Saturday Morning Rounds February 8, 2020 - What's in a name? The gender gap in medical leadership, as it turns out

Posted by BossB, MD on February 8, 2020
BossB, MD

Saturday Morning Rounds
A weekly round-up of everything that captured our attention over the last 7 days

What we're reading

What we're reading

Why Don't Women Self-Promote As Much As Men?

'Tis the season of annual reviews, and self-assessment is becoming an increasingly important part of that process in all kinds of institutions.

In this HBR article, the authors/researchers

"found a large gender gap in self-promotion — with men rating their performance 33% higher than equally performing women. To understand what’s driving this gap, [they] looked at two factors that might influence one’s level of self-promotion: confidence (you may be unsure of your actual performance) and strategic incentives (you may talk up your performance to get a raise or promotion)."

Read the article itself if you want to get into their study design (which is fascinating), but long story short they covered every angle they could think of to test both confidence and strategic incentives as possible explanations for the gender gap in self-assessment.

In the authors' own (likely flummoxed) words:

"In every setting we explored, we observed a substantial gender gap in self-promotion: Women systematically provided less favorable assessments of their own past performance and potential future ability than equally performing men. And our various study versions revealed that this gender gap was not driven by confidence or by strategic incentives, and that it was robust both in the face of ambiguity and under increased transparency."

Essentially, no matter what they authors did to increase confidence or decrease the downside of self-promotion, women were still more likely to rate the exact same objective performance far lower than their male counterparts.

Why might this be? The authors close by advancing a theory that we suspect is at the center of this phenomenon:

"Prior work investigating self-promotion has pointed to the potential for gender differences in backlash — in which those who self-promote 'too much' are punished. If women are punished for excessive self-promotion more than men, this could lead women — more than men — to internalize the risks of describing their performance too favorably."

More to come on this topic in today's "tip of the week"

Who we're following

It's super bowl weekend and Oikos greek yogurt just dropped an ad that highlights why many of us watch each year.

Hint... it's neither for the football, nor for the ads 🍑

What we're reading

Chair Versus Chairman: Does Orthopaedics use the Gendered Term More Than Other Specialties?

What's in a name? As it turns out, a lot of the gender gap in medicine, and specifically in medical leadership.

A great deal of research supports the idea that it's difficult to "be what you can't see." Lack of representation in any given role makes it difficult to envision ourselves occupying that role.

So what does that mean for medicine? Well, these researchers sought to answer that very question with an elegant and compelling study design.

They looked at the websites of 719 primary academic departments, and compared the ratio of female chairs to whether those departments' websites use the term "chairman" or the term "chair."

Unsurprisingly, the fewer women chairs in a specialty, the greater the use of a gendered leadership role title.

What does this mean for the gender gap? The authors' discussion section highlights the following facts:

  • Titles are only one factor contributing to department culture and influencing the gender gap in medicine
  • Titles do impact workplace equity and the message of inclusion
  • The gender based title “Chairman” reinforce stereotypes that only male can be chairs
  • Female applicants are perceived to be less qualified for high-status positions when a masculine title is use (Ref: Horvath LK, European Journal of Work and Organizational Psychology, 2016)

So what can we do about this? Change the damn websites!

Seriously though, if you're reading this, it means that there might be any easy opportunity to advance gender equity in medicine at your fingertips. We'll dig into how you can do so in our "tip of the week." Stay tuned :)

Who we're following

Dr. Mary O'Connor, MD (@MaryOConnorMD) is:

  • One of the authors of the article we're highlighting this week
  • One of the few pioneering women in orthopaedic leadership (first female AAOS President, currently the Director of the Center for Musculoskeletal Care at Yale Medicine and Yale New Haven Health)
  • One of our favorite follows on Twitter - always celebrating other peoples' good work and championing women in medicine

She's trying to get the word out about the importance of this language shift, so give her a follow and help out! Every like/RT/share increases awareness.

BBMD tip of the week

Social media is a great way to bring about awareness, but real structural change can come slow on those platforms.

The quickest route to living in an environment of equal opportunity & access for all is to create it yourself, and you have more power to do so than you might realize.

Here's how you can make a low-effort/high-impact difference today:

  • Take a few seconds to review your own institution's website(s) and see what kind of language is used
    • If it's not gender-neutral, simply forward the paper or this email to the leadership team and follow up in a week to hold them accountable
    • If it is gender neutral, then use the power of positive reinforcement to your advantage! Let your leadership team know that you caught them doing good, and call them out publicly if at all possible
  • Share the paper or this email specifically with academicians you know who aren't on social media. The more quickly and ubiquitously this concept can spread, the more difficult it will be to ignore.
  • Think of other low-hanging-fruit study designs like this one that could make a gender-equitable policy (a) easy to implement and (b) almost impossible to say no to

Even if your leadership isn't a model of gender equity and cooperation, or worse yet if you've fought some pitched battles with them and things are tense, we still recommend that you publicly "catch them doing good" with this leadership title example if they are.

Why might that be?

Because human beings are strongly, subconsciously driven to be consistent with their prior behaviors and their public image.

So if you make "gender equity champion" part of their public image, it won't let them off the hook. It'll give them something to live up to and create external pressure + visibility, thus making it much more difficult for them to say no when you bring forth a bigger ask (like parental leave, equal pay for equal work, etc).

Quote we're contemplating

"It's not so much how busy you are, but why you are busy. The bee is praised. The mosquito is swatted" - (different) Mary O'Connor

We've been thinking a lot lately on slowness & intentionality, especially as they pertain to work-life integration. Expect to see something more substantive on this topic from us in the next couple months.

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PPS - As always, please let us know your requests and suggestions by replying to this email (we read 'em all) or getting at us via Twitter. Which section above is your favorite? What do you want more or less of? Just send a tweet to @BossB_MD and put #SaturdayMorningRounds in there so we can find it.

Have a wonderful weekend, y'all!