEd, Department of Radiology, University of Wisconsin Hospital and Clinics, E3/311 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792-3252; e-mail: [email protected].
Women and Leadership in Health Care: The Journey to Authenticity and Power Catherine Robinson-Walker, Published by Jossey-Bass/1999/227 pp/ $44.00
Jannette Collins, MD, MEd This is a three-part book focusing on the key challenges of gender in health care; specific skills and behaviors that can help women excel in today’s challenging and demanding environment; and gender as it relates to leadership, aging, and stages of maturity. It is targeted at health care clinicians, executives, managers, healers, support personnel, and providers in all leadership roles who are called on to make decisions of import for and with the patients and resources on their watches. Robinson-Walker emphasizes that “many women are sure to find affinity with the female voices in the book, but men too will hear stories that bear witness to their own lives and callings.” She is the executive director of the Academy for Healthcare Quality, a collaborative venture of the Joint Commission on Accreditation of Healthcare Organizations and five leading universities throughout the United States. The book is based on interviews with participating leaders from the 1997 Gender and Leadership in Healthcare Study (GLHS). Robinson-Walker reports that as of 1999, women were not present in senior management positions to the extent expected, given that 85% of U.S. health care workers are female. This is not expected to change simply because more women are entering the pipeline. By the late 1970s and early 1980s, women were found in significant numbers in graduate programs in health administration. Yet today, they have not attained the levels of leadership that their male counterparts have, and as they age, female health care executives continue to experience lower career attainments compared with men. So-called feminine values of responsibility, connection, and inclusion are quite different from the traits of the
competitive, rugged individual or lonehero model of leadership we have traditionally revered. “Women are more likely to strive for consensus and less likely to be autocratic in approaches to problem solving.” Women don’t want to appear better than other women, because this violates their egalitarian sensibilities. What is important to women is connection and similarity rather than difference. A number of GLHS contributors commented on the impact of low self-esteem among women in health care settings: “She consistently doubts herself even when she performs at consistently high levels. . .criticism can immobilize her.” The book makes the point that women feel that they have to know at least 75% of a job before they are even willing to apply for it, whereas men don’t feel that they have to know even 50%. Women seem to demonstrate loyalty through attachment to emotions such as grudges. One GLHS participant commented, “Women personalize and don’t get over their losses easily. Women don’t lose as gracefully as men. They can carry the hurt longer than men.” I would have liked the author to comment on why this might be so. Is it because when women are wronged, they are not afforded apologies or other recognition of fault on the part of the wrongdoers? Is it different for men? What is the explanation for women reacting differently than men when they experience losses? How should women channel their resentment? It is well established that there are custom, language, and dialect differences between the sexes. Men generally communicate to fulfill task functions, and women normally communicate to fulfill the social-emotional function. Women need to be in constant communication to preserve feelings of
© 2004 American College of Radiology 0091-2182/04/$30.00 ● DOI 10.1016/j.jacr.2004.01.007
trust. This is important for women, for much of their perceived success and fulfillment at work is based on trust. Women who don’t conform to these “rules of talk” can be viewed with suspicion by other women. Body language contains gender-coded messages, based on the premise that “the more space you occupy, the more power you have.” The male body position is one leg up, ankle across the other knee forming an A, with the hands behind the head. Or men will put one arm across the next guy’s chair. RobinsonWalker calls this behavior “puffing.” Female body language is quite different. Women are taught not to cross their legs in this manner, to fold their arms, and to assume smaller spaces. This type of body position equals the statement “It’s okay to push me over.” Suggestions for managing the “glass ceiling” include actively grooming women for top-level positions and providing flexibility in job structure (e.g., offering shared leadership positions). Individuals who experience extensive mentoring report more promotions and higher incomes. Mentors of the most successful women in health care organizations seem to be men. Men who say that they are comfortable working with women are secure in their positions, have high self-esteem, and often have professional wives or daughters who are pursuing careers. Research has shown that women are more caring and empathetic but are seen as less competent than men. Robinson-Walker outlines tips for overcoming this stereotype: simply be competent; indicate a mastery of fact and detail (e.g., demonstrate knowledge at an encyclopedic level); be organized, disciplined, and methodical (being messy implies a lack of expertise); don’t rely on prepared notes or read a speech; carefully endorse oneself personally (noting awards, degrees, and achievements); use language that is authoritative, definitive, well organized, and embodied in short sentences (avoiding breaks in the voice, high pitch, and too many “uhs” and “ahs”); and never say, “I’m not an expert.” This book touches on a number of 293
294 Book Review
issues that will stimulate self-reflection and perhaps raise more questions than it answers. It would serve well as a
springboard for women’s group discussions. Better yet, a joint discussion of the book between male and female
health care providers would facilitate a more uniform understanding of gender issues.
Jannette Collins, MD, MEd, Department of Radiology, University of Wisconsin Hospital and Clinics, E3/311 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792-3252; e-mail: [email protected].