The healthcare industry has long been a leader when it comes to women’s representation in the workforce. It has proved to be an attractive destination for the roughly 40 percent of US STEM college graduates who are women.1 In fact, in the United States, nursing is the largest healthcare profession, and 88 percent of nurses are women.2 And while women in healthcare have found it tough to climb the career ladder and break the glass ceiling, our prior annual-survey-based reports—first published in 2019—have found positive trends toward improving promotion rates and overall retention.
However, our most recent survey shows that progress might be slowing; barriers remain that require focused investment from healthcare organizations. Women’s representation hasn’t seen much change between 2020 and 2024, and in fact, attrition rates have gotten worse. Our analysis is focused on the workforce at healthcare organizations (including payers, providers, and healthcare services and technology firms) and is based on data obtained for Women in the Workplace 2024: The 10th-anniversary report and the Women in the Workplace 2020 report published by McKinsey and LeanIn.Org (see sidebar, “Research methodology”).3
McKinsey research published in 2021 raised concerns about the potential for lingering challenges from the COVID-19 pandemic to put disproportionate stress on women in the healthcare workforce compared with men in healthcare.4 Subsequent research on the healthcare workforce pointed to challenges in promotion and retention, noting that the industry has room for improvement.5 These concerns remain evident in our most recent analysis.
Women’s overall representation at healthcare organizations is stagnant
Changes in representation for women of color show mixed results
The promotion rate for women hasn’t improved
Attrition at several rungs of the corporate ladder has gotten worse
The share of women in external hiring largely hasn’t increased
The urgency of women’s advancement
Across industries, there have been some meaningful, albeit modest, strides in increasing women’s representation in the workplace, but women still remain underrepresented at every level of the pipeline. In healthcare, on the other hand, women continue to be overrepresented at the entry level, but that decreases at every next rung of the corporate ladder, leading to underrepresentation in the two most senior levels. In fact, our analysis indicates that progress toward greater representation in healthcare organizations has recently stagnated and that there’s a danger of sliding backward due to higher levels of attrition. Achieving gender parity in the workforce remains a critical benchmark for a healthy business.
There are a couple of key actions that healthcare companies can take to improve the representation of women in their workforce. First, organizations can consider programs to develop their in-house women, particularly to fix the broken rung. Alongside strengthening the skills of current women employees, organizations can work toward ensuring that their representation among leadership roles keeps improving. They can double down on initiatives that have spurred improvements—for example, tracking promotion and attrition rates and helping managers support employees’ career advancement. Particularly in senior leadership, the progress of women across industries is fragile. It can often be a result of the addition of new senior roles, which isn’t a sustainable practice. And in general, companies can continue to debias their hiring practices and performance reviews.
Second, consider continuing to offer flexible workplace options. Research shows that burnout is lower when employees can work in their location of preference, and lower burnout can lead to reduced attrition. However, each organization should determine the type of flexible work options that are appropriate based on the workforce and the organization’s needs. Whether it’s at provider organizations, payer companies, or healthcare service and technology firms, adding other forms of flexibility to work schedules could also go a long way toward creating a more supportive environment. Developing flexibility around work hours may reduce the strain on women and help curtail the “Great Breakup”—the trend of women leaders leaving their jobs in substantial numbers.
In addition, moving forward into this new normal, leaders should be trained to manage employees working remotely or at flexible times. As it is, men who work on-site seem to enjoy more benefits than women who work on-site: Men are more likely to be “in the know,” receive mentorship, and have their accomplishments noticed and rewarded, according to the Women in the Workplace 2024: The 10th-anniversary report.6 To avoid deepening these gender-based biases, leaders will need to be conscientious, making sure they don’t unconsciously confer potential benefits on employees who spend more time working in person.
Without focused efforts to create a better environment for women—one in which they can truly thrive—the industry risks the possibility of more women leaving their jobs, with those who remain still facing an uphill battle to climb the career ladder. It’s past time for the industry to see the benefits of having strong representation of women at the entry level translate into a higher proportion of women in senior-leadership roles.
