Cultivating leadership for Women in Medicine

AMWA 8.24.2016Erin Snyder MD, Erin Contratto MD

Leah Leisch MD, Teri Bryan MDDivision of General Internal Medicine, UAB

What are the characteristics of great leaders?

Leadership Defined

Perception vs Reality

The Wage Gap• Cost of wage gap when compared

to white men is:– 10 cents for Asian women– 22 cents for white women– 36 cents for black women– 46 cents for Latina women

• As a result of the gap, over a career, a woman loses:– $315K for Asian women– $440K for white women– $717K for black women– $854K for Latina women

Slide courtesy of Sheri Burnett-Bowie, MGH Center for Diversity & Inclusion

Letters of Recommendation

• Women letters shorter, less focused on accomplishments– 2X likely to have gender references – contain doubt-raisers, reference personal life– “Grindstone” adjectives (hard working, dependable)

• Men letters – “Standout” adjectives (stellar or outstanding)

Slide courtesy of Sheri Burnett-Bowie, MGH Center for Diversity & Inclusion

Hiring and Promotion

• CV of psychologist sent to entry level and tenure review level jobs to 238 academic psychologist positions

• Named Brian or Karen Miller• Brian more likely to be hired at entry level and

evaluated more positively• Equally likely to be hired at tenure level, but 4X

more likely to include comments of caution or concern for Karen

Steinpreis et al

What Is Our Unconscious Bias, and What Can We Do About It?

Recap of our card exercise

Intrinsic barriers– Leadership skills gap• working with interdisciplinary team • time management

– Imposter & tiara syndromes– Balancing obligations– Align decisions with career trajectory– Negotiation

Leaders Clinicians• “Create conditions that

enable & encourage others to achieve a shared goal through collective action.”

• Trained as individuals

• More accountable to professional bodies than local hierarchies

Bohmer et al. NEJM 2013.

Healthcare leadership skills gap

• Leadership needed at all levels of healthcare delivery– Decrease cost– Improve quality– Providing access

• MD’s: no formal training to assess leadership competencies

Stoller, JK. Perspective Med Ed 2014.

Quote Bundles

• Reflect on the theme of the quotes, how this is illustrated in medicine, and means of addressing this issue.

Confidence

• “It’s hard to lead a cavalry charge if you think you look funny on a horse.” -Adlai Stevenson II, politician

• “Don’t be intimated by what you don’t know. That can be your greatest strength and ensure that you do things differently from everyone else.” - Sarah Blakely, founder of Spanx

Overcoming imposter syndrome

• Learn to accept insecurity• Find support: co-workers, relative, friends• Mentoring (bidirectional)• Document successes & failures

Fitzpatrick et al.

Boldness

• “The thing women have yet to learn is nobody gives you power. You just take it.” -Roseanne Barr, actor

Tiara Syndrome

• Reluctant to apply for promotions• Good performance will naturally lead to

rewards• “someone will notice and crown your

head”• Women require more encouragement

from bosses to seek senior positions

Fitzpatrick et al.

Overcoming tiara syndrome

• Make yourself available for interim roles– gain confidence– define terms before acceptance

• Take “shots on goal”• Request feedback• Let your supervisors know what you want

Fitzpatrick et al.

Opportunity

“There is nothing like a concrete life plan to weigh you down. Because if you always have one eye on some future goal, you stop paying attention to the job at hand, miss opportunities that might arise, and stay fixedly on one path, even when a better, newer course might have opened up.”

–Indra Nooyi, CEO of PepsiCo

Align opportunities with career path

• Prioritize your needs & interests

• Recognize if you are earning “good citizen” points for new role (can use for negotiation later)

Balancing obligations

• Find 1 mentor of same gender or with similar focus on personal/professional life

• Learn the art of “saying no”

• “YES” to 1 time commitment is “NO” to othersWietsma et al.

Negotiating 101

• Prepare

• Ask

• Package

PAP

GoalBottom lineCompany (Division/Department Goals)

Negotiating 101: Men vs. Women

Negotiating 101

Negotiation• Practice skills outside of work• Start with low-risk situations• Prepare

- (remember to “reset” the bottom line)• Anticipate & prepare for pushback

Fitzpatrick et al.

A chance occurrence…

PAR Statement

ProblemAction Result • A brief, specific, and quantitative statement• Describes the results of your work• Demonstrates attributes and skills• Showcases accomplishments and impact

Example PAR Statement

• Problem: We identified a need to improve patient notification of test results in Resident Clinic.

• Action: I worked with faculty and residents to create a process for streamlining result notification.

• Result: – Patient notification improved from 16 % to 90%– Improvement in management of chronic disease was also noted. – These results were published in a peer reviewed journal– Templates that were created are now being adapted for use in

other VA clinics.

Create your PAR Statement

• Problem: that you had to solve • Action: what you did to address or solve it • Result: what happened? be specific and

quantitative

Elevator Speech

Prepared for a brief, chance encounter Constructed like a PAR Spotlights your uniqueness Leaves a positive memory Always have an “ask” in mind

A Chance Encounter….

Resources

Resources• ACP Leadership Academy and Webinar

– www.acponline.org/education_recertification/resources/leadership_development/

• SGIM LEAD program, leadership roles within regions, committees, meetings– www.sgim.org/alcgim-tools-programs/lead

• SHM online learning community: leadership modules– shm.community360.net/default.aspx

• AAMC Women Faculty Development Seminars, LEAD program– www.aamc.org/members/leadership/catalog/323252/

womensleadership.html

References• Bickel J. How men can excel as mentors of women. Academic Medicine 2014; 89(8). • Blumental et al. Addressing the leadership gap in medicine: residents' need for systematic leadership

development training. Acad Med. 2012; 87(4):513-22. • Bohmer RMJ. Leading clinicians and clinicians leading. NEJM. 2013; 368 (16)• Fitzpatrick TA et al. Waiting for your coronation: a career-limiting trap. Nursing Economics. 2014; 32 (3). • Stoller JK. Help wanted: developing clinician leaders. Perspective Med Ed 2014• Wietsma A. “Barriers to success for female physicians in academic medicine.” Journal of Community

Hospital Internal Medicine Perspectives. 2014;4.