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When Medical Institutions Hire Leaders, External Female Candidates Have an Extra Disadvantage

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Executive Summary

In a study of leadership hiring at 13 major medical centers, the authors found a preference for hiring female leaders from within, while favoring external male candidates. They conclude that this gender skew is unlikely to be due to chance and say it raises important questions about gender bias in health care hiring. They note that this external hiring bias isn’t just unfair; it also puts the hiring institution at a disadvantage.

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While 70% of firms still promote from within to fill the CEO’s chair, increasing numbers of companies have looked outside for their new chief executives in recent decades, reasoning that they can leverage their experience in another domain to promote innovation, learning and high performance. The literature is mixed on how these external hires do, but it does seem that insiders have a slight edge.

We were interested in whether large academic medical centers adhere to the still-dominant preference for internal leadership hires, since the complexity of the healthcare endeavor might favor them, and, if so, whether that pattern worked for or against female candidates, who are currently underrepresented in the top ranks?

To find out, we studied the 13 leading academic medical institutions that appeared on both the US News & World Report 2017-2018 Hospital Honor Roll and 2018 Best Medical Schools report. (See list below.) We looked at the hiring history for 185 department chairs and 13 deans and found that people in both roles were slightly more likely to have been hired externally (56% and 54% respectively). However, while male deans outnumbered female deans by three to one (a ratio that’s still common across healthcare leadership) we were surprised to find that only three of the ten male deans had been internally promoted, while all three of the female deans had. These are small numbers to be sure, but they are statistically significant. As such, this gender skew in academic medicine is unlikely to be due to chance and raises important questions.

Insight Center

Why the inclination toward hiring female leaders from within? One possibility is that unconscious biases against women are stronger when a female candidate is not personally known in an institution. Though the literature in healthcare that speaks to this point is sparse, several studies in other sectors show that men are given preferential attention from external recruitment and hiring practices while women in the external labor market are more likely to be rejected for higher level jobs. Many businesses have focused on ensuring a fair process for internal hires, but recent studies show that external hiring practices are rampant with gender discrimination that promotes disparities among top leadership.

Gender bias in external hiring isn’t just unfair; it might also put the organization at a disadvantage. Studying a different industry for his book Chasing Stars, Boris Groysberg of Harvard Business School showed that among externally hired Wall Street investment bankers, women appeared to bear the pressures of a new work environment better than their male counterparts. External male new hires tend to suffer a decline in their performance after the move, while external female hires do not.

Our findings raise concerns about gender bias in the recruitment and hiring of leaders at leading medical institutions, and these organizations should seek to both understand and develop remedies to address it. This challenge has become even more pressing as the number of women entering medical school surpassed the number of men this year. Though the medical field has succeeded in erasing gender discrimination at the school admissions level, it must redouble its efforts to correct continued imbalances at the top.

Institutions evaluated: Stanford, Johns Hopkins, University of California San Francisco, University of Pennsylvania, Columbia, Yale, Duke, University of California Los Angeles, University of Michigan, Harvard University (Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, and Mass General Hospital), Cleveland Clinic, University of Washington Saint Louis, and Mayo Clinic



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Thanks !

Thanks for sharing this, you are awesome !