It is almost certain that your healthcare organization has a non-discrimination in hiring policy and diversity programs in place. The question is, are those programs working? It may be time to re-visit your organization’s approach to diversity in healthcare leadership. There are many misconceptions about the things that work and the things that do not. While the current processes you have put in place may have the best intentions, they may not be helping you to achieve your goals.  Over the years, as Summit Talent Group has assisted healthcare organizations with their executive search needs, we have seen trends that show there is still an imbalance in the industry. Some popular practices end up having negative effects in creating diversity in healthcare. Today we will take a look at the current landscape, dive into the things that are working, those that are not, and give you some direction to help you get started on your journey to building a team that improves the experience of patients and the quality of care.

Diversity in Healthcare Leadership

The healthcare industry has a long way to go when it comes to diversity in healthcare leadership. This is especially so when it comes to their governing boards. According to a study by the Institute for Diversity in Healthcare Management, as of 2015, only 14% of board members were minorities. This is the same number reported in 2013. When looking at executive leadership positions, there was a 1 percentage point decrease from 2013 at 11%. The one area that saw improvement was first and mid-level management positions with an increase of 4 percentage points to 19% since 2011. These numbers are alarming when juxtaposed patient demographics. Healthcare leadership simply does not mirror the population that is seeking treatment.

Gender imbalance is also an issue that needs to be tackled by the healthcare industry. More than half of the US population is female, but according to the American Hospital Association, as of 2014, there were only 1,508 female CEOs. When compared with a survey by the Association of American Medical Colleges (AAMC) which found that 49% of all matriculants in healthcare educational programs in the country were women, one can see that there is quite a disconnect here.

Why is this the case when diversity and inclusion are on everyone’s lips? Because the focus is on the wrong place. Those who are looking to make a positive change in diversity need to stop worrying about checking off numbers. The focus should be on creating a more balanced and inclusive environment for both team members and patients.

What is Not Working for Diversity in Healthcare Leadership

If you ask pretty much any healthcare organization if they are committed to diversity and inclusion, you will get a resounding ‘yes’. Most organizations will tell you that they have implemented diversity training programs to train their leaders, hiring tests to reduce bias, and even grievance systems to give employees a voice. But we are still faced with large imbalances in the workplace. The issue is that these practices, while well meaning, do not work. The above-mentioned tools work to lower risk of lawsuits, but they end up increasing bias and resentment in the workplace. Why? Let us take a look at the data.

Mandatory Diversity Training Does Not Work

Research by Alexandra Kalev and Frank Dobbin that looked at over 800 U.S. based companies suggests that diversity training actually has the result of lowering diversity within certain demographic groups such as African American women and Asian American men and women, and made no change among white women and other minorities. Why does this type of program not work? Humans do not like to be forced into doing things. We resist control. When we are forced to do something, we go into the experience with a negative bias. For example, a study that looked at predicting participation in voluntary diversity training found that white subjects who saw themselves as forced to sign a document about bias became more prejudicial than those who felt they had a choice.

Hiring Tests Are Not Evenly Implemented

The same study showed that managers use hiring tests selectively. It found that some white managers made strangers (who were mostly minorities) take the tests, and ended up hiring friends and acquaintances who were not subjected to the tests.

Lauren Rivera’s book ‘Pedigree: How Elite Students Get Elite Jobs’, sheds more light on this issue. In cases where managers did adhere to proper practices of testing everyone, results were ignored. When white men performed poorly on tests, this was ignored. When women and African Americans performed poorly, this was paid attention to. This may not have been done on purpose; a tester’s bias affects how the test results are seen.  

Performance Reviews Tend to be Biased

Performance reviews are often put into place to help managers make the right decisions when it comes to pay increases and promotions. However, these performance reviews have been shown to be less favorable towards women and minorities. In fact, the CEB has found that 9 in 10 HR leaders see these reviews as inaccurate and the Harvard Business Review found that 61% of a rating is based on bias, not performance. What effect does this have? The U.S. Department of Labor has found that most people will leave a job if they feel unappreciated. If employees feel underappreciated after a biased performance review, they will begin the search for a new position causing turnover and possibly affecting the diversity within the organization.

Grievance Procedures

Grievance procedures are meant to make it easier for employees to stand up when they feel there is unfairness in the workplace. This type of program is meant to give them an outlet to report issues in pay, advancement, and even in termination. While the law mandates that managers are not to retaliate against an employee who brings up a complaint about discrimination, this is not always the case. According to the Equal Employment Opportunity Commission, a large number of managers end up retaliating against these employees. In 2015, a total of 45% did. When confronted with this type of environment, employees learn quickly that speaking up does not pay and that it may have negative repercussions for their career within the organization. This results in less reporting of injustices and skews the actual landscape of inclusivity.

What Works for Diversity in Healthcare Leadership

The key takeaways from the above are to make diversity incentives optional, not punitive, and more natural within the scope of the organizations. The idea is to get managers engaged in solving the issue, getting them to have contact with more people, and getting them to become advocates of social accountability.

Make Things Inclusive

The key is to not make people feel as if they are forced to participate. Instead of mandating that managers attend programs for diversity and inclusion, invite them to attend. An invitation has a positive connotation and makes it easier for managers to become advocates for the cause.

Create Mentoring Programs

Mentoring has been shown to be incredibly effective. Mentoring engages the mentor/manager, builds them into diversity advocates, and creates a culture of change. According to Cornell University, mentoring programs have consistently been proven to be more successful than other diversity initiatives when it comes to promotion and retention. However, this depends on a few factors including the seniority of the mentor, matching personality traits, and the involvement of the mentee’s supervisor.

Contact & Engage

It is not enough for organizations to put diverse people together in the same place. In order for contact to create strength in diversity, the contact must be engaging and match people towards achieving a common goal. Creating this type of team can see increases of up to 6% over a five-year period.

A good way to increase this type of contact is to rotate management trainees in roles and departments. This allows them to be in touch with more people within the organization, and get to understand the inner workings of different departments as well as a better understanding of the workings of the entire organization.

Partner up with the Right Executive Search Firm

Not all search firms have the same commitment to diversity in Healthcare Leadership. Developing a relationship with the right search firm will yield successful results. The right firm can open up your healthcare organization to a pool of candidates that was unavailable to you in the past.

The takeaway? Do not make it mandatory for managers to go through diversity training or try to set checkboxes for their hiring and promotion choices. Instead, build an environment in which your managers will want to become fierce advocates for diversity and inclusion voluntarily and you will see a more robust workforce flourish on its own.

If diversity in healthcare leadership is something your healthcare organization feels strongly about, the team at Summit Talent Group is the right executive search firm for you. We are committed to helping you build diverse teams made up of the best candidates to fit your organization’s culture.   If you would like to speak to us about how we work, contact us.

Kyle Wortman

Business Manager, Summit Talent Group