Editor's note: This is part of a series on women in the healthcare workforce.
Among the many inequities in the U.S. healthcare system, the disparity of women in leadership roles, especially compared to how many working in the industry overall, has a major impact.
While about two-thirds of the hospital workforce is made up of women, just 34% of hospital leaders are female. And only about 13% of healthcare CEOs are women, according to a 2019 report from Oliver Wymann.
That's also despite women making the majority of household healthcare decisions.
Healthcare Dive spoke, separately but asking the same questions, to two women currently in healthcare C-suites to discuss the hardships they face and why their roles matter to their companies.
Mala Murthy is CFO of Teladoc Health, a position she's held since June 2019. Prior to that, she held leadership roles at American Express and PepsiCo.
CFO, Teladoc Health
In September, Margaret Pastuszko was named president and chief operating officer of Mount Sinai Health System in New York, where she has worked since 2000.
President and chief operating officer, Mount Sinai Health System
These conversations have been condensed and edited for clarity.
HEALTHCARE DIVE: Why is it important to have women in the C-suite?
MARGARET PASTUSZKO: Because you want to have a difference of opinions, you want to have different experience brought into decision making. You want to hear different points of view. So I think it's not necessarily unique to women. I think it just focuses on the same reason why we really want diversity. We want different backgrounds, we want different opinions. We don't want to generalize without having that in depth understanding and those experiences brought into and reflected in broader decisions that will affect those individuals. And the other thing is that I think it will help us better appreciate who our customers are. Women are participating in the decision making. You can have lots of studies about who makes what decisions, but there's no question that they're participating in that decision making. And you want to have leadership reflecting that. I think it's very important. It creates inclusion and creates diversity. It creates what I hope is actually better decision making at the end.
MALA MURTHY: The first step is, I do think women leaders set a tone of collaboration. And they set a tone of a diversity of voices being heard. I've seen this very consistently. I have seen it myself. When I have men on my team and then I have women join, it's a different tone. I think both sides bring their own strengths to the team, and you need that diversity and you need them complementing each other for the full strength of the team. I think women have, because many of them have played the role of caregivers, I think they do understand what it means to balance caregiving with being ambitious, both. I say this to our female leaders internally all the time, it is important for us women to declare our ambitions. So that is an important part of what it is to be a woman executive.
What can the healthcare industry and individual companies do to encourage women to be in leadership roles and foster the right environment?
PASTUSZKO: I can speak for some of the things that have helped me throughout my career, and it comes from every gender. It doesn't simply come from women. It is having that support structure in the organization. Yes, there's all other things: creating child care services, creating more flexibility in how the work is done, creating non-traditional work hours so that you don't have to be present between 9 and 5 — maybe it's 9 to 12 and then 2 to 7 — creating non-traditional ways of accomplishing those goals have been really successful factors for all of us who sometimes at some points in our life require that flexibility. Whether it's a woman or a man who really just has to manage other priorities in their lives. So it's having the structures where you don't have to choose among those priorities and figuring out how you can make it work and realizing that every situation changes over time.
MURTHY: First is, and I have done this myself: mentorship. So, have a structured program of mentorship and take the time to mentor other women. Mentor men, too, let me be very clear. I'm not saying we don't mentor men. But I mentor a couple of women here at Teladoc. And I have to tell you, I think I get as much out of those conversations as they do. Because I continuously learn when I'm talking to them, like my light bulbs go off so often when I'm talking to them. So, No. 1, I would say, much more of a structured program of mentorship and taking vigorous participation in it and providing that one-to-one mentorship and coaching. We have what are called business resource groups, or BRGs, and they are a critical component of our diversity, equity and inclusion ecosystem. And as part of that, we have a BRG called allied women's empowerment, or the AWE group, which I love. Having some type of a visible resource group like that is so necessary.
What are some unique challenges that women in leadership roles face?
PASTUSZKO: The unique challenge is sometimes going into an environment, especially in a C-suite, where it's not necessarily that comfortable. Because you're walking into a pre-structured setting that used to exist for many years. I think that's a challenge and not letting that bother you because, frankly, the best way to change is just joining the club and entering the room. Don't let that bother you that the room looks a little bit different than you. And I think that's in every area of diversity, that people who are walking into a role which is occupied by people slightly different than you and just doing the work. You focus on the work as opposed to the circumstance. The other challenge, I think, is truly believing that what you are doing is making a difference. So that you're setting an example, whether it's to your children or to others. That it's valuable work. And that you're in effect, in a way, raising a stronger younger generation because they're seeing variety and they're seeing that there is value and there is added value to what you're bringing to the table.
MURTHY: One of the challenges that I've seen come up over and over again is I think women themselves have a tendency to not articulate their ambition. It's something that is very near and dear to me. I didn't do that either. I knew I was more talented than many of my colleagues, but I had this almost, if you will, blind faith in the quote unquote system, that it's a meritocracy and they would recognize my innate ability that in my view set me apart. I felt I was good, or better, from a competence perspective. I had invested in the relationships to be effective. And I knew I influenced my business partners to grow the business, etc. But you know what I never did was, I don't think it even occurred to me to say: 'I want. I am capable of.' And what I do think men consistently do much younger in their careers is to start declaring their ambition. I think women do end up having to compartmentalize their life a lot. I've done so myself. And there is a level of stamina and energy and drive needed to be able to juggle all those many, many compartments. And it is a challenge. I'm not saying that men don't do that, I think they do. But I've seen it being done far more often, with many more compartments, amongst women. So, I have had to play the role of spouse, of Mom. I have aging parents at home in India, 10,000 miles away, who I am keeping tabs on every day. If there's a crisis, I go. I traveled 10,000 miles to see my dad in India because I really believe I need to be there for him in the moments of crisis.
How has the COVID-19 pandemic affected your work in the C-suite?
PASTUSZKO: I think the pandemic had both positive and, obviously, very, very stressful effects on the healthcare industry, etc. It definitely brought a different level of stress on our front-line workers, because there's no substitute for the front-line workers and their hands-on care of our patients. I think there was such amount of stress that nobody can comprehend. And, yes, in general our nursing front-line workforce is women, so they were disproportionately affected by it. On the the other hand, I think, in the longer view the pandemic had a lot of positives that women can take out of it because it eliminated some of the silos that existed. It also eliminated a lot of commuting times, which were not necessary, which puts a lot of stress on being able to be at work and be at home. It also made the rarity into a routine so you could achieve your tasks in a different way.
What advice do you give to young women now entering the healthcare workforce?
PASTUSZKO: What I say to them is remember, one, why you went into this field. Because that's still why we're there. Remember that. Focus on the fact that you're making a difference more than on the challenges that you're facing every day. Because I think that is allowing us for a solution orientation as opposed to identifying the problem along the way and letting them stop us from achieving our results. The advice I give to all the women that I work with that are younger and entering this workforce, or have been in this workforce for a few years: Don't give up. You're making a difference. And at the end of the day, that's what counts. That's what kept me in this industry for all these years because even during the hardest time, I felt like I've made a difference and I think there is few more powerful things to keep you in the race, then actually realizing that what you do matters.
MURTHY: What I'm saying to other young women is, No. 1, most importantly, be self aware. And it comes with time. It comes with seasoning. It comes with making mistakes and bearing the scars of that, and learning from it. I have had many failures in my career and in life. And you know what I've tried to do is learn from it, be reflective, be self aware. No. 2 is: There is no substitute for competence. None. You've got to know your work really, really, really well. You've got to take the time to learn it from the ground up. There are no shortcuts to that. And people have to respect you for the mastery of what you are about, what you do. No. 3 is invest in relationships around you. Not because it's about furthering your career or your agenda, it's because I think that when you build effective relationships, you get as much as you give. It allows you to contribute positively to the fabric of the culture around you. And again, there are no shortcuts to that.
Is there anything else on this topic you'd like to add?
MURTHY: As I think about the next generation of leaders, of women leaders, they will be having to influence and be effective in a world where problems may be different from what I have faced. I see how passionate people are in these generations around climate change, around social justice. So it's going to be a very different environment for leading. In the old framework of leadership, there was a lot of hierarchical, command and control, top-down leadership. In the new world, it is going to be about inspiring. You've got to inspire your team, and you've got to inspire your team through these new sets of challenges that are all around us. I really believe that it is important for us to voice ambition. And I think the ambition that we voice doesn't have to necessarily be about vertical ascent, like getting to the next level. It can also be about, how do you create, for example, lateral change around you. Ambition can be very different 20 years from now than what it was 20 years ago. The definition of ambition and what they will declare as ambition will be very different going forward than what I did as a first generation immigrant into this country just trying to get a foothold and be secure. And I think that's marvelous.