Baby Boomer women began entering the workforce in droves starting in the early 1960s. A few years later in 1978, psychologists Pauline Rose Clance and Suzanne Imes coined the phrase Imposter Syndrome to describe feelings of self-doubt many leaders experience, particularly women. The syndrome reflects deep-rooted insecurities about whether a high-achieving person believes she is the leader other people perceive her to be.

Sounds like it’s a personal issue that leaders must overcome, right? But what if we explore beneath the surface and delve into what factors contribute to these feelings. More and more research is finding that despite 60 years of being in the workforce, women still face numerous barriers to reaching executive-level leadership positions and many of them are the same ones they’ve been battling since the 1960s.

Earlier this year I asked women in healthcare to share with me their insights on what barriers are keeping them from attaining the highest levels of leadership in an industry where the majority of workers are female. My survey focused on four key areas: Mindset, Life-Work Tension, Bias, and Access to Power. Answers revealed that women leaders are often their own worst critics, that women are often torn between home and work responsibilities, that bias and stereotypes hold them back at work, and they are frustrated by lack of access to mentors and champions.

Workplace distress

Let me share a story with you about a former client and what led her to leave her career in healthcare. Susan was hired by a hospital to start a hospice and palliative care program. Her approach to caring for the emotional needs of dying patients was progressive and outside the mainstream at the time she introduced it.

Her approach was innovative and her leadership style collaborative. However, these traits were not valued or appreciated by upper leadership. As a result, leadership in her department wasn’t supportive of her efforts and in fact, undermined her on numerous occasions. Susan said she was so emotionally exhausted by this environment that she left the hospital after 10 years.

Experiences like these are some of the reasons why, although more than 50 percent of medical school students are women, the percentage of women who hold top-tier leadership positions in health care remains at about 16 percent.

Changing the conversation

What can you as a physician leader do to change this? First, let’s revise how we think about and talk about Imposter Syndrome. By labeling it as a syndrome, we are placing blame on the individual, and not on workplace cultures that perpetuate bias and stereotypes. In Susan’s case, leadership did not want to take a risk on her. Her work environment undermined Susan’s efforts and left her discouraged and doubtful of her professional vision and personal leadership style.

A recent article in the Harvard Business Review notes that “Even as we know it today, Imposter Syndrome puts the blame on individuals, without accounting for the historical and cultural contexts that are foundational to how it manifests in both women of color and white women. Imposter syndrome directs our view toward fixing women at work instead of fixing the places where women work.”

Remember the expression, it’s not paranoia if they really are out to get you? It’s the same in workplaces where new ideas are pushed aside, where fresh approaches are frowned upon, and where traditional masculine characteristics are rewarded with promotions and bonuses. Women leaders see these policies and that’s when the doubts creep in. Are they not good enough? Are they not working hard enough? Does anyone really believe they are capable? Leaders must shift the conversation away from it being a woman’s problem and understand that Imposter Syndrome is a workplace problem.

Policies to stop bias

Bias is not something that changes easily or quickly. As the article we first cited notes, many of the same hierarchal constructs from the 1960s are still inhibiting the success of women decades later. One way to combat bias inherent in workplaces is to create data-driven procedures and policies. For example, Susan could have collected year-to-year surveys to show that families and patients were responding with appreciation for her efforts. Showing an increase in the number of patients seeking her hospital’s end-of-life services also would demonstrate her measurable contribution to the bottom line.

An article from Forbes outlines three ways for leaders to help their teams overcome imposter syndrome. In addition to changing the conversation, and implementing measurable methods for assessing performance, the article suggests using language that promotes confidence in your team member’s ability: “As a manager, you can help reduce feelings of imposter syndrome by simply and directly telling someone, ‘I know you’re capable of taking this project on. You’ve already done great work for our team, and we all feel confident you can manage this.’ “

While biases are slow to change, policies can be changed relatively quickly, resulting in immediate impact on reducing barriers created by biases and stereotypes. This is where your power as a leader comes into play. You can immediately start using positive and encouraging language to your team members, expressing your confidence in their skills. You also can implement policy change within your department to reward measurable contributions and emphasize that you welcome innovative approaches to solving problems.

We end with this quote from Socrates:

“The secret of change 

is to focus all of your energy, 

not on fighting the old, 

but on building the new.”

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