The Leadership Labyrinth: Career Advancement for Women

By McDonagh, Kathryn J.; Paris, Nancy M. | Frontiers of Health Services Management, Summer 2012 | Go to article overview

The Leadership Labyrinth: Career Advancement for Women

McDonagh, Kathryn J., Paris, Nancy M., Frontiers of Health Services Management

ALTHOUGH WOMEN HAVE LONG HAD an influential impact on healthcare, the top executive roles in healthcare have generally eluded women. This problem is beginning to receive more attention as healthcare is undergoing cataclysmic change. The transformational leadership skills of women are needed in healthcare more than ever, and understanding the reasons for this dearth of women in the boardroom and executive suite will be important for addressing this leadership gap. Hearing the stories of women who have advanced to CEO positions is also important for change, and feature authors Teri Fontenot and Alyson Pitman Giles provide enlightening insights by sharing their unique journeys to the top.

Gender stereotypes about leadership continue to have an impact in the workplace (Eagly and Carli 2007). Women are often seen as nurturers and rarely as leaders. The stereotype of a strong, commanding, and male leader still influences decisions about placement in leadership positions. This discrimination can be very subtle and hard to recognize. Ironically, according to Fontenot, traits traditionally viewed as feminine are the ones "that are vital for today's successful healthcare leader."

Valian's (1998) work on how gender schémas professionally disadvantage women illuminates why the advancement of women has been so slow. Valian contends that a set of implicit or nonconscious hypotheses about sex differences plays a central role in shaping the professional lives of men and women. The most pressing consequence of such bias is that men are consistently overrated while women are underrated. These small advantages and disadvantages accumulate and result in large disparities over time in salary, promotion, and prestige. Although many women and men express egalitarian beliefs, they are often unaware of how these unconscious gender schemas are a factor in judging leadership performance.


The direct connection between gender diversity and enhanced organizational performance (McKinsey Global 2010) leads to a compelling business case for promoting women, but there remains a pronounced lack of gender diversity within executive leadership in healthcare. The availability of women qualified for leadership roles in healthcare is a unique strength of the field, particularly when one considers the transformational leadership abilities of women leaders. However, the field's efforts at transformation may be hindered by the lack of optimal inclusion of women on executive teams.

Gender-diverse teams have greater access to the depth and breadth of skills and experiences necessary to increase organizational effectiveness, improve financial performance, and enhance collective impact. Diversity among the top ranks of leadership therefore increases an organization's capacity for transformation. The ability to forge a new leadership style that enhances the performance of executive teams will ultimately produce collective transformational change that is both progressive and sustained.

Women and Transformational Leadership

Why have women accomplished so much and achieved superior results in the face of such obstacles? Women seem to have a leadership advantage based on their natural proclivity toward a transformational leadership style. Transformational leaders gain trust and confidence and build shared vision by serving as role models. They provide inspirational motivation and intellectual stimulation and rely on individualized consideration. Transformational leadership attributes are more closely aligned with traditionally female characteristics, such as an interpersonally oriented, participatory style. There is a strong correlation between transformational leadership and organizational effectiveness, and research demonstrates that leaders who develop a transformational style also produce greater financial success (Barsh, Cranston, and Lewis 2009). As Fontenot notes, "these soft skills are getting hard results. …

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