An internal survey of faculty, staff, and program alumni at Stanford University’s Byers Center for Biodesign revealed some of the same patterns as their industry-wide research on gender bias. While well-intentioned male leaders reported a respectful and inclusive office environment, some female faculty and staff experienced unconscious bias and microaggressions. And while both male and female leaders thought they were making strides in diversifying our fellowship program, alumni found their progress lacking. The team adopted a “small wins” model of change that focuses on setting and achieving narrow, attainable goals to produce a sense of success that is contagious and builds momentum for larger gains and systemic transformation. They’ve identified 10 small wins organizations can undertake immediately to help build a staircase that will lead to larger success.
Health technology is a growing field at the intersection of health care and high tech, providing medical devices, digital health tools, and health care IT. While health care is often considered a leader in gender diversity, with women making up more than half its workforce, health technology looks much more like the tech industry when it comes to gender, race, and other forms of diversity. Our recent survey of 403 people working in health tech, for example, found that 90% of respondents were in a company where the majority of senior leaders are men.
In our experience training future leaders in health tech innovation at Stanford University’s Byers Center for Biodesign, we’ve struggled with the question of how to advance equality in our field. Our latest research about gender in the health tech workplace made the challenge we face much clearer: Many men seem to think sufficient progress has been made and that women now enjoy equal standing and opportunity. Women, on the other hand, still perceive a highly unequal workplace rife with systematic barriers.
In response to our survey, women shared numerous stories of gender bias, including being shut out of promotions, talked over or ignored in meetings, having their technical expertise questioned, and being told they were too aggressive or difficult to work with. These experiences of discrimination are all too familiar to many professional women, particularly in STEM fields.
What was far more revealing was the limited awareness many men in our survey had about the challenges faced by their female peers. For instance, 80% of responding men believe their workplace “empowers women to reach their full potential,” while just 36% of women agree. Only 35% of women believe their organization’s criteria for promotion is the same for both genders, while 84% of men say it is equitable. Half of women involved in fundraising felt men and women on their pitch team were treated differently by investors, compared to one in 10 men.
The men in our survey largely attributed gender disparities to individual choice. For instance, when asked what holds women back from senior leadership positions, the most common response from men was women’s desire to balance work and family. Women, in contrast, said the biggest barriers to advancement are systemic factors like stereotyping and exclusion from networks of communication and influence.
This difference in perspective is troubling because it means women’s ongoing struggles to achieve professional parity are largely invisible to many of their male colleagues. Yet these struggles have real consequences for their success. Women in our survey were far more likely to have witnessed or experienced gender discrimination and to report gender disparities in compensation and opportunities for advancement. They had lower levels of job satisfaction than their male colleagues and were twice as likely to be considering leaving their current job.
Closing Perception Gaps at Stanford Biodesign
As a training program for the next generation of leaders in health technology, it felt imperative for us to address the perception gaps we uncovered, starting at our own organization. An internal survey of Biodesign’s faculty, staff, and program alumni revealed some of the same patterns as our industry-wide research. While our well-intentioned male leaders reported a respectful and inclusive office environment, some of our female faculty and staff experienced unconscious bias and microaggressions. In addition, although both male and female leaders thought we were making strides in diversifying our fellowship program, alumni found our progress lacking.
To begin addressing these perception gaps, we adopted the “small wins” model of change developed by Stanford sociologist Shelley Correll. This approach focuses on setting and achieving narrow, attainable goals to produce a sense of success that is contagious and builds momentum for larger gains and systemic transformation. It also emphasizes improving organizational processes rather than relying solely on individual-level transformation.
We used this simple but powerful approach to get moving and sustain progress. Our internal survey revealed that female faculty members routinely helped administrative staff with cleanup tasks at important events, such as resetting meeting spaces during breaks, while their male counterparts walked away. As anticipated by our research, male faculty members were largely unaware of this pattern and its potential implication that certain administrative tasks are “women’s work.” Once the issue was surfaced, however, there was immediate buy-in on new standards of shared responsibility for lending a hand.
Another internal small win has been making diversity, equity, and inclusion a regular agenda item in our bi-weekly program-wide team meetings, as well as routinely hosting speakers and small group discussions on related topics. Creating space for discussion around these issues makes it easier for team members to voice concerns and suggestions. It also demonstrates leaders’ commitment to addressing diversity and makes internal disparities more visible to those who have failed to see them.
We also pursued a series of small wins to improve the recruiting and application process for our fellowship program. We broadened our recruiting efforts by targeting diverse university engineering programs and technical societies for women and underrepresented groups. We balanced genders on our faculty and alumni application review committees and included more reviewers of color. We adjusted our application scoring system to reduce the emphasis on education and professional experience, which might disadvantage individuals without a privileged background, and increase the value placed on categories such as leadership, creativity, and essays where applicants tell their personal stories.
The perception gap can be particularly pernicious when it comes to “small,” easy-to-overlook disparities like the makeup of a review committee or the rubric for scoring applications. But we believe small wins add up. Historically only about one-fourth of our fellowship graduates have been women, but 40% of those accepted to the program for 2020-21 are women and two out of 12 are Black. We are tracking our metrics to hold ourselves accountable and continue to raise the bar.
Encouraging Small Wins Across the Health Tech Industry
Building on our successes at Stanford Biodesign, we are working to close the perception gap and share the small wins model of change with others in our industry. We believe the small wins approach is a good starting place for start-ups and mid-sized companies – which are plentiful in health tech – that want to address workplace equality but may lack the HR personnel or financial resources to implement comprehensive diversity and inclusion programs.
Through our Diversity by Doing (DxD) HealthTech initiative and a summit we convened on gender in health technology, we’ve been sharing a sample list of 10 small wins organizations can undertake immediately. It includes ideas like making sure everyone has an opportunity to speak during meetings, asking rather than making assumptions about what responsibilities or challenges an employee might be willing to take on (such as a project or role that involves substantial travel), and committing to recruiting and screening at least three qualified candidates for the next job opening who would diversify the team in a substantial way.
While small wins may feel inconsequential, they build brick by brick a staircase that takes us to bigger successes. But a crucial first step is making sure we’re all on the same page. The vast majority of men in our industry survey think women in their workplaces have as much strategic ability, commitment, and other professional capabilities as men. Yet many of them are blind to the widespread systemic barriers their female colleagues still face. In our experience, the same is often true of white people in health tech, many of whom support racial diversity in theory but are largely unaware of the discrimination people of color face in their companies and how they may contribute to it.
As 2020 has us grappling yet again with the importance of diversity and the central role health care plays in our social and economic well being, now is the time to act. People in power in health tech and other industries must open their eyes to the continuing challenges that their colleagues from underrepresented groups face. Organizations need to surface the inequalities that are so obvious to women, particularly women of color, but largely invisible to (mostly white and male) leadership. While exposing these issues to the light may seem like a small win, closing the perception gap is an essential first step on the path toward equality.