Health care is an industry where women consumers make 80 percent of buying and usage decisions and represent 65 percent of the workforce—a relatively high share compared to other industries such as financial services (46 percent) or technology (26 percent).

Yet despite their influence as customers and the core workforce, they are notably underrepresented in the industry’s leadership, making up approximately 30 percent of C-suite teams and 13 percent of CEOs. Health care, unlike other industries, does not have a “women in health care” problem. It has a “women in health care leadership” problem.

Source: Oliver Wyman analysis

What Is Holding Back Progress?

The gender gap in industry leadership is well-documented, as are some commonly cited contributors to this gap, such as the pay gap, the good ol’ boys club, unconscious biases, microaggressions and childbearing. Many of these impediments came up in conversations with women in leadership positions. Most cited experiencing some form of micro-aggression, whether a man’s misattribution of an idea, assumptions about work-versus-family priorities or erroneous assumptions about career ambitions.

However, focusing solely on these well-known components may be too simplistic. Intangible factors that are challenging to address, such as affinity (which we defined in a recent report on health care leadership as the “innate instincts that shape our ability to trust someone”), influence decisions on hiring and promoting. Since women may have a harder time expanding their networks and building more affinity—and because few executives truly appreciate the impact that affinity has on trust and decisions—they may also over-rely on ability and delivering results to get ahead.

Leaders need to reframe self-promotion from being perceived as boastful to something that is helpful in enabling female leaders to understand the results they drive.

Factors Driving Promotion to Industry Leadership

While trust is key to getting promoted, most executives don’t consciously recognize how it is established and how it ultimately impacts promotion decisions. When asked how trust factors into decision making for promotion, people for the most part readily identify two dimensions.

The functional or rational factors (ability and integrity) are what all people, men and women alike, believe are used in assessing for promotion. However, few executives explicitly recognize or understand how affinity impacts trust-based decision-making. The report concluded it is much more difficult for women to achieve the same level of implicit trust in male-dominated workplaces. If an individual is not purposeful in understanding and addressing barriers to building trust, he or she will not make meaningful progress.

Source: Oliver Wyman analysis

Current Prevailing Trends in Comparison to the Past

Today, most men recognize the gap at the top leadership level and believed it should be addressed. Over a decade ago, less than 50 percent of the C-suite likely believed in egalitarianism at work and home. Currently, the figure is approaching 70 percent.

Leaders are aware of the challenge and intellectually recognize the need to change. Well-intended executive teams have hired inclusion and diversity leads and are setting goals to attract and promote women and diverse populations.

However, the lack of results is real. Most leaders honestly struggle to understand why they are not making more progress.

Report Findings

An uneven playing field. There is a natural human tendency to form more effortless connections with “people like me,” and men still hold most senior positions. Separately, ingrained perceptions of male-female relationships serve as impediments to developing deeper, empathetic work relationships.

An overreliance on results. Women tend to view themselves as problem-solvers at work and expect their results to speak for themselves, which can widen the “affinity gap” compared to men.

Misperceptions of ability. Natural, unspoken differences in beliefs—like what makes a good leader—can often lead men and women to misinterpret each other’s behaviors and ultimately bias perceptions of ability. These misperceptions are exaggerated for women at the top, as evaluation of traits such as leadership or strategic thinking are more ambiguous and those evaluating candidates are more likely to be men.

The (lack of) confidence gap. While the confidence gap and imposter syndrome are frequently cited impediments for women, most senior women respondents spoken to did not lack confidence. Rather, they often spoke about having a different definition of what “prepared” means for a given role.

The Way Forward

Given the composition of most leadership teams in health care today, the burden of adapting is falling on women more than men. This added effort just to be heard is often invisible to those who think, listen and speak like the majority. Organizations must be committed to addressing such challenges. Not only does it affect how individuals are perceived (and potentially promoted); it also means that organizations are losing the value of bringing diverse teams together.

What if men and women were to be open and honest about streamlining these differences? Would male leaders be more likely to expand the range of their communications, employing more “why” and enhancing their perceived empathy with others, as well as finding a way for women to be heard more in male-dominated conversations? There must be a balance when it comes to sponsorship and mentoring, and misperceptions must be dispelled.