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Bill Klaproth (Host): This is a special podcast produced for the 26th Annual Healthcare Marketing and Physician Strategies Summit, HMPS, October 6th through the 8th in Aventura, Florida, as we speak with session presenters and keynote speakers. I'm Bill Klaproth.

With me is Dr. Kevin Fickenscher, President Krios Strategic Solutions and Board Member of the Carol Emmett Foundation and Anne McCune, CEO of the Carol Emmett Foundation, their session, Women in Healthcare How Finding a Mentor or Even Better a Sponsor Can Accelerate Your Career.

Kevin and Anne welcome. And thank you so much for your time. We appreciate it. So, women are significantly underrepresented in senior executive and board positions in healthcare. We certainly know this and we know that we need more women leaders in healthcare, but why is this a pressing issue now?

Kevin Fickenscher, MD (Guest): It's very important now because we're at a very important transition point in healthcare, from my perspective, in that, at the present time, healthcare represents about 19% of the gross domestic product of the United States. There is real need to transition from the traditional fee for service model to more of a value-based model. And the value based model requires that we move towards operating more effectively as teams. And it has been shown very clearly from the literature, from surveys that have been done, et cetera, that women in particular are better and more inclusive in their leadership style, around team building and leadership, and problem solving and decision-making that really involves the team, if you will. To say nothing about the fact that, we've got 70 some percent of all of the healthcare providers across the board are women. And only 13% of the hospital CEOs are women and maybe 25 to 30% of the C-suite are women. So, we've got a real disproportionate number of women who moved into leadership roles.

So, I think it's an issue that really demands that we pay attention to it and try to figure out how we can be more effective at bringing women into major leadership roles within the healthcare industry.

Host: Yeah, that just seems to make sense. The disparity between the C-suite right and the other women that are in healthcare. And like you said, women certainly are better and more inclusive when it comes to team building. So, Anne, let me ask you then. So, then what are the trends when it comes to the talent pipeline for women and how does that relate to healthcare?

Anne McCune (Guest): Thank you again, Bill for the opportunity. I wanted to sort of preface my comments on the trends, to talk a little bit about the Carol Emmett Foundation. We're a national nonprofit dedicated to achieving fully inclusive gender equity in healthcare leadership and governance. And we do it through two major initiatives. One is a fellowship which is an individual type program where organizations and we have scholarships, sponsor individuals to engage. And then we've got a learning community called the Equity Collaborative and the Equity Collaborative, it's a self-driven learning community. It's got 15 membership organizations. Really the goal of that is to address some of the structural and cultural differences and issues within the organizations that are prohibiting both women and persons of color in their advancement career wise. So, we've partnered with McKinsey who has been analyzing since 2015, women in the workplace in the US across all sort of industry sectors.

And since 2015, McKinsey has seen very marginal progress in the representation of women in the corporate pipeline. And that means looking at where they begin in entry level positions up through the C-suite. And so across all industries, we saw about 17% of all women in the C-suite nationally. At 2020, it rose to 21% so progress, but really when organizations want to have 50% of women in the C-suite, you're seeing this incremental process progress being quite slow. On the healthcare side, it's a little bit different. And it's interesting, because women account for 66% of all entry healthcare employees that come into an organization where industry-wise, they're around 47%.

And as they move to the C-suite, the share of women declines in more senior roles, moving to, about 30% are in the C-suite now, where as we talked about overall in the industry, it's around 21%, it's still, disproportionate to what I think the expectations are for organizations to be more highly functional, but at least it's some process.

Host: Yeah, that is good. And when we talk about the pipeline, I would imagine the challenges to women of color are even greater. Is that true Anne? Can you talk about that?

Anne: Yeah, it's especially when you want to be looking at physicians. When a patient goes out to seek medical advice and medical care, they certainly want to have someone who sort of looks and represents them. And the number of men and women of color who are in health, who are at medicine are there, but it's not proportionate to the diversity in our overall population.

And we've just seen a high level of under representation of women and women of color in senior management positions and the issues are not something that can say do we solve this by attrition of people moving out of those positions and replacing them with women or persons of color, that's not going to happen. There are going to have to be specific planning and specific efforts that will help fill that gender and racial gap.

Host: That makes sense. And then I'm thinking Kevin, the pandemic, there had to be repercussions as well, to everything that we're talking about today, women in leadership roles, women in healthcare, the challenges that women of color face. How did the pandemic affect all of this of the workforce today?

Dr. Fickenscher: Well, the pandemic has clearly had a massive impact on the way we do our work. I mean, initially, the move towards telecommuting offered increased productivity. And we saw that across all industries. But we quickly learned that the home office is not exactly the quiet place, where you can get a lot of work done. And in fact, one of the issues that my wife and I face, we're both professionals is that we have a small house that we live in. We have difficulty when we're both on conference calls with the noise from each call seeping over into the others. So, there are some issues that have evolved around how to do our work, and I would also say that the other problem that we've really realized is that what I would characterize as the work-home life-balance, has really gotten out of kilter because there are no limits on when you can contact somebody at quote "work", which is often at home. I find that my days often start at seven o'clock in the morning and end at 10 o'clock at night, and that's not uncommon in a professional life.

Those issues have been compounded for both men and women. Men, from surveys that have been done, for example, by Forbes, perceive that the female partner has contributed about 45% of the care in the home. Women on the other hand, perceive that men have contributed about 29%. So, there's a disparity that exists. But that disparity is less than it was in previous surveys. So, the point is that we're really seen a significant change, I think in how men and women who are both engaged in professional careers and in pursuing work, are engaging with one another with fathers being more involved in childcare.

In some respects I look back on my life. I was hardly at home. I was traveling all the time for 25 - 30 years where I would come home on Friday evening and I'd leave on Monday morning and I wasn't around. I didn't participate in developing my children the way I retrospectively look back and say, gosh, I wish I shoulda, coulda, woulda.

So, there's all of those issues come into play, but the pandemic has leveled the playing field, when it comes to work-life balance, it's put it on the table. And I think that senior leaders within organizations really need to take the mask off of work-life overlap and try to determine how they can support their employees in this balance issue. And take advantage of lead programs, for example, and other services that can support people that are working in environments where they have both work at home and at work.

Host: Right. The pandemic certainly a disrupted just about every aspect of life. That's for sure.

Anne: I was just going to add, because I think there are two major sort of terms that are out there. And I think Kevin alluded to them. One is the she session, and this is the departure of over 2.5 million women from the workforce during the pandemic, which caused a great brain drain across a lot of industries, but including healthcare. And part of the reasons for this were really whether women were sandwiched between caring for elderly parents or educating their children, or other circumstances they've made the decision to stay home, at least for now to stabilize and to focus on their family. That has had a big impact on women's career development, especially with this break. I mean, to the comment to say, if somebody takes a year break a way and starts to recruit, is this going to set them back on a career trajectory? I do mention that because women sort of unequally, have left the workforce, whether it's tentatively or permanently, it's a factor to consider.

Host: Right, the great brain drain as you called it. So, Anne as we talk about, you mentioned career development and we've been talking about getting more women into the pipeline, into healthcare and up the leadership ladder if you will, into leadership positions. Can you tell us about sponsorship? What is that, and is that a way to help promote women?

Anne: You're going to find that I'm pretty passionate about sponsorship because it is the practice of seeking out talented junior people and advocating for opportunities to demonstrate their leadership. What this really means is having you as a leader to sponsor a protege you're going at risk to take on this person and to advocate for them. Sponsorship has been advanced. It's been demonstrated that it's advanced leadership through history, but it's been largely limited to white men in higher socioeconomic levels. And so today, as we really consider sponsorship, we need to be going to step back and say, why has it been? Because people generally move to sponsor somebody who looks like them, who comes from the same background like them and who feels safe. That's the phrase of birds of a feather flock together. We get close to those who we are near. We've seen that.

So, if we're going to really take the role of sponsorship, and be committed to a more just and equitable society, we've got to really advocate for sponsorship of more marginalized, whether it's gender or races, it's going to be an important activity. So, how do we bring to the attention of leadership in an organization, those talented people and give them opportunities to contribute? That's the real question.

Our Equity Collaborative at the Carol Emmett Foundation is really conscious that unless specific focused and energetic practices and policies and culture changes around sponsorship take place and are made a priority, we will not see organizational leadership benefiting from diverse perspectives and sponsorship, really working across all races and genders.

Host: Yeah, it does play an important role. So, thank you for saying that and how a sponsorship needs to take hold among women, as well as you say, basically, it's been for white men in the past. So, a time for that to start changing that's for sure. So we hear about sponsorship and then we also hear about mentorship. So Kevin, what is then mentorship?

Dr. Fickenscher: Mentorship really is from my perspective, is really a very proactive engagement with an individual in helping them to not only actively traverse their career, but also to consider what their career is all about and to have a sense of direction, a sense of focus. Mentors really offer advice and support, on an irregular basis, like when it's needed in the moment. Mentors can provide support. I think it's also inclusive of both, not just formal discussions, but also informal conversations. I met with one of my mentees here last week, who is a major leader in government who is moving into the private sector.

And we had a very long conversation around what does it mean to go from a government role into a private role? And how does that transition occur and what are the things that I've learned about my experience in the private sector that need to be applied or considered by this individual who's very prominent, very skilled, very capable, but has been in a different environment.

So it's really helping them to look at their skills, to look at their qualities, their confidence level, and helping them to craft a career vision. I have a number of individuals that I've had the opportunity to mentor over the years. And one of the most exciting parts from my perspective, is helping them to craft their vision. I know that it's something that my mentor did for me. As a matter of fact, my mentor is 87 years old. He and I still talk on about an every other week basis and he's still giving me advice, and I find that to be a wonderful experience. I think the other thing that mentors do is that they also increase visibility, share about the unwritten rules of getting along and moving forward in an organization.

Host: Right. So then Kevin, what is the relationship between mentoring and sponsoring?

Dr. Fickenscher: From my perspective, the sponsor is somebody who really is active in promoting an individual, but it's more of a step away, if you will, from the person they're active versus a mentor is very proactive, where you're almost engaged in sort of a day-to-day basis or week-to-week basis in helping them to think about their career, about where they're going, about what they're doing, and really in some cases, as a mentor, being across, helping them to think about the cross-fertilization between their personal life and their professional life and mentors really are a part of the family, if you will, versus a sponsor is somebody that is helping you to get known, to be present, to be shown within your professional roles. I don't know. Anne, what are your thoughts on that?

Anne: I view, sponsorship as more skin in the game. As I mentioned before, I think it's the senior executive sort of taking a risk in a way to publicly within an organization, actively promote their protege and that may be inviting them into the boardroom, sharing important information that can help them advance, and giving them opportunities, whether it's taking on projects or interim roles to prove themselves and to have that support. There's been some research around, mentoring and sponsoring and mentoring is very important, I think, to Kevin's point that it's having that relationship with someone that can help advise you in the steps of growth along the way.

But we found that women more than men, have mentors. In some of the cases, even by having a mentor, they're not getting promoted. So this is where I think the role of the sponsor comes in is really recognizing that individual and promoting that individual, to gain as much professional growth as possible.

Host: Like you say, you have more skin in the game, it's a more active role of trying to help that person up the ladder into bigger and better positions. You're really in it together with that person trying to pull that person up. That's kind of the way I look at it. So, then let me ask you this then Kevin, what is the process of discovery?

Dr. Fickenscher: I think the process of discovery involves a number of different functions, if you will First of all, a sponsor needs to discover you. And so, through that, how do you get a sponsor to discover you? Well, one of the things you have to do is you have to take on stretch assignments. You have to be able to raise your hand and say, hey, I'm here. And I'm willing to take on this particular role or engaging me in this set of tasks, I'm willing to help consider how we're going to reorganize. I'm gonna lead a task force and write a special report. And I want to really offer myself up as an individualas part of the team. As you engage in those activities, to be able to very clearly differentiate your skills compared to the skills of others or your peers that are involved in working with you.

And I would say asking for feedback, that that's an important part. I think unfortunately, women haven't traditionally gotten a lot of good feedback. Especially from males. They might from women. Anne would be in a better position to comment on that one. But at least from my perspective, I don't think my male counterparts have been very good if you will, at providing effective feedback for the women colleagues that are up and comers, if you will.

Host: Yeah. I'd love to get your thoughts on that Anne.

Anne: I just think feedback in general is a problem. I think generally professionals are uncomfortable in providing constructive feedback to others, they're always able to provide praise, but I think it's a situation in general that I think we as an industry, has to really think about how to provide that, have that crucial conversation and to provide that feedback. I think to Kevin's point, men are also uncomfortable and the Me Too movement in the last couple of years, hasn't helped it either, because I think there is more of a fear, I think whether it's a man or a woman in providing that feedback, the context of that feedback may be interpreted in the wrong way leading to other or greater issues. And so I think it's just avoided at this point. And unfortunately, it's, a successful, team and a successful organization are those that feel that they've got the psychological safety and the space to be able to provide the kind of feedback that can permit great progress moving forward.

Host: Right. So great progress moving forward. Do you think of leaders? So let's talk about leadership and purpose. Kevin, let me start with you.

Dr. Fickenscher: I think that this is a core problem for a lot of individuals, regardless of whether they're men or women. Understanding their role, their capabilities, and what they're all about in terms of leadership and purpose. There's a real difference between having a career path and working within an organization that takes you down a series of different roles over time and having a career purpose.

And I think too many leaders really have not spent sufficient time talking to themselves, having a personal conversation around what is my purpose, what do I at the end of the day, want to do with my life. And if you're clear about that, you can be a very effective leader. You will contribute in ways that are not purposeful necessarily they're just part of your ambience. They're part of who you are. So, for example, and I use myself as an example, just to provide a metaphor. My purpose is very simple. It is to make healthcare better. I defined that purpose about 40 years ago. And so everything I look at, all the organizations that I've worked in, all of the positions that I've held, have always come back to answering the question. Does it help me to make healthcare better? That's purpose versus path, which is, I've worked in large healthcare systems. I worked in startups, I've done this, I've done that. I've done Tele-health, I've done, you know, all sorts of different things, different activities, but my purpose has always been, does it help to make healthcare better? And I think that too many leaders have not really engaged in a healthy conversation with themselves around what their purpose is all about.

Anne: I think managers manage, but leaders lead and I think a lot of time, people think it's all about the duties that they have to perform versus the people they have to inapire. We have to sort of step back and really focus on what we can do to advance leaders.

Many people take on highly, high-level jobs that include a great amount of risk and a great amount of conflict. And in order to take those jobs, you've got to accept the responsibility that you're going to be paid, in order to really lead through and, not just manage and check the boxes, but really lead and lead purposefully. And so I think it's really taking the time to really focus on what does a leader need to support their confidence, their curiosity, you know, and their relationships.

Host: Yeah, really good thoughts. Thank you for those. And then Anne, part of this too, is networking too. Tell us about the power of networks. Give us your thoughts on that.

Anne: Sure. When you think about what you need in order to navigate this industry, you cannot be on an island. You have got to be within a community. And research over the years has talked about the six degrees of separation where they've gone through various examples of how many contacts does it take for passing a piece of paper to one person and what they've found in various studies, it's that the six degrees of separation. I believe in healthcare, it's about like 1.5. And so in a world, if you are an extraordinary leader and a strong leader, you're not standing alone, you know, it's not about the me, it's about the we. It's also not about who you know, it's who knows you.

Being known and having a community of, or a network of peers is something that's very important. Professional associations provide that. Just as this, the group that we're speaking with in Miami, is that it's a network of individuals that need one another to be able to advance their own agendas, and to have that support, to learn from each other and to I think advance and support one another in their advancement.

Host: Yeah, I think that's really good. It's not who you know, it's who knows you a lot of the times. So that's so true.

Dr. Fickenscher: I think there's one other element that I'd like to add if I could, and that is, I think a network is also important in two elements. One is that having a network that is diverse. That is not sort of unidimensional if you will. For example, the network I belong to includes individuals that are in the insurance industry. They're in venture firms, they're in healthcare delivery, they're on the physician side, they're on the healthcare system side, just a whole variety of individuals. And I think that's a variety is important. Second issue that I think is important, as you think about your network is who are the individuals that I can be vulnerable with, that I can share my anxieties, my concerns, and test them out, so that I can become more effective in the organizations that I'm responsible for. So vulnerability and, susceptibility.

Host: Yeah, another really good point. Well, thank you both for your time. As we wrap up, I just want to quickly get some final thoughts from you. Anne, anything else to add about women and healthcare?

Anne: Just really one other final comment about the power of the network is we all have a responsibility to reach out to others to include them. And it's really taking the steps of not just taking those who, you know, and you're comfortable with, who look like you and who act like you, but really looking for the quieter leaders and maybe those that are, whether they're introverted or they aren't sort of traveling in the same circles as you, you know, take the time to really invite them into your network, and be inclusive. Having the basis of the network, will open the doors for perhaps greater mentorship and sponsorship, which we believe really helps to support the trajectory and the success of leaders and women in healthcare.

Host: Yeah, really good thoughts. And again, as we wrap up Kevin, any final thoughts from you? Anything you'd like to add about women in healthcare?

Dr. Fickenscher: Yeah. I'd like to circle back to the very beginning, which is, I think given the challenges that are facing healthcare and the fact that women have different styles, different abilities that they bring to the table, that it's going to be important for us to really foster and support the development of women leaders. And to really bring them into the fold in a very full and robust way, because we need their modeling, we need their approach. We need their sensitivities that are often missing in a male only environment.

Host: Absolutely. A hundred percent true on that. Well, Kevin and Anne, thank you so much for your time today. This has really been informative and we look forward to learning more. As I know, you'll go into all of these topics and thoughts more in depth during the session. So, thank you so much for your time today. We really appreciate it.

Dr. Fickenscher: Thank you.

Anne: Thank you, Bill.

Host: And once again, that's Dr. Kevin Fickenscher and Anne McCune. And for more information, and to register for the 26th Annual Health Care Marketing and Physician Strategy Summit, please visit healthcarestrategy.com/summit, that's healthcarestrategy.com/summit. Thanks for listening.