Racial, gender disparities in Boston hospital executives echo national trends in diversity and wage gap

When it comes to the makeup of hospital leadership in Boston, the gender and racial scales are decidedly tipped toward men, both historically and presently. That is the key finding of a survey conducted by the Boston Globe.

The new survey by the Boston Globe, in fact, found that 80 percent of the 103 clinical department heads for the city's six major teaching hospitals are men, and almost 90 percent are white. Blacks occupy only three department head positions and hispanics only four.

There is also a glaring gap in the ranks of women and Asians, despite their significant presence in the physician workforce. Women constitute 34 percent of physicians and 13 percent of all physicians are Asian.

The data from the Globe is far from the only recent evidence supporting a continued gap in diversity and gender in the medical profession. Major disparities persist when it comes to wages as well. According to research from both Medscape and HIMSS, while compensation is on the rise, the chasm between what male and female doctors are paid is deepening as well. 

HIMSS U.S. Compensation Survey, published last month, found that women in health IT earn an average 18 percent less than male counterparts, while racial disparities account for a 12 percent difference -- and being both female and non-white can cost a woman 28 percent of salary.

In Boston, at Brigham and Women's Hospital, the Globe found that of the 15 department chiefs or chairs, 13 are men and only 2 are women. Of the 13 men, one is Asian and one is Latino, the rest are white. At Massachusetts General, of the 20 department leaders, 15 are men and five are women. All of them are listed as white.

At Boston Medical Center, there are 18 department heads, and of them, only four are women. The remaining 14 are men. Of the men, one is Black and one is Latino. Of the women, two are Asian, the study showed.

At Tufts, there are 15 male department heads and 5 female. Among the men, one is black and one is Latino. Among the women, there is one Asian. The rest are listed as white. Beth Israel Deaconess Medical Center is lead by 13 department chairs and 10 of them are men. Of them, 9 are white and one is black. The 3 female chiefs are all white. Finally, at Boston Children's, there 15 male chiefs and 2 female. Of them, there is one male Latino chief and one Asian female chief. The remaining department heads are listed as white, the survey showed.

A C-suite leader at Mass General commented to the Globe that he believed change would be slower to come because shifting this paradigm requires that black and Hispanic children be given more opportunities to get into medicine. The report also said that people of color don't always feel welcome in the area, and because there so few black and Hispanic hospital leaders, they are frequently tapped for hospital committees to increase their diversity, taking time away from research that might lead to promotions. Boston Medical Center trains search committees to better recruiting tactics that would bring in more minority candidates, and they use search firms with better track records for diversity, the Globe report said.

It's not just true among health IT workers and hospitals executives, either. Medscape, for its part, looked at compensation among its base of doctors and found that salaries averaged $299,999 according to the report, an increase from $294,000 in 2017, and with looming shortages demand is increasing.

But male doctors are making a lot more than female physicians. Male primary care physicians earned nearly 18 percent more than their female colleagues, averaging $239,000 versus $203,000 for women. Male specialists earned an average $358,000 versus $263,000 for women, a gap of more than $100,000.

Racial disparities persist as well. Medscape found that African-American physicians earned an average $50,000 less per year than white physicians, with those numbers reaching $308,000 for white physicians versus $258,000 for Black physicians. Gender compounds this particular issue, as African American women made almost $100,000 less than their male counterparts. Asian-American physicians earned an average $293,000 per year and Hispanic/Latino physicians earned an average $278,000, the research showed.

As populations become more diverse, the physician workforce that cares for them should as well. By extension, those that lead those physicians should also represent the diverse population of patients and physicians they supervise.

Cultural misunderstandings and miscommunications can hinder patient care and affect outcomes. And if physicians find a workplace unwelcoming, they could choose to take their talents elsewhere. This could adversely affect retention rates and cost hospitals money when they have to hire a replacement.

Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com