Sixty-five percent of the healthcare workforce is female, yet women account for just 30 percent of C-level executives and 13 percent of CEOs at healthcare organizations, according to 2019 data from Oliver Wyman.
Closing that gap begins with the executive search process. Becker's caught up with Donna Padilla, managing partner and healthcare practice leader at the executive search firm WittKieffer, to discuss how hospitals and health systems can improve the search process. Ms. Padilla has conducted more than 500 executive search assignments for healthcare executives.
Here she discusses best practices for creating a diverse pool of candidates, her thoughts on diversity mandates and what true progress will look like for the industry.
Editor's note: Responses have been edited lightly for length and style.
Question: What is the most effective way to improve diversity at the executive and board level?
Donna Padilla: I wish I had a silver bullet. At a basic level, it needs to be a priority for the board and the senior team, but it also needs to resonate down to the front-line staff. Diversity isn't just going to come from the five C-suite players and representation on the board. It's a collective process around pipeline and succession planning, intentionality, where the organization puts itself, how it begins to connect with initiatives around gender and ethnic diversity. Our sense, and some of the research we've seen, is that diversity begets diversity.
Q: Creating a more diverse executive team and board starts with a more diverse candidate pool. Can you talk a little bit about how hospitals and health systems can create diverse candidate pools?
DP: They can create diverse candidate pools by being very honest with themselves about what the absolute "need-to-haves" and what the "like-to-haves" are, and then try to keep the box open on the [candidate] profile as much as possible. For example, if you're doing a chief search and you say, "We need a mandatory 15 years of experience in a similar-size organization with the same job description," that's basically reverting back to who's been in those roles the last 15 years. You can't invent diverse people who were in those roles 15 years ago. Be more open and talk about progressive leadership experience that's translatable to the role at the outset of the search. It's really thinking about how broad you can be when you're casting your net, and realistic. What you don't want to do is say we're super broad and open, and then get a pool that you in no way, shape or form have any intent of hiring.
Obviously, that's just the start. Then you have to put a process in place as you go through those searches to eliminate bias. It's how you set the committee, the interview questions. It's the ability to check yourself and be conscious of the bias you have. Everybody has some bias. There's lots of considerations — panels versus non-panels, ways to mask interview questions and make sure that you've got very representative committees that can call out something and say "Hey I heard that answer very differently than you did" — but it really starts with seeding the profile to say what's the purpose of the hire here?
Q: How important is it that the search committee itself be diverse?
DP: It's pretty important for a couple of reasons. One, it's the gateway. It's the first view a candidate really has, if they're not familiar with the organization, as to how it represents itself. I think many organizations are being very thoughtful about how they seat their committees, especially on the academic side. It's important for the outcome of the search, and because it creates an expectation within the organization. It just eventually becomes a habit and people don't even think you're being intentionally diverse in the committee. They just know they've got the right people at the table.
Q: Let's go back to the implicit bias element you mentioned. Are there any specific tools or best practices that can help limit bias during the executive search process?
DP: A number of organizations now have a video and a training, and someone from their HR team or their talent team makes sure the hiring committee has checked themselves and understands what they should be aware of and what they need to keep top of mind. I know that many organizations do ongoing training as well. Obviously, it's a very heady, complicated topic.
The other ways to do it are really making sure people debrief separately, so you don't end up with a groupthink mentality. Especially in a panel or committee where people are silently voting. There are a number of books out there with more best practices, whether it's the type of interview questions, or it's tied to the profile, there's a ranking and understanding of feedback so people feel like they're being heard and have input. There's lots of different ways to do it. I think the frustration at times is that even with best intentions, the percentages of representation across the C-suite don't always seem to be changing significantly. We have pockets of diversity by function, but not necessarily across the whole.
Q: If you're an aspiring leader who is a woman and/or minority, what can you do proactively to resonate with a predominantly white, male selection committee?
DP: I've prepped a number of candidates for that situation, where I'm going to be the only other woman in the room when we're there, and I don't get to vote. Part of what I say to aspiring female executives is even when you're in a career and you've done this for years, you still need sponsors that are male and female. What you never want it to feel like is that the candidate coming in is going up against the enemy. It's also about really making sure that committee understands that their job there is to recruit, discern and bring the right talent, and everyone's trying to do it with the best intentions.
Q: We're starting to see more diversity mandates. One example is California, which mandated all publicly traded companies appoint at least one female board member by the end of 2019. Do you think diversity mandates are helping or hurting the cause? Why?
DP: We can't move a committee or a slate forward without some representation. It's the right thing to do because it challenges the organization to continue to look. Mandates work as long as there's an ability to recruit more broadly and in an inclusive manner. My dream would be we don't have to have mandates because we just pick the right talent and we have representative slates and we've got a good mix of people. But we're at a moment where without it happening on its own, there are institutional mandates because we're concerned that just the right thing to do isn't going to stick.
Q: Is there anything else you think is important to mention?
DP: The other thing that comes up sometimes is pipeline percentages. Companies often have mandates for 35 percent of a C-suite be diverse, for example. The thing I think we miss in those percentage goals is what constitutes the team; we'd like to see women gain greater representation across the board, including positions leading up to the CEO, the COO, the CIO, the CFO, and other roles in which they're really underrepresented. I think that's where true gender equity success lies. I don't want executive search as an industry to be content with percentages that don't unpack where we have representation in each of those pipeline verticals.
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