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By Sheila Talton
If you judge the 20-year effort to attract more minorities into undergraduate and graduate-level health administration programs in the U.S. by results – which, in the end, is the only valid metric – it’s painfully apparent that not much has improved. A 2019 study by the American College of Hospital Executives (ACHE) and the American Hospital Association (AHA) showed that 89% of all hospital CEOs were white. Given that only 60% of the overall U.S. population is white, the lack of diversity in healthcare (especially in the C-suite) is both real and costly.
As a black woman, I can confirm that those statistics reflect both my observations and personal experiences throughout my professional career. Countless times I have witnessed white peers handpicked and/or groomed to lead large business functions, even when I or other people of color had similar or even superior leadership, technical and/or management skills. And though some people of color and women eventually do reach the vice-presidential level, they become increasingly rare in the C-suite and in boardrooms.
While there are higher percentages of women and people of color in clinical and operational roles, lack of diversity in the upper levels of healthcare leadership stubbornly persists, as it does in other industries. To be fair, some healthcare organizations have made progress in pursuing diversity at the uppermost levels. Among them are some of the Blue Cross Blue Shield health plans, where more women and people of color have senior roles. Most of the commercial payors and the providers, unfortunately, still have a lot of work to do. (One notable exception is Kaiser Permanente. Former CEO Bernard Tyson, an African American, was a visionary who transformed Kaiser’s C-suite by including women and people of color. Sadly, Tyson passed away in 2019.)
There’s no doubt that lack of diversity in healthcare leadership is an issue of fairness and equity. But it’s more than that. By excluding large swaths of potential healthcare leaders from the C-suite pipeline simply because they aren’t white males, healthcare providers and payors are failing to effectively leverage all the executive talent available to them.
Bright, ambitious, and well-educated leaders-in-waiting are eager to apply their skills in one of America’s largest and most important industries. Yet they consistently are denied a chance to demonstrate their abilities or to assume greater responsibilities. And because so many gifted leaders – who happen to be women or people of color – are being kept out of tracks to high-level positions from which they could improve the quality of healthcare and make a difference in people’s lives, we all lose.
Beyond lip service
We can’t afford to not be using all of the skills and talents we have available to us, both in healthcare and the other larger businesses globally. As the numbers make clear, however, whatever the company, including healthcare organizations, the initiatives around diversity over the past two decades aren’t working. New strategies and decisive action are called for, with measurements that indicate effectiveness.
Opening the C-suite pipeline to women and people of color is the single most impactful action healthcare organizations can take to increase diversity at the executive level. The programs and measurements should not be the same for women as African Americans. The issues are different, and the numbers/measurements need to address challenges for both groups. Historically, we have used the word “diversity” as a catch-all for Hispanic, Asian, women, etc., but it is time to address each group accordingly. This isn’t about job quotas. It’s about training, retention and preserving corporate IP. If women and people of color truly are not being given a chance to grow and prepare for positions in senior leadership, they will leave and take your corporate IP with them.
Healthcare organizations should emulate proactive leadership in diversity initiatives being undertaken by many businesses in other industries. One of the reasons business in general is more responsive and proactive regarding executive, employee, board and supplier diversity is the pressure from shareholders. Large mutual funds such as Fidelity, Vanguard, Black Rock, T. Rowe Price, etc. want companies to make diversity a key component of their ESG (environmental, social and corporate governance) initiatives. As a result of shareholder pressure, the boards of directors of these companies, who represent the shareholders, are insistent that measures and metrics are connected to diversity. Most health systems’ boards are made up of large donors and these donors/boards of directors are not tying measures and metrics to the executive leadership in health systems. But board members of healthcare organizations can still and should hold health system leaders accountable for increasing executive and employee diversity, often equated with its talent and quality of healthcare.
In addition to pursuing genuine diversity among top leadership and continuing to encourage diversity in clinical and operational ranks, healthcare organizations can extend these ambitions to the supply chain. If you’re not cultivating a more diverse base of supply and service providers (such as medical products, technology, and accounting and legal services), you’re not maximizing opportunities for cost and quality. Smaller boutique firms usually have employees that came from large legal firms, consulting firms, etc. The quality of supplies and services they provide is equal to that of the big firms, with usually a lower cost basis.
Create your own opportunities
None of the above is meant to suggest that talented women and people of color – or any young, aspiring professional – should wait for someone to give them an opportunity. There’s always more work to be done in an organization than there are people to get it done. Seize the initiative and volunteer to do something that solves a problem or creates an opportunity for your organization, and which stretches your skills. Do it well and continue to do it. I guarantee people will notice. Further, you will increase your value inside and outside the organization because you will have grown professionally and created a tangible success story, both for the enterprise and yourself. That’s how great leadership careers are built.
You should also nurture relationships with mentors and sponsors. A mentor is similar to a coach or personal trainer. They can help you develop professional skills and prepare you to take on a new role or job. A sponsor is a champion, a person who advocates for you to step into an expanded role, a new role, or a promotion. Mentors and sponsors are invaluable to aspiring leaders. Organizations should encourage and create informal mentoring programs.
Diversity in the executive ranks is about far more than “doing good.” By failing to make diversity a priority, this is a failure in developing talent and promoting excellence that ultimately affects quality healthcare delivery.
Sheila Talton is the founder and CEO of Gray Matter Analytics.