Are hospitals ambivalent about diversity in leadership?

Karen Cheung

 Karen M. Cheung

Statistically, hospital leadership positions are woefully lacking in diversity, in which boards and executive positions do not represent the population breakdown nationwide or the communities they represent.

"The boardroom doesn't reflect the community," John Combes, senior vice president of the American Hospital Association (AHA) and president of AHA's Center for Healthcare Governance, said Wednesday at the American College of Healthcare Executives' (ACHE) annual congress.

According to AHA 2011 data on governance, hospital boards are made up of 90 percent Caucasians--the survey's term, not mine. African Americans made up 5 percent, Hispanic/Latinos 3 percent, Asian/Pacific Islanders 1 percent and American Indians less than 1 percent. But the perception of community representation is wrong, according to Combes. Hospitals are overestimating how diverse their boards actually are. Although board members are mostly made up of Caucasians (90 percent), survey respondents estimated the Caucasian portion to be much lower at three quarters (76 percent).

Combes' comments on the AHA data echo another study about hospital perception of racial and ethnic leadership demographics. According to an executive search firm Witt/Kieffer survey released in January, overall, less than 15 percent of surveyed healthcare professionals say hospital leadership has closed the diversity gap. However, 24 percent of Caucasian professionals believe the diversity gap has been closed, but only 11 percent of minority professionals agree. Even more, 60 percent of leaders who are Caucasian see their organizations' cultural diversity programs as effective, while only a third (33 percent) of minority professionals agree.

Survey respondents diverged on why. Caucasian healthcare professionals cited a lack of diverse candidates, while minority respondents attributed the gap to upper management's lack of commitment to diversity.

The data beg the question: Are hospitals overly optimistic about representation or have hospitals grown ambivalent to diversity initiatives?

When I spoke with the Asian Health Care Leaders Association representatives at ACHE this week (actually representatives sought me out--I'm guessing because of my black hair), they said the atmosphere really varies across institutions. Some hospitals are very committed to diversity and make sure a minority is included in the applicant pool, although that doesn't mean a guaranteed hired position, while others aren't as strict about such parameters.

In fact, others are downright mad over affirmative action initiatives or foreign-trained staff. Here's a sample of the website comments we've received when FierceHealthcare reported the story, entitled "Diversity missing in hospital leadership:

"We have far too many overseas medical staff in Australia. Some have no idea whatsoever of our culture, and don't want to know. They keep operating in their own little world, barely speaking English."

"So what! Appears to me at least medical care should be left to the [sic] those best able to do it and not reduce the quality with quotas and other artificial barriers to that care."

When asked about the strategy of filling quotas, Witt/Kieffer Senior Advisor to the CEO and Senior Vice President Jim Gauss told FierceHealthcare, "As a general rule I agree 'quotas' are not the most effective manner to achieve diverse leadership teams and boards. However, it has been an effective tool in some organizations, and this is really organization dependent," he said in an emailed statement.

Gauss added that the diversity in the leadership is crucial to organizational performance and the community image of hospitals and systems.

"It is my experience that diversity in all areas allows for better decision making, can assist in performance improvement and quality of care delivery," Gauss said. "The field as a whole seems to be making progress, but we still have a long way to go."

- Karen (@FierceHealth)