Women in Oncology Pharmacy Leadership: Strides to Close the Gap—A Review of HOPA’s 2019 White Paper

Alana Ferrari, PharmD
PGY-2 Oncology Pharmacy Resident
Duke University Hospital
Durham, NC

In August 2019, The Journal of Oncology Pharmacy Practice published HOPA’s white paper on the issue of women in oncology pharmacy leadership.¹ The publication highlights the current disparity between women and men in oncology pharmacy leadership in the United States: women represent 58.1% of pharmacy professionals, but only 25% of those women hold leadership roles.² In an effort to understand how this disparity is affecting female oncology pharmacists, HOPA’s Leadership Development Committee held a summit in 2017 to deliberate on this issue and discuss the results of a national HOPA membership survey assessing the barriers that prevent female oncology pharmacists from assuming leadership roles. The authors of the white paper identify common sentiments expressed by survey respondents, describe key barriers, and provide suggestions to institutions and individuals on how the profession can encourage and promote female representation in oncology pharmacy leadership.

An online survey distributed to the HOPA membership through its e-mail discussion group in the summer of 2017 was returned by 160 respondents; the group was made up of men and women who had a range of experiences and years of service in oncology pharmacy practice. Opinions on resources available for leadership training were divergent. Approximately half of the respondents perceived a lack in leadership training resources, whereas the other half believed that numerous opportunities existed and that creating more leadership training experiences was unnecessary. However, there was a consensus among respondents about the benefit of providing more formal leadership training through educational efforts. The Leadership Development Committee noted that schools of pharmacy have already begun to add these leadership development practices to their foundational curricula and that the American Society of Health-System Pharmacists has integrated similar efforts into the goals and objectives for accredited residency programs. However, the implementation of these experiences varies greatly across residency programs. In the future, HOPA can support leadership development training programs by constructing a HOPA-sponsored leadership fundamentals course for postgraduate year-2 oncology residency programs and by encouraging engagement by trainees in HOPA.

The analysis of the survey results identified and described six main barriers affecting female oncology pharmacists. Two of the six were institutional barriers: a lack of succession planning by superiors and a lack of emphasis on formalized leadership training for continued career growth in the pharmacy profession. In a 2018 survey carried out by the American College of Healthcare Executives, succession planning was not reported as a priority for executives.³ In addition, 70% of executives polled in another survey by the American College of Healthcare Executives denied having formalized succession plans in their workplaces.⁴ The HOPA committee infers that if more workplaces were to develop formalized succession plans and consider female internal hires for leadership roles, internal talent would be nurtured and the proportion of women assuming leadership roles would increase. Regarding the lack of formalized professional development training, the Leadership Development Committee states that in some cases professional organizations are deficient in providing training courses that would help establish foundational leadership skills. Professional organizations like HOPA should continue to organize leadership workshops and mentorship programs with current leaders to help enhance leadership skills and support female leaders whose goals change throughout dynamic careers. Although these steps will help in the future, the immediate need is for opportunities in the workplace for professional training and managerial roles for women who have a strong bent toward leadership.

Another set of barriers identified were interpersonal: the problem of women bullying other women and the existence of sexual harassment. The Leadership Development Committee noted that a commonly expressed perception was a lack of support for other women among female leaders. This lack of support may be manifested as bullying behavior. The Leadership Development Committee members offer possible reasons for such behavior, but they emphasize the need for women to support other women in the field. By encouraging each other, opposing bullying, and creating supportive environments, women can help each other succeed and overcome discrimination in the workplace. HOPA has a large proportion of women in leadership roles, so HOPA leaders hope to set the precedent for other disciplines and professional organizations.

Unfortunately, sexual harassment remains an issue in the workplace and threatens affected employees’ sense of safety and value. Not only do such violations cause personal suffering, but they have an adverse impact on professional aspirations. Members of HOPA’s Leadership Development Committee believe that even though national stories of abuse have shed light on these occurrences, the eradication of sexual harassment will occur only when the broader culture changes. HOPA plans to include leadership training program strategies for addressing harassment and constructing supportive, respectful workplace environments. Although these efforts will not eradicate sexual harassment, they can provide tools to help leaders combat this societal epidemic, protect those who have been harmed or who are at risk, and prevent future occurrences.

The last two barriers identified were concerns about work-life balance and perceived self-worth and confidence. Challenges in maintaining work-life balance are certainly faced not just by women: a 2015 study reported that 70% of women felt “unable to take any time off work” compared with 60% of men.⁵ Balancing personal time and obligations with professional responsibilities can be a challenge. Endorsing the belief that work-life prioritization is a personal decision, the Leadership Development Committee advocates that female oncology pharmacists find a balance for themselves and seek continued professional involvement while taking time away from work. Workplace environments should provide equal opportunity for both job and personal satisfaction without allowing perceptions about gender roles to influence career placement decisions. HOPA also plans to provide resources to women throughout their career trajectories for maintaining their credentials while they choose to use family- or personal-leave time.

By creating more professional development programs for members, encouraging early involvement of trainees in HOPA, and developing training tools to fight discrimination in the workplace, HOPA demonstrates its commitment to the advancement of women in pharmacy leadership roles and to the reduction and elimination of disparities between men and women in pharmacy leadership. However, the HOPA Leadership Development Committee cannot be successful in these efforts without the involvement of members and cooperation from institutions. HOPA places the responsibility of creating cultural change on institutions and current women pharmacists. With members and healthcare institutions uniting to support changes that will facilitate progress, these efforts can be successful in the future.

References

1. Shillingburg A, Michaud LB, Schwartz R, Anderson J, Henry DW; endorsed by the Hematology/Oncology Pharmacy Association (HOPA). Women in oncology pharmacy leadership: a white paper. J Oncol Pharm Pract. 2020;26:175-186. Epub September 25, 2019.
2. Goldin C, Katz LF. A most egalitarian profession: pharmacy and the evolution of a family-friendly occupation. J Labor Econ. 2016;34:705-745.
3. American College of Healthcare Executives. Survey: healthcare finance, governmental mandates, personnel shortages cited by CEOs as top issues confronting hospitals in 2018 [press release]. January 25, 2019. Available at https://www.ache.org/about-ache/news-and-awards/news-releases/top-issues-confronting-hospitals-in-2018. Accessed February 20, 2020.
4. American College of Healthcare Executives. Succession planning practices and outcomes in U.S. hospital systems: final report. 2017. Available at www.academia.edu/270324/ Succession_Planning_Practices_and_Outcomes_In_US_ Hospital_Systems_Final_Report. 2007. Accessed February 20, 2020.
5. HR in Asia. Is it true that women take more sick leave than men? October 9, 2015. Available at https://www.hrinasia.com/general/is-it-true-that-women-take-more-sick-leave-than-men/. Accessed February 20, 2020.