Five Reasons Women Physicians Leave Healthcare Institutions
Dec 13, 2024
I became a coach and founded Brave Enough to help keep women physicians in medicine.
For the last 8 years I have coached hundreds of women through job transitions, burnout, and launching new careers and businesses.
Through my CME conferences and retreats, I've had the opportunity to hear from thousands of women physicians on what makes them leave an institution or leave healthcare in general. According to the AAMC, women are leaving medicine in record numbers.
As leaders, if we can understand risk factors facing women in medicine, we can discuss concerns openly in one on ones and listen with intent. Most women physicians give ample opportunities for leaders to encourage them to stay. Leaders must listen to understand in order to stabilize our workforces and decrease attrition.
Top 5 Reasons Women Physicians Leave Healthcare Institutions
Here's what I have found to be the most common reasons women physicians make the decision to leave their institutions. (I recognize some of these reasons may also be why male physicians leave an institution, but I can only speak to the physicians I coach – who happen to be women.)
1. Pay Inequity
I have coached dozens of women who find out (often on accident) that their male counterparts are making more than they are to do the same work. Or worse, many of the women I coach find out that male colleagues who have less responsibility, less experience or less years of service are making more than they are.
This creates distrust and a sense of betrayal and makes it hard for women to trust leaders who support unethical pay practices. I always say, if you want to retain women, the first thing you should do is make sure you are paying them. It’s the low hanging fruit of gender equity.
2. Being overlooked for a job they are qualified to do.
Data shows that women, more often than men, pay what is called a “loyalty tax” meaning they are more likely to stay loyal to a boss or leader even if it limits their ability to advance themselves. This can lead to bitter disappointment when women stay loyal to a leader, are qualified for a promotion, and end up being bypassed by a younger or less qualified male.
Many women I coach leave for this reason, and we spend a lot of time working through the grief that comes when they realize they have been loyal to a boss who does not practice fair treatment at the cost of their own career.
3. Lack of advancement opportunities.
Often high-achieving women work for years to reach the top, only to hit the glass ceiling, fall off “slippery ladders,” and get blocked for top positions with very little feedback on why they were not chosen. I have coached many highly qualified women leaders who, while having all the job requirements to advance, are simply told “it is not your time” or “it’s just not you” with little hard evidence as to why.
At some point, these high-achieving women describe feeling invisible and may have even been told by their own institutions they must leave to advance. This can be devastating to a woman who sees their male colleagues able to advance within their institution and not face the same ultimatums and restrictions.
4. Inability to be their authentic self
Literature supports that women leaders and physicians are judged more harshly by their peers and supervisors on performance reviews when compared to their male colleagues for similar actions. And women leaders are judged more harshly for mistakes, missteps and errors when compared to male leaders. Women who adopt a more agentic leadership style often experience bias, harassment and backlash.
We also know from NASEM reports that medicine has one of the highest rates of sexual harassment and discrimination – second only to what is experienced by women in the military. These experiences can result in women leaving institutions where they do not feel safe, or do not feel they can lead authentically without experiencing backlash. Women may leave due to inability to lead or work authentically or being judged for being authoritative when stepping into leadership roles they have earned.
5. Lack of honoring work-life boundaries.
Despite the advancement of women in the workplace, women physicians spend approximately 8-10 hours more each week doing domestic duties than their male physician colleagues. Women physicians are managing motherhood, aging parents, and domestic duties at the same time they are climbing the career ladder.
Respecting work life boundaries are key to supporting women in medicine. Yet, we know that women are often given more “citizenship tasks” (we published this research here in 2021), which are tasks that do not lead to promotion.
Women physicians often find themselves burned out at higher rates when compared to their male colleagues. Thus, having a supervisor, chief or chair who respects women’s work life boundaries is key. When leaders do not respect a physician’s work life boundaries, they often find themselves needing to leave the institution to protect both their own and their family’s wellbeing.
Often, when a woman decides to leave her institution, she will tell me that her supervisor or boss will act surprised despite women expressing their concerns or their wish to advance multiple times in prior meetings. While the culture of medicine has never been busier, and leaders are overwhelmed, if we want to keep women in medicine, it starts with listening to them.
Pay women. Promote women. Sponsor women. Let women lead.
Perhaps we will be surprised by their loyalty, not their exit.
If you find yourself facing any of these scenarios and in need of support, I would love to work with you. Tap here to learn more about my one on one coaching program.
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