Running a hospital is a woman’s job
In the 1993 film “Malice,” Alec Baldwin, playing a self-obsessed surgeon, rips into the deposing lawyer who represents an injured patient in a legal case. “You ask me if I have a God complex?” he says. “Let me tell you something. I am God.”
Baldwin nails the scene, but what really makes the moment work is its believability. The actor taps into the stereotype of a misogynistic, egotistical, BMW-driving surgeon on top of the medical world. That we can so easily accept this portrayal does not paint the profession in flattering colors.
More than two decades later, there are still plenty of brilliant male doctors with well-fed egos, but the stereotype doesn’t resonate as much, in part because of the influx of women into high-level hospital jobs. Women were once discouraged from trying to enter medical school — let alone striving to become a surgeon or administrator. Thankfully, that has changed, though their ranks still are slim at the top tiers of the medical profession.
Our city stands apart from others across the country in that an unprecedented number of women now lead Boston’s major hospitals. Brigham and Women’s, Children’s, New England Baptist, Boston Medical Center, Mt. Auburn Hospital all are led by women. They were preceded by pioneering women at Faulkner, New England Medical Center, Sturdy Memorial in Attleboro, and the recently closed Quincy Medical Center.
They are also assuming other leadership roles that were long denied to women — for example, Dr. Katrina Armstrong was recently named physician-in-chief at Massachusetts General Hospital.
Boston should celebrate this distinction, while acknowledging that more needs to be done. Studies like a recent one by Credit Suisse have shown that companies with more female executives enjoy greater success than those dominated by men.
But of course this wasn’t always a commonly accepted notion. Dr. Betsy Nabel remembers that when she was in medical school at Cornell, and wanted to become a heart doctor, she was discouraged by Dr. G. Tom Shires, who was chief of surgery at Parkland Memorial Hospital in Dallas the day President John F. Kennedy was assassinated and went on to serve as chair of surgery at the school.
“He made it very clear that there is no role for women in surgery,” Nabel said.
Undaunted, she went on to become an accomplished cardiologist and today is president of Brigham and Women’s.
Nabel credits two men for providing inspiration — her father, who talked science at the dinner table, and her mentor, Dr. Eugene Braunwald, the well known cardiologist, with whom she worked at the Brigham.
It’s important to emphasize that despite the remarkable against-the-odds achievements of women like Nabel, gender equality in hospital management is still many years away. Up until 2013, for instance, not one woman had headed a department at the 102-year-old Brigham and Women’s. Under Nabel, two of the 15 department chairs at Brigham and Women’s are filled by women. It’s incremental progress, not revolutionary change.
Nationwide, only about 15 percent of all medical chiefs are women, and they are woefully underrepresented on hospital boards. Even in Boston, the percentage of women serving on boards is far too low — ranging from only 20 percent at Children’s Hospital to a more respectable 37 percent at Boston Medical Center.
Boston Medical Center president and CEO Kate Walsh says that when a woman holds a high position at a hospital it’s still the “exception and not the rule.”
Still, each hire of a woman in a leadership role makes another dent in the establishment’s facade. Armstrong, who says she never expected to get the top job at MGH in 2013, understands that her standing can benefit other women.
“I think women leadership does have an effect on the pipeline on women being hired, promoted, and retained,” she said.
Further back in that pipeline— at the medical school level — women have finally caught up to men, constituting nearly half of all students. In the early 1990s, they represented less than 40 percent. It’s an encouraging trend.
Ellen Zane, the former head of Tufts Medical Center, says women have always had to “work harder and be better” to ascend in the hospital industry. The fact that a good number have made it to the top in Boston bodes well for the city’s standing as a health care hub. Diversity in leadership — and the advantages it brings — will help Boston and its hospitals move far ahead of those cities and institutions that are led only by men.