Minority healthcare executives are markedly less satisfied with their career progress and less happy about race relations in their institutions than white executives, a recent survey by the American College of Healthcare Executives reveals.
Moreover, while the pay gap between black men and white men in healthcare has narrowed, the gap between black women and white women has widened.
Altogether, the survey shows some progress toward the goal of boosting the career attainments of minority and women healthcare executives, but improvement was less than what had been hoped for, observers said.
"It's very disturbing," said Richard Wade, senior vice president of communications for the American Hospital Association. The study doesn't describe the actual numbers of minorities in management positions, "but it does tell you about perception, about discrimination, about how they're viewed in organizations. Those things are going to take time to clear up. We've got to be aggressive."
Minorities are well-represented in the American healthcare work force but have not entered the executive ranks in proportion to their numbers, previous studies have shown. Critics have taken the healthcare industry to task for failing to work hard enough to bring qualified minorities into the field and move them up the career ladder.
Carl Ellison, interim president of the Institute for Diversity in Health Management, said the study indicates "a need for continued work in this area. . . . It did not contain any surprises for me."
The ACHE conducted the survey in conjunction with the Association of Hispanic Healthcare Executives, the Institute for Diversity and the National Association of Health Services Executives. It surveyed 410 blacks, 408 whites, 264 Hispanics and 124 Asians about their career outcomes, factors that might account for differences in those outcomes and respondents' attitudes. The detailed questionnaire was distributed in 1997.
It follows by five years a similar survey by the ACHE and the NAHSE, which also documented dissatisfaction among minorities and a pronounced pay gap. The disappointing results of the 1992 survey spurred the formation of the Institute for Diversity. The 1997 survey was expanded to include Hispanics and Asians.
"We're committed to doing this study every five years," said Thomas Dolan, president of the ACHE. That way, change can be measured over time. For now, comparisons over time can be made only for blacks and whites, he said. "When we do it again in five years, we'll be able to compare blacks, whites, Hispanics and Asians."
Also, the study measures differences in achievement and compensation by gender. That, Dolan said, is how researchers discovered that the disparity in pay between white women and minority women is growing. That pay gap increased to 17% in 1997 from 8% in 1992, while the gap between black men and white men narrowed to 12% from 18%.
Perhaps reflecting those disparities, only 47% of black men were satisfied with their earnings while 67% of white men were.
Likewise, there's a huge disparity between what blacks and whites think about hiring and promotion. More than 40% of blacks but less than 5% of whites thought their race or ethnicity worked against them in these decisions. Hispanics and Asians also experienced this problem but not as severely as blacks.
Black women were less satisfied with pay and fringe benefits than white women. Black women also thought they were punished more harshly for mistakes and were treated with less respect by supervisors. On the same issues, Hispanic women fell between whites and blacks. Asians were the most satisfied with autonomy and job security but the least satisfied with respect from subordinates.
Among males, 69% of blacks were satisfied with the level of respect from their supervisors, whereas 80% of whites, Asians and Hispanics were satisfied.
Almost 90% of blacks and 70% of Asians thought relationships among different groups could be improved, but only 54% of whites thought so.
The study recommended ways to rectify the problems, including considering more minorities when recruiting for executive jobs and encouraging minorities to seek graduate and postgraduate healthcare education.
Jim Lott, senior vice president of the Healthcare Association of Southern California, said the findings didn't surprise him, based on his 25 years as a minority healthcare executive.
The key problem, he said, is the failure of the industry to entice minorities into graduate and executive-training programs. "In this field, like any other specialized field, you need to get your ticket punched at certain stations," Lott said. "Minorities are not pursuing those opportunities to get their ticket punched." That's why the pool of healthcare management doesn't represent the country's demographic profile.
"It's incumbent on us in the industry to champion advanced education for executive positions in minority communities," Lott said. "The fault lies with the industry, not with the potential candidates."
The survey measured salaries and perceptions but didn't try to count the number of minorities in the healthcare executive suites. Dolan said failure to complete the survey would compromise the results of such an effort.
"You can't mandate compliance," he said, pointing out that about half the individuals surveyed for the ACHE study didn't respond.
The only way to take a reliable inventory of minority positions is to require all organizations to report on the ethnic composition of their work force, and probably only the federal government could do that, Dolan said.