“Equality is giving everyone a shoe. Equity is giving everyone a shoe that fits” (Naheed Dosani, referenced in [1] below).

This year’s theme for International Women’s Day is equity. So what does ‘equity’ actually mean and how does it translates to medicine and medical leadership?

Equity is more than equality. Equality refers to providing the same treatment and opportunity for all. Equity goes beyond this to recognise that we are not all the same, we don’t start from the same place or require the same things to live and work equitably in society. Equity asks us to acknowledge that we must see difference and respond by making adjustments to create a just and fair playing field (see the 'resources' section below for more information).

So what does this mean for our leaders in medicine, leading on and for equity? Let’s take a look at some practical actions all leaders can consider.

An important part of leadership work is to create safe and healthy workplaces for each and every team member to work in, so that they can bring their expertise, experience and talent to the task at hand – everyday, every time. International Women’s Day can focus our attention on the fact that men and women and all genders can experience the workplace – its structures and processes and leadership roles – very differently. This is particularly evident in the fact that there are such clear differences in the representation of men and women in senior roles, vocational pathways, full time roles, unpaid roles, carer roles, etc.

We know from years of research that men are over-represented in senior leadership positions. We also know that there is a sizeable gender pay gap, which in medicine manifests in the split of part-time/fractional vs full time positions and in the specialist pathways historically pursued by different genders. We know that women are over-represented in those doing unpaid work, raising children, and in taking up parental leave – all activities that create their own barriers to paid work, promotions and superannuation contributions. There is work to be done here.

As leaders we need to grow our skills in moving with agility and adaptability between this macro level knowledge of general social and organisational biases and reality and the micro-level reality of our own workforce and specific men and women in our teams. That is, we need to both KNOW that women face additional barriers to leadership positions AND see each individual woman and man on our team for who they are, what they bring, and what they need to excel and to contribute effectively. Not every woman is experiencing discrimination and not every man is finding it easy to be seen and recognised as a leader in the current system.

So, leaders, as you start to look to the year ahead, look around you at the individuals on your team. Notice gender and consider it as a factor at play in influencing leadership in the workplace – how it is seen, rewarded, promoted and paid. Start to build a data dashboard for you team:

• How many people are there – what roles are they in?
• What compensation is provided to different work, different roles?
• Who is doing organisational work that is not paid? (committees, etc)
• Who is taking parental and carers leave?
• Who is taking fractional or flexible appointments to enable family care?

These are just some areas that having leaders thinking about them can help work towards achieving equity. Once we work on observation and analysis, then we can start opening up conversations on these issues. Slowly and carefully.

We recognise that these can be sensitive and often polarising topics. These are significant areas in which the gender ‘gap’ is very clear. There is no clear or easy fix for these. There is only slow and steady change achieved by raising awareness, opening conversations, adjusting and tweaking recruitment processes, being open to re-thinking training requirements and structures, roles and job design, flexible work loads and routines – with the end goals of enabling greater equity in participation.

See our next Leadership Insight and the AMA Victoria’s next VicDoc magazine for more on this topic.

Dr Anna Clark (PhD)
Dr Anna Clark is AMAVs Leadership consultant, coach and educator, currently offering individual coaching for doctors and directing the AMA’s professional development programs in leadership, the Emerging Leader Program and Middle Leader Program.

Resources:

• [1] "Equity and Equality," part of the University of Maine's Rising Tide Canter and its 5-Minute Professional Development Series: The Current
• [2] IWD Difference between equality and equity | International Women's Day
• Resources for understanding the gender pay gap | WGEA