Editor's Note: This article was last updated on June 8, 2020.
Females nationwide make 80 percent of healthcare’s buying and usage decisions, represent 65 percent of healthcare’s workforce, yet are 13 percent of healthcare’s CEOs, according to Oliver Wyman’s Women in Healthcare Leadership 2019 report. One exception? Florida’s Blue’s far above-industry average 40 percent female C-suite representation. To learn more, Julie Murchinson, Executive in Residence at AVIA, Advisor at Health Velocity Capital, and former Chief Executive Officer at Health Evolution, and Terry Stone, Women in Healthcare Leadership co-author, Oliver Wyman’s Managing Partner of the Health & Life Sciences Practice, and Global Chair for Inclusion and Diversity, interviewed the President and CEO of Florida Blue, Patrick "Pat" Geraghty, to learn how he’s shattering the status quo of female healthcare leadership.
Q: [Murchinson] Although many smart people in healthcare intellectually recognize the gender leadership gap, the industry remains stuck. How did you start closing this gap at Florida Blue?
Geraghty: I started by bringing my Chief of Staff from Minnesota – an African American female – to Florida, where there hadn’t been a Chief of Staff before. I inherited a direct report team of eight white males. We were changing that culture right out of the box, even before we made other explicit moves to change the organization’s culture.
Women now make up about 46 percent of our leadership ranks, 40 percent in the officer rank alone, and 4 in 11 board members. Women make up 70 percent of our organization’s employees and were making most of the healthcare decisions in virtually any family in our membership.
Q: [Stone] Our philosophy at Oliver Wyman is: “Diversity is an outcome you can strive for. An inclusive culture is key.” Was there a specific strategy your company rallied behind?
Geraghty: When I arrived at Florida Blue, we had a department of a dozen people who worked full-time on diversity, and we had received an award because of this structure. But, the composition of our leadership team did not merit an award, and results are more important than awards. So, we quickly disbanded this diversity department. Diversity would now be managed by the executive management team, and I’d chair regular diversity discussions at my leadership team meeting as part of our regular agenda. It wasn’t a compartmentalized side activity, but was integrated into our business. That was a critical first step.
Next, we realized most employee resource groups were doing more “cultural awareness” than anything else. We acknowledged this was a good first step, but also knew we could go further. We created GuideWell communities, which represent Latinos, women, the military, LGBTQ, the physically challenged, and beyond. These communities come together around a common purpose and provide unique insights into our customers. GuideWell communities actively educate our organization and communicate from our organization back out to our communities.
Through these discussions, we’ve made changes to our products and services. For instance, we now advertise and communicate with our Hispanic communities differently than before. The Hispanic GuideWell community, HOLA, emphasized they felt they were pulling us to do things in Spanish. Now, our Hispanic community is engaged very early on in the design process of product, advertisement, communication, and retail. This mindset shift is being integrated throughout the organization.
Through efforts like these, we structured a thorough governance around diversity broadly. We made sure diversity was an executive table discussion. Our seriousness about diversity and how our leadership team is addressing the issue every day is clear in the way we show up inside and outside our organization.
Q: [Murchinson] What was the timeframe from when your diversity group shut down, to when you started achieving your goals? Did you ever have that “aha” moment?
Geraghty: Impact didn’t take long, although it wasn’t as mature or structured as we are today. My “aha” moment came three weeks into my job when a young woman on our diversity team wrote me an email with a tremendous amount of “chutzpah.” She challenged my decision to dismantle the functional diversity group, thinking we were turning our backs on diversity. I was so impressed by her candor, I immediately invited her to my office. When she wanted to tender her resignation, I shared with her my bigger vision for diversity. Not only did she turn the corner and become one of our best advocates – she got promoted multiple times. This young lady is losing her eyesight, yet became the lead person in our organization for people with physical challenges and a community spokesperson, helping us win awards for accommodating people with vision and other physical challenges. She was young, passionate, she challenged the CEO in his first month on the job, and she pushed us to understand all sides can modify their position when the best information is shared.
Q: [Murchinson] According to Oliver Wyman’s research, 70 percent of companies receive an Inclusion and Diversity award – even those with the lowest percentage of females in the C-suite. Why the disconnect?
Geraghty: We fell into the same trap, thinking our award was an outcome. When we challenged ourselves to face the fact that no female was in the company’s top ten jobs, we did not feel recognition-worthy. Walking the talk is powerful. If we’re not setting real goals, it’s easy to fool yourself. If you’re having discussions about candor, you lose all credibility if you cannot recognize where you fall short on performance.
Q: [Murchinson] Oliver Wyman’s report uncovered a rarely discussed concept: “affinity” – hidden influences, implicit assumptions, and a lack of awareness – differs greatly between men and women. And this “affinity” often determines who gets promoted next. What’s your “affinity” experience?
Geraghty: I’ve worked in environments where, say, the CEO played golf in a business setting, and it was important to play golf with him. Whereas men felt golf represented an inclusive shared experience that gave them inside time with the boss, women just felt excluded altogether.
I enjoy golf, but my team would tell you in the seven years I’ve been in Florida, I’ve not played a round of business golf, besides a rare game with a customer or client. We have never done anything that includes men and excludes women. It’s important to be purposeful about shared gatherings with activities everybody is comfortable in. I explicitly have eliminated single gender activities from the culture to focus on things that include, versus exclude, so everyone feels they’re getting equal access.
Q: [Murchinson] That’s a unique thing to hear a leader say – especially a male leader. When someone in the C-suite says, “Ah! I know the perfect person for this new role!” what impact do extracurricular activities have on the hiring process?
Geraghty: What’s most relevant is a leader’s initial experience. I grew up thinking I’d be a lawyer like my father, but I ended up in insurance like my mother – something we joke about in my family. My parents both worked. My mother, who managed men in the 1950s in the actuarial department of Metropolitan Life, said, “When I was supervising men, I was told, ‘You won’t be paid what your predecessor was paid. He had a family.” My brother, my three sisters, and I heard that early on. And, my father – way ahead of Title IX – integrated our town’s sports program so young women could play softball, basketball, and soccer. Chores in our home were gender neutral. My brother and I vacuumed, did dishes, and folded laundry.
I brought this background with me into the workplace. While at the World Economic Forum, I attended gender related sessions with great discussion of “man speak” – men speaking over women in meetings. When I raised this at a board dinner, some female board members said “man speak” sometimes happens here, too. I then had the same discussion with my executive management and leadership teams, making clear to the broader organization I wanted the team to engage on these important topics to help evolve our culture to be fairer and more inclusive.
When I interview people, I ask about their upbringing, backgrounds, what they were exposed to, and how their thinking’s evolved. When we’re hiring somebody, we want cultural fit, so we’re not working with people who conflict with the positive environment we’ve built at GuideWell.
Q: [Stone] What kind of reaction did you get during these built-in bias discussions?
Geraghty: Women identified with the issues and challenges right away. They’d say, “Oh my God, I can’t even believe you brought this up. It’s wonderful to have this subject on the table for discussion.” Men reacted with a little defensiveness, guilt, and a feeling of “Maybe I’ve been there, and I wish I hadn’t.”
Regarding defensiveness about built in bias, consider this. At Davos, an orchestra leader said the world’s great orchestras were 4 percent female and 96 percent male – until some orchestras started doing auditions behind curtains. This 4 percent then spiked to 40-45 percent. Everybody’s got biases, and when you think you don’t, that’s when you fall into the trap.
Q: [Stone] In our research about “affinity,” we noticed an intangible sense of personal connectivity develops trust. You can be skilled, have a good track record and high integrity, but still lack “affinity.” How are you creating “affinity” organization-wide?
Geraghty: At last year’s town hall meeting, we had a Star Trek theme. It bonded the leadership team and became an annual ritual – What’s our theme? What will we wear? How will we embarrass ourselves in front of our entire organization once again? When you make fun of yourself in front of 12,000 people, it can be a real bonding experience. (I’m looking at two people who are laughing as I’m telling you this.)
These interactive settings and opportunities are so different than the traditional male-only bonding experience. Instead, there’s an opportunity to build greater team unity – and greater trust – among colleagues. This way, you’re getting to know people in a more personalized way. When our meetings are more accessible, people have fun and learn.
Q: [Murchinson] What’s one example where a diversity meeting led to tangible change?
Geraghty: When I first arrived at GuideWell, the reserved executive parking was close to the building. They literally had a separate way to enter the area. In our diversity meeting, someone challenged us outright as to why that parking area existed, especially since it was closer to our building than the physically challenged parking was. So, I asked, “What would it take to change that?” Somebody wanted to defer it to a committee, but instead we decided to change it that night. The person running facilities said, “Well, we could send somebody out there to open up the lot to first-come, first-served." Well, the first person the next morning saw the parking area was open to all, pulled in, parked, got out of his car, and tweeted a picture of himself parking near the building, and we didn’t have to announce a thing. It went viral across the organization.
That was the start of, “It’s going to be different here.”