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Many reasons have been offered to explain the gap between the salaries of male and female physicians and scientists, between their levels of federal funding for research and their academic promotions. One pervasive problem has been overlooked. I call it “the invisible woman” problem.

In reality, female health care professionals are everywhere — women account for approximately 75 percent of hospital employees and health service managers, 50 percent of US medical school graduates, and 40 percent of the faculty of US medical schools. They hold positions at every level — including president, CEO, and other positions in the C-suite. Yet their names, faces, and voices are often not seen or heard.

Take a look, for example, at some of the annually published “best healthcare quotes lists.” Last year, Becker’s Hospital Review published one called “On the record: 50 best healthcare quotes of 2015.” In the list, which was compiled by a woman, almost three-quarters of the quotes by individuals were from men. Although they were listed “in no particular order,” the top four quotes were from men. A similar list by Forbes, “The Most Important Healthcare Quotes of 2015,” included entries from 10 men and two women. Interestingly, the two women were part of a three-person quote that included a man. Thus, no woman was quoted individually with her own voice.


Other examples of the invisible woman are easy to spot. Health care websites — both professional and consumer-oriented — often feature male doctors’ faces, names, credentials, and comments. Professional women and underrepresented minorities are frequently shown in photos but without their names, credentials, or comments, making them virtually unrecognizable and unheard.

I recently received an e-newsletter from a physicians’ medical society with the subject line, “Why aren’t there more women in science?” The newsletter summarized an article on the need to better support female scientists and linked to it. Just below the article was a call for proposals for scientific presentations at the medical society’s annual conference. The photo that accompanied it was a group of men. It made me wonder why the medical society would highlight the gender gap issue and then turn around and reinforce that problem. Another e-newsletter from a different organization highlighted “just a few of the many rock star faculty” speakers — four men — for a conference, despite the fact that numerous female physicians and scientists would also be speaking.


Highly successful women help power thousands of hospitals, research institutes, nonprofit organizations, and businesses throughout the US and around the world. Next month I’ll be meeting more than 250 of them at the inaugural Harvard Medical School three-day continuing medical education course titled “Career Advancement and Leadership Skills for Women in Healthcare” that I’m directing.

As part of the opening talk, I plan to focus on how to accomplish a goal using a real-life example that will support the course participants in their leadership development. The goal I selected — after numerous discussions with medical professionals and journalists — is improving the visibility and impact of female health care leaders by increasing their representation and position in lists of the best health care quotes of 2016. It’s a small step, to be sure, but one we believe may lead to other steps that support a diverse health care leadership work force and in turn improve health disparities.

Here’s how we will accomplish this goal: share the problem in a clear manner backed by data; engage stakeholders such as physicians, journalists, and hospital communications directors; participate in a respectful dialogue in many venues including social media (#QuoteHer); and track the outcomes. We will also examine the loud roar on social media over #WhatADoctorLooksLike and #ILookLikeASurgeon.

I hope this exercise will help start conversations about diversity and inclusion among health care professionals, for women, and for other underrepresented groups such as ethnic minorities and individuals with disabilities.

It’s high time that women who have dedicated their careers to medicine are seen and heard. You can quote me on that.

Julie K. Silver, MD, is an associate professor and the associate chair for strategic initiatives in the Department of Physical Medicine and Rehabilitation at Harvard Medical School and for the Spaulding Rehabilitation Network. Follow the “invisible woman” discussion at #SheLeadsHealthcare and #QuoteHer.

Editor’s note: The photo that originally accompanied this article was changed to more accurately reflect its content.

  • As a 4th year Internal Medicine and Pediatrics resident physician I ran two codes just a few months apart. One was in an adult hospital where no one in the room recoginzed me as the physician in charge and kept asking the male intern I was supervising what to do next. A few weeks later I ran a code in a pediatric hospital and the female nurses complained that I was “too bossy” and “didn’t ask for nursing permission to use a central line” to the nurse administrators who then complained to my attending physicians – both women who understand all too well and congratulated me on a job well done. I was the same person running both codes and in both instances I was acting like the physician that I am, not “bossy”. I spoke with my male co-supervisor who said he has never been accused of being bossy when he was doing his job and he’s never been ignored or passed over for the female in the room.

    I will keep acting like the physician that I am because I save lives when I do that and no one will shame me into anything less.

  • Dr. Silver is visionary. One way we become “invisible” is many women doctors are not trained in outreaching to media and Dr. Silver is master (is that the right word in this context?) of galvanizing women to take risks and hone their message. I am sure that this will be a great conference.
    I have to say HMS has introduced “part time” as the way of signaling time commitment and one can be sure this will have an impact on visibility for those women in child bearing ages who are trying to climb the academic ladder and be seen.

  • Important topic – thank you for drawing attention to this. As a female physician, I can relate to this gap. Unfortunately, the photo depicts a staff nurse, not a physician and it seems we perpetuate this misconception ourselves. Many nurses do occupy leadership roles and fall into this category of being ignored. But a staff nurse delivering the best in health care probably does not represent a nursing health care leader. I may be in an unusual hospital/practice setting but most of the non-physician (predominantly nursing) health care leaders are women. They are definitely not invisible. Whereas the majority of the physician health care leaders are men. Female physicians still are still underrepresented in comparison to our male counterparts. Again, thank you for sharing.

  • I have to echo the comments of the previous person who asked why you posted a stock photo of a nurse, I will not however allow this oversight to drown out the important point about the invisibility of female healthcare leaders. The media should seek our voices to over come natural unconcious bias toward men.

    • Thanks for your comment. The headline of the article and, more important, the article itself talk about the invisibility of female physicians and health care leaders. Nurses also occupy leadership positions and can be (and often are) even more invisible than physicians.

    • I fully agree with Dr. Haas. The title of the article includes “female doctors” and healthcare leaders. The photo would more appropriately be of a female doctor, in this case.

      Women physicians are absolutely less recognized than nurses. I cannot even begin to count the number of times someone has assumed I’m a nurse when I walk in the room, simply because I’m female. My male physician colleagues don’t get confused for a nurse, ever.

      Nurses have plenty of recognition. It’s time for some parity for women physicians.

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