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Historically, men have dominated provider roles in healthcare due to limitations and biases that discouraged women from entering these fields. Women now exist in more healthcare spaces than ever, officially the predominant providers in some specialties, such as pediatrics and OB/GYN, and doubling our presence in dozens more over the last two decades (AAMC). Per the Association of American Medical Colleges (AAMC), women have driven the growth in supply of providers over the last 18 years (AAMC). However, our journey to the career and role we want is still filled with obstacles that hinder true equity.
From barriers to recognition to persistent pay gaps, women continue to face challenges that impact their professional growth. This blog post will explore these hurdles, highlight specific examples, and discuss how resilience plays a pivotal role in helping women navigate their own growth and myriad challenges in healthcare professions.
A Personal Story of a Woman in Medicine
In academic medical centers, physicians often participate in multiple roles outside of clinical practice, including education, research, and leadership. A medical doctor (MD) may have their time divided into percentages or proportions of effort for the duration of their career, with the balance shifting according to preference and/ or departmental need. For physician assistants (PAs), a diverse career is far less common. Per the NCCPA 2023 Statistical Profile, only 3.5% of PAs work in non-clinical spaces (NCCPA). A non-clinical role is defined as one where a PA does not provide direct patient care.
Once established as PA faculty, where the primary role is teaching, many PAs then lose their time or capacity to provide care. Only 2/3 of PA program faculty practice clinically, and less than half have time protected by the PA program to do so (PAEA). While medical doctors in academic institutions are expected and encouraged to have diverse roles, and have their time allocated to do so, physician assistants struggle to maintain the same protections. Additionally, women in academic medical roles are less likely to achieve advanced faculty positions, remain in an academic career, and be promoted to a leadership role (Carr et al).
I found this to be personally true. While working at my prior institution, an academic medical center with a top ranked medical school and an established physician assistant program, I was encouraged to take on research projects and promote myself in the education space by an encouraging supervising physician. However, once designated full-time faculty, I found the environment of PA education, especially as a woman in a large academic medical center, to be profoundly lacking in support and parity. While I experienced significant advancements in my ability to teach, learn, and grow my skills, I found walls where there should be windows, and condescension from leadership where there should be encouragement.
Without warning, comparative metrics, or even a direct conversation, my clinical effort was dissolved, citing a need to save money for new hires, and with reference to the flexibility of the PA role, as if my career at the institution was otherwise replaceable. When a small proportion of my effort as faculty was lost, which provided some funding for my position, I was given bland suggestions to make up for the time, without recognition of the work I had done (with significant overtime) or discussion of my value at the institution. Having just finished a program at the reputed Harvard-Macy Institute, among medical doctors and other healthcare professionals encouraged to broaden their scope, a loss of this minuscule (by comparison) protection of my worth and time felt deeply trivializing of my career and ability.
Would this happen to an MD? Would this happen to a male in my place? I can't know, but research suggests: probably not.
The Barriers to Recognition and Pay Equity
Gender bias remains a significant challenge in the healthcare sector. Many women find that their contributions are often overlooked. This lack of recognition stems from long-standing stereotypes that view women as supporting roles rather than leaders. For instance, a 2021 study found that only 13% of women in healthcare leadership roles believe their work is recognized compared to 22% of men (Mose).
The gender pay gap is a troubling reflection of these systemic inequalities. Data shows that female healthcare workers earn, on average, about 25% less than their male counterparts for similar roles. In particular, female physicians earn around $180,000 annually, compared to their male colleagues who average $240,000. This disparity persists even when factors like specialty, years of experience, and hours worked are taken into account. And for physician assistants, a field where women are actually the predominant gender, female PAs earn approximately $113,882 per year, while male PAs earn approximately $161,778. This means women earn roughly $0.70 for every $1.00 a male PA earns, reiterating the gender pay gap identified in other professions and reflecting a similar pay gap to MDs (My PA Box).
The Promotion Gap: Limited Opportunities for Advancement
The promotion gap is another major hurdle. Despite women making up nearly 60% of medical school graduates and 70% of PA school graduates, they hold only about 30% of leadership positions. In education, while 70% of PA faculty are female and 27% identify as male, many more males serve as program director, with 39% of program directors being male and 58% identifying as female (PAEA). The contrast in these proportions reveals biases in academic and healthcare hiring and promotion practices.
Physician assistants (PAs) overall are less likely to be promoted to advanced positions. PAs play an essential role in healthcare and are present in every specialty, yet we often encounter limited advancement opportunities compared to physicians, who typically have more pathways to leadership roles. In fact, only 5% of PAs have top-tier leadership positions, leaving many feeling constrained in their ability to influence policies and practices or even have a voice at the table.
Many women report feeling the need to prove themselves repeatedly, often believing they must exert extra effort to achieve the same recognition as their male counterparts. This constant struggle can be draining, but, as a positive, it does foster a unique resilience among women, allowing us to navigate our careers with determination and a deeper insight.
Work-Life Balance: The Ongoing Challenge
Achieving a healthy work-life balance is challenging for women in healthcare, who often juggle demanding jobs and family responsibilities. A recent study revealed that 70% of women in healthcare reported feeling stress from the pressure to meet both professional and personal expectations. Multiple articles suggest that deficient working conditions, diminished autonomy, and poor work-life balance predominantly effect women and lead to increased likelihood of burnout (Karakcheyeva et al). Burnout, unfortunately, is both prevalent and a deeply challenging result of a healthcare role.
The healthcare field demands long hours and emotional labor, which can complicate personal life. Many women find that their professional commitments interfere with family obligations, leading to feelings of inadequacy. The constant balancing act can be overwhelming.
Adopting policies that support work-life balance is essential for employers to promote longevity and overall career success for their providers, especially their women providers. Creating flexible work schedules, offering mentorship programs, and improving parental leave options can significantly help women manage their responsibilities more effectively and reduce related stress.
Using Resilience for Good
Despite numerous barriers, women in healthcare demonstrate remarkable resilience. This hard-earned quality is vital for overcoming obstacles and often translates into strength and determination. Women frequently inspire one another through shared experiences, cultivating a supportive network that allows for shared growth.
Resilience involves more than simply enduring tough times; it’s about leveraging challenges for growth, even if not noted right away. While the initial result of trials, impeded promotion, or other career blockades can be infuriating frustration and emotional anguish, the ability to recognize inner strength, dedicate yourself to recovery, and find something better is a skill that more than makes up for the initial injury. Many women can use their experiences to fight for change, advocating for equity and representation. This advocacy is critical in pushing for systematic improvements, leading to a more inclusive healthcare environment, better health policy, and improved patient care.
As women build resilience, they become skilled at finding innovative solutions to challenges and navigating complex workplace dynamics. This adaptability often leads to fulfillment both personally and professionally, once their skill is put to action.
The Future for Women in Healthcare
The journey for women in healthcare is marked by significant challenges, including recognition barriers, pay disparities, and promotion gaps. The struggle to maintain a work-life balance adds to these difficulties. However, the resilience born from these experiences acts as a powerful catalyst for progress and change. And if the data from the last 25 years is predictive, women will grow to dominate certain sectors in healthcare and naturally insert themselves into leadership roles, providing more robust platforms for systemic change.
Women in healthcare are breaking down barriers and laying the groundwork for future generations. Addressing the systemic issues contributing to inequity is essential for fostering a more inclusive environment where women can thrive. A commitment to equitable practices is crucial—not only for individual success but also for the collective advancement of healthcare as a profession and patient care as a whole.
Want to talk about being a woman in medicine? Let's meet.
