We specialize in change leadership: A call for hospitalists to lead the quest for workforce gender equity

Abstract

From a new concept to 44,000 practitioners in just 18 years, 1 there is no doubt that the word "hospitalist" is synonymous with innovation, leadership, growth, and change. Yet 2 articles in this month's Journal of Hospital Medicine prove that even our new field faces age-old problems. Although women comprise half of all academic hospitalist and general internal medicine faculty, Burden et al. 2 showed that female hospitalists are less likely than male hospitalists to be division or section heads of hospital medicine, speakers at national meetings, and first or last authors on both research publications and editorials. This is made more concerning given that women are more likely to choose academic hospital medicine careers, 3 as they represent one-third of all hospitalists but half of the academic hospitalist workforce. 2,3 Findings in general internal medicine were similar, except that equal numbers of women and men were national meeting speakers and first authors on research publications (but not editorials). Weaver et al. 4 shed even more light on this disparity, and found that female hospitalists made $14,581 less per year than their male counterparts, even after adjusting for relevant differences. Weaver and colleagues also found other gender-specific differences: women worked more nights and had fewer billable encounters per hospitalist shift than men.Unfortunately, these trends are not new or limited to hospital medicine. For decades, almost equal numbers of women and men have entered medical school, 5 yet women are under-represented in high status specialties, 6 less likely to be first or senior authors on original research studies compared to men, 7 less likely to be promoted, 8 and women physicians are consistently paid less than men across specialties. 9,10 Simple analyses have not yet explained these disparities. Compared with men, women have similar leadership aspirations 11,12 and are at least as effective as leaders. 13-15 Yet equity has not been attained.Implicit bias research suggests that gender stereotypes influence women at all career stages. [16][17][18] For example, an elegant study conducted by Correll et al. identified a "motherhood penalty," where indicating membership in the elementary school parent-teacher organization on one's curriculum vitae hurt women's chances of employment and pay, but actually helped men. 19 Gender stereotypes exist, even among those who do not support their content. The universal reinforcement of such stereotypes over time leads to implicit but prescriptive rules about how women and men should act. 20 In particular, "communal" behaviors, including being cooperative, kind, and understanding, are typically associated with women, and "agentic" behaviors, including being ambitious and acting as a leader, are considered appropriate for men. 21 This leads to the "think leader, think male phenomena," where we automatically associate men with leadership and higher status tasks (like first authorship or speaker invitations). 22,23 Furthermore, acting against the stereo...

Perceived Barriers to Professional Equality Among Women in Gastroenterology

“…The root causes of the income gap, are likely multifactorial. One factor has been described as the ‘motherhood penalty’, which penalizes women for having children, in turn benefiting male physicians through promotion and higher pay ( 7 ). Some physicians argue women should be paid less because having children results in fewer hours worked.…”

Fixing the leaky pipeline: gender imbalance in gastroenterology in Asia‐Pacific region

“…16 Gender inequality remains a pervasive issue in the medical field and other professions, driven by factors such as persistent pay gaps, discrimination against expectant mothers, and sexual harassment. 17 The "Maternal Wall" is a hidden penalty that leads to the swift elevation of male colleagues. 18 These issues are not unique to gastroenterology but are widespread across various fields.…”

Advancing Diversity, Equity, and Inclusion in Hospital Medicine

“…Studies continue to demonstrate persistent gaps in equity for women and underrepresented minorities (URMs) 1 throughout nearly all aspects of academic medicine, including rank, 2‐4 tenure, 5 authorship, 6,7 funding opportunities, 8,9 awards, 10 speakership, 11 leadership, 12,13 and salaries 2,14,15 . Hospital medicine, despite being a newer field, 16 has also seen these disparities 17,18 ; however, there are numerous efforts in place to actively change our specialty's course 19‐22 . Hospital medicine is a field known for being a change agent in healthcare delivery, 22 and its novel approaches are well poised to fundamentally shatter the glass ceilings imposed on traditionally underrepresented groups in medicine.…”

“…Hospital medicine, despite being a newer field, 16 has also seen these disparities 17,18 ; however, there are numerous efforts in place to actively change our specialty's course 19‐22 . Hospital medicine is a field known for being a change agent in healthcare delivery, 22 and its novel approaches are well poised to fundamentally shatter the glass ceilings imposed on traditionally underrepresented groups in medicine. The importance of diversity, equity, and inclusion (DEI) initiatives in healthcare has never been clearer, 23,24 particularly as they relate to cultural competence 25‐28 and cultural humility, 29,30 implicit and explicit bias, 27 expanding care for underserved patient populations, supporting our workforce, and broadening research agendas 28 …”