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Women make up 50.8% of the US population, according to the 2010 US Census.
Women make up 50.8% of the US population, according to the 2010 US Census.1 Women also comprise a majority of those entering the pharmacy profession, receiving 61.9% of first professional pharmacy degrees in 20172 and consistently earning the lioness’ share of degrees for years.3 Additionally, women account for about 74% of the US health care workforce.4
Indeed, women make the overwhelming majority of health care decisions for themselves (94%) and others (59%)5; this is particularly significant given that the total US health care national expenditure was $3.2 trillion in 2015.6 Research has also indicated that nonprofit and for-profit companies generate more successful outcomes and higher profits when they elevate women to senior leadership roles and ensure gender diversity within their boards.7
All these data support having women at the helms of health care and pharmacy organizations, yet if you look more closely at the C-suite leaders of health care systems, insurers, pharmacy chains, and pharmaceutical companies, you might think the United States was populated exclusively by men. As of June 2018, there were no women running a top-10 pharmacy chain or pharmacy wholesaler in the country, and of the top 10 specialty pharmacies, only one is run by a woman. In 2017, the first woman to run a top-15 pharmaceutical company was named (congratulations to Emma Walmsley of GlaxoSmithKline), and in 2018, a woman was named to the helm of a top-10 health care insurer (congratulations to Gail Boudreaux of Anthem). However, neither woman is a health care professional or a pharmacist.
The paucity of women at the top of leadership in pharmaceutical companies, academia, hospital pharmacy, and several other areas of health care has not gone unnoticed. Several pharmacy professional organizations have studied and published literature on this issue, focusing on settings such as hospital pharmacy,8 academia,9 and other areas of pharmacy practice.
But in 2018, when we’ve already recognized this as a problem for decades, why is there still such a disparity between women as decision makers and women in pharmacy leadership roles? Are there differences in perceptions of opportunities for leadership with women in pharmacy? I conducted an informal, nonscientific survey of my pharmacy network and received over 30 responses. Here are some insights into gender and leadership from women in pharmacy, grouped by number of years within the profession. Some respondents chose to remain anonymous.
Women Newly Retired From Pharmacy
The good news: The longer women were in the profession, the more positive they felt about opportunities for women in leadership positions and the more likely they perceived that women had just as many opportunities to lead as men.
“I had many opportunities for leadership roles in my career over 40 years,” said Susan Sutter, RPh, a retired pharmacist and a former independent pharmacy owner. “I’ve mentored many women pharmacy students and young pharmacists throughout my career and have seen many find leadership roles if indeed they desired that as part of their career.”
Women With 26-Plus Years in Pharmacy
Generally, those with 26 or more years of experience in pharmacy were positive about the opportunities for women in pharmacy leadership and were the most responsive to the call for interviews for this article.
Lucinda Maine, PhD, RPh, executive vice president and CEO of the American Association of Colleges of Pharmacy, identified herself within this category. “I began my career just at the inflection point where women comprised 50% or more of the enrolled pharmacy students. I was immediately offered opportunities to engage in leadership activities at the local, state, and national levels,” Maine reflected. “What I observed at the time was that not many women had assumed state or national leadership positions, but by the time I was 5 to 10 years into my career, that began to change.”
Sue Paul, BSPharm, a pharmacist and an entrepreneur, also felt generally positive regarding the status of women in pharmacy and leadership roles. “I am finally getting to use the full magnitude of what I was taught in pharmacy school, and I am able to serve patients to help them achieve better health outcomes,” she stated. “Pharmacists have an amazing opportunity to lead with the emergence of pharmacogenomics, nutrigenomics, and epigenetics. I feel the downsizing in traditional pharmacy roles will propel the evolution of enhanced pharmacy services in other areas.”
Kathy Campbell, PharmD, another pharmacist and entrepreneur, defined leadership in a way that stretches beyond the pharmacy profession. “We limit our view of leadership in pharmacy. My most impactful opportunities to lead are often found by empowering patients in their own health and well-being, as a leader in my community health, as a mom, legislatively within our profession, and within my business organization,” she said. “You do not have to be the pharmacist in charge to be a leader, and this is often not distinguished in pharmacy.”
Other women within this category had concerns regarding innovation and the future of pharmacy.
“The pharmacy profession has not traditionally done a great job of creating leaders, and there is a true leadership void, particularly in developing women leaders,” shared Amy Gutierrez, PharmD, a pharmacist with more than 26 years of experience. “Leadership is critical to the evolution of pharmacy. We must find ways to develop and nurture pharmacists to take on these critical roles and advance our profession.”
Canadian women pharmacists chimed in on this survey, as well, and based on their comments, there also appears to be a disparity of women leaders in pharmacy in our neighbor to the north. Christine Hrudka, BSP, a pharmacist for more than 26 years and the current chair of the Canadian Pharmacists Association, noted that we need to mentor more young women in pharmacy, adding that “we need gender equity on all provincial and regulatory boards.” The idea of gender quotas on boards and governmental organizations has been mandated in other countries with some success,10 and policy makers in California have considered following this example.11
Women With 16 to 25 Years in Pharmacy
Based on the responses, women in this category seem to be the most likely to be at a critical point in their career trajectory to switch into the C-suite path. However, women in their 40s tend to also be sandwiched between caring for children and elderly parents. Neuropsychiatrist Louann Brizendine, MD, has suggested that although women are ready to lead by their 50s, many organizations have already passed them over as C-suite potentials because they were reviewed in their 40s and couldn’t take on the larger roles at that time.12
Responders in this category generally felt that men and women did not have the same leadership opportunities within pharmacy. One anonymous pharmacist who self-identified with this age in practice thought that more openness is needed to facilitate more women leaders in pharmacy. “Openness to women’s innate different leadership style and acceptance of such, with less reliance on the ‘old boys’ club’ as pharmacy experts, would be a better way to gain more women leaders in pharmacy,” she wrote.
Another anonymous pharmacist with 16 to 25 years of experience felt that mentoring and leadership courses are needed. “In my experience, women have been the extremes of my worst and best bosses,” she said. “It is great when they lead with integrity, but I’ve had some women bosses who are too aggressive in asserting themselves. They are so committed to proving themselves that they lose sight of the big picture and forget how to treat people.”
A final anonymous pharmacist in this bracket of tenure stated, “I think organizations need to do more to gender-blind themselves and decrease bias when making hiring decisions. If names and gender identification were wiped out from résumés, I think there would be a lot more women in leadership positions within pharmacy and health care.” She added that it is also important for men in pharmacy and health care to stand up for their women colleagues and empower them to take on leadership roles within their organizations.
Women With 6 to 15 Years in Pharmacy
This group of women pharmacists seem to be unsure about whether pharmacy leadership opportunities are meeting their expectations.
“In my experience, men lead at a higher level in corporate pharmacy. They may allow women to lead a specific store, but the ultimate hierarchy is answering to a man,” said Angie Glotzbach, PharmD. “Women owners and women in state board positions would balance the sexist position that is the history of pharmacy.”
“Men are promoted into leadership roles based on perceived competence, while women have to demonstrate absolute competence for the same opportunities,” added an anonymous pharmacist with 6 to 15 years of experience. “[Women] also have to be team players and pick up the pieces when the male leader inevitably implodes.”
Women With 2 to 5 Years in Pharmacy
Those 2 to 5 years out of pharmacy school and into the workforce have viewpoints specifically about pharmacy school curriculum. According to an anonymous pharmacist in this category who works in health care consulting, “It is imperative that pharmacy schools and the Accreditation Council for Pharmacy Education begin to address the glaring oversaturation of traditional pharmacy jobs. It is simply not enough for students to just graduate with a PharmD anymore.”
Recent Graduates From Pharmacy School
Gender disparity in pharmacy leadership was a notable source of anxiety for women who recently graduated or are graduating from pharmacy schools.
“Although I feel I don’t have enough experience to fairly evaluate the profession, I do feel guidance in this area is lacking for women who are about to enter the profession of pharmacy,” stated an anonymous PGY4 student. “Perhaps pharmacy schools could provide education or at the very least resources on women and leadership in the profession or pharmacy.”
“As a young pharmacist, you are ambitious and hopeful in the ability to grow your career as a woman,” a recent graduate responded. “In school there are plenty of opportunities to lead and grow, but I am uncertain whether those opportunities will carry over as much as I hope for them to in my pharmacy career.”
Conclusion: We Have More Work to Do
We have a problem in pharmacy and health care C-suites: There are few women at the helm. Although women early in their pharmacy career have mixed feelings and perceptions about leadership roles within the profession, midcareer women generally perceive more disparity between genders, and women later in their careers feel most optimistic.
With women making most of the health care decisions in this country, representing a majority of the population, and gaining more economic power than at any point in history, now is the time to recognize this problem and start working toward solutions. Ultimately, diversity in C-suites and boardrooms will create stronger, more innovative, and more sustainable organizations in the long run.
Erin Albert, PharmD, JD, MBA, PAHM, is a writer, a pharmacist, an attorney, and a former professor. Follow her on Twitter (@ErinLAlbert) or at her website, erinalbert.com.
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