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DiversifyingTheSurgicalWorkforce:TheImportanceofLeadership

MaryHawnMDMPHProfessorandChair

StanfordDepartmentofSurgery

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Disclosures

• Imposter • Informed

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PurposeofMyTalk

DefineDiversityandInclusion

WhyisitImportant?

DescribeImpactofBias

ImportanceofEffectiveLeadershiptoAchieveGoals

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Diversity

Nosingle definition:Complex,multidimensionalconcept

Primarydimensionsofdiversity(hardtochange):humandifferencesthatareinbornshapeourbasicself-imageinfluencehowweviewtheworld.

Thesixprimarydimensionsincludeage,ethnicity,gender,physicalabilities/qualities,race,sexualorientation.

Secondarydimensionsarethosethatareacquired,potentiallychangeableInclude,butarenotlimitedto,educational,geographiclocation,income,maritalstatus,militaryexperience,religiousbeliefs,andworkexperience,etc.

Griggs,1995McGrawHill

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DiversityisImportantforSuccess

Ifyouwantaccesstothebesttalent– youneedtoconsiderall talent

Diverseteamsmakebetterdecisions30%rule

Youcan’tbewhatyoucan’tsee

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Arediversitymetricssufficient?

Noteverythingthatcountscanbecountedandnoteverythingthatcanbecountedcounts

• AlbertEinstein

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My Career Journey to Date

• Born6th of7children• Leadfrombehind• Strategicalliances

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Inclusion?

MIKE

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• LikeDiversity,Inclusionhardtodefineasasingleconcept

• Diversitywithoutinclusionwillatbestfailandmayleadtobacklash

• UnlikeDiversity,muchmoredifficulttomeasure

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4KeyLeversofInclusion

1.InclusiveLeadership-Makingsureeveryonespeaksupandisheard-Empoweringteammemberstomakedecisions-Safeenvironmenttoproposenovelideas-Takingadvice-Givingactionablefeedback-Sharecreditforsuccess

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4KeyLeversofInclusion

2.Authenticity-Over30%ofWomen,Asians,Blackssaytheyhavetoconstraintheirauthenticselfto‘fitin’totheworkplace-Inscienceandtechfields‘actinglikeaman’regardlessofgenderleadstosuccessinleadership

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4KeyLeversofInclusion

3.NetworkingandVisibilitySponsorship

– someoneinpowerwhoelevatestheirprotégé’svisibilitywithinthecorridorsofpower

- putstheirreputationonthelinefortheirprotégéHavingsponsorshipisassociatedwithcareersatisfactionLackingsponsorshipisassociatedwithdroppingoutofthefield

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4KeyLeversofInclusion

4.ClearcareerpathstosuccessRecognizethatnotonepath/trajectoryworksforall

Creatingalternativepaths

Removingbarriersthatblockalternativepaths

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DiversityisbeingaskedtotheParty

InclusionisbeingaskedtoDance

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Let’sreviewsomedata

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PipelinebyGender(2015)

Students

Men Women

Residents

Men Women

AsstProf

Men Women

AssocProf

Men Women

Prof

Men Women

Chair

Men Women

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RecentProgressatChairLevel(**maynotbeexhaustive)

• MaryHawn• Omeida Valazquez – firsthispanic• SandraWong– firstasian• BetsyTuttleNewhouse• MelinaKibbe• Sharmilla Dissanaike• MaryKillakey• MarthaZeiger• NitaAhuja• JenniferTseng• RebeccaMinter• **noBlackfemalechairyet

Chair

Men Women

Chairs2017

Men Women

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Biasesfacingfemalesurgeons

Male+Surgeon=Surgeon

Woman+Surgeon=WomanSurgeon–Oftenconfusedfornurse,MA,tech,assistant

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RecentdataonWomeninMedicine• Femaletraineesmorelikelytosufferdepressionduringtraining

• Lesslikelytobeintroducedas’Doctor’bypeers

• Referralswilldiminishwhenhavebadoutcome,thesameisnottrueformen

• Womenearnlessthantheirmalepeers,lesslikelytoadvanceintoleadershipandoftenleadershipisin‘supportive’roles

• Womenhospitalistsandsurgeons’patientshavebetteroutcomes

• Allthisfeedsintowomenfeelingliketheyhavetobetwiceasgoodtogetrespectandadvancement

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Sohowcanleadershipbreakdownthese

patterns?

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Firstlevelofleadership

• Leadyourself• EmotionalIntelligence• Selfregulationofemotions

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The3A’s

•Availability•Affability•Ability

• Inthatorder……

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Networking&Visibility

Reputation:Whatitis.

Characterislikeatreeandreputation likeashadow.Theshadow iswhatwethink ofit;thetreeistherealthing.

AbrahamLincoln

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Reputation:WhydoIwantit?• Unlikehighschool,havingareputationisimportantforadvancement.• Youcanbedoingreallygreatthings,butunlessyourrecognizedforyouraccomplishmentsyouwillhavetroublewithacademicadvancement.

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Reputation:HowdoIgetit?

Youcan’tbuildareputationonwhatyouaregoingtodo.

HenryFord

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Reputation:HowdoIgetit?

Beingavailable

TeamplayerBeingaffable

NetworkingBeingable

DemonstrateknowledgeDemonstratepassion

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ABILITYTicketstoSuccess– Grades– TestScores– Awards– Letters– Research– Volunteerism

Youhavetoberecognized(haveareputation)fordoingthesewell.

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Reputation:HowdoIkeepit?

Ittakestwentyyearstobuildareputationandfiveminutestoruinit.

WarrenBuffett

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TicketPunching

Buildingyourreputation• Youstartwithacertainamountofgoodwill• Youcanmakemistakes• Youcanbelate• Youcanupsetsomeoneunintentionally• Andasyoudotheseyouwillusesometickets…..

TicketstoFailure• Inflatedselfworth“I”• Tooimportant• Problemswithoutsolutions

• Ifyouaresurroundedbyalotofproblems,timetogetamirror

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TicketPunching

“Youneverknowhowmanyticketsyouhaveuntilyou’vepunchedthelastone”

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Reputation:CanIchangeit?

Areputationoncebrokenmaypossiblyberepaired,buttheworldwillalwayskeeptheireyeonthespotwherethecrackwas.

JosephHall

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Youcanleadyourself,nowtipsforleadingothers

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Leasteffectiveorbadpractices• Holdstrongbeliefthatyoucanmakeobjectivejudgement• Claimtoberaceorgenderblind• Holdstrongbeliefthatyourdepartment/disciplineisameritocracy• Assumingbiastrainingissufficient

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WhyareTeamsImportant?

• Thepowerofteamstoaccomplishsomuchmorethananindividual• Collectivewisdom• Diversityofideas

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HowtoMotivate(ornot)HighPerformingTeams

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HowtoMotivateHighPerformingTeams

• Importanceofinclusivity• Everyonehasarole• Everyonecontributes• Alternateleading/following

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HowtoMotivateHighPerformingTeams

Rewardscanvaryimmensely

MoneySenseofcontributionRecognitionPurpose

…..anddoughnuts

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• mul ·ti ·pli ·ers• noun• leaderswhousetheirintelligencetoamplifythesmartsandcapabilitiesofthepeoplearoundthem;ideasflowandproblemsgetsolved.

• Thesearetheleaderswhoinspirethepeoplewithwhomtheyworktostretchthemselvesandsurpassexpectations.

• Theseleadersusetheirsmartstomakeeveryonearoundthemsmarterandmorecapable.

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• di·mi·nish ·ers• noun• thosewhobelievethattheyareperpetuallysmarterthanothersandtherebysquashtheintelligenceofthosetheylead

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LeadLikeaGardener

• Theworldhaschanged,yetweoftendemandunrealisticlevelsofknowledgeinleadersandforcethemintoineffectiveattemptstomicromanage.

• Thetemptationtoleadaschessmaster,controllingeachmoveoftheorganization,mustgiveway toanapproachasagardener,enablingratherthandirecting.

• Agardeningapproachtoleadershipisanythingbutpassive.Theleaderactsasan“Eyes-On,Hands-Off”enablerwhocreatedandmaintainsanecosysteminwhichtheorganizationoperates.

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Reputation:CanIchangeit?The‘unfair’reputation‘SecondGeneration’GenderBias

• Notovert,difficulttoputyourfingeron• Feelingofbeingpassedover• Effectivefemaleleaderslesslikelytobe‘likeable’

Bias?DoubleStandard?Both??

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Whohasitall?

‘WhyWomenStillCan’tHaveitAll’- AtlanticMonthlyEssayAnn-MarieSlaughter

Discourseisdestructivetowomen-Makesourinherentchoicesthefocusofour‘success’orlackthereof.-Mendon’ttalkthisway-Ingeneral,itleadstowomenbeingcriticalofwomen

SherylSandberg

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UABGISurgeryCirca2006

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UABGISurgery2014

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My Academic Success: Mentors and Sponsors

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Mentors and Sponsors: Across Gender/Race

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MostImportantDecisions

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Onlistening

“I’llbebrief…. becausewhenI’mtalking,I’mnotlearning”

JohnDoerrVentureCapitalist