A prominent new study reminds healthcare industry leaders to remain alert to gender issues when developing human capital strategies. This, following the recent release of the 2025 edition of McKinsey/LeanIn.org’s long-recognized “Women in the Workplace” study (“Study”). However, any responsive strategies should reflect awareness of the legal and compliance realities of the current workplace environment.
The Study’s Background. The McKinsey/LeanIn.org effort warrants attention in the midst of the many end-of-the-year reports prepared by accounting, academic and public interest groups, as interesting as they may be. Published annually for over ten years, “Women in the Workplace” is generally regarded as the most prominent study on the state of women’s employment in American business. Grounded in extensive sourcing, the study’s goal is to provide corporate leaders with information and recommendations from which to advance the role of women in the workplace.
Industry Relevance. The study is particularly relevant to the health care industry for three specific reasons:
First is that women constitute a significant percentage (e.g. up to 80%) of the country’s health care workforce, according to data made available by a variety of governmental, consulting and academic organizations.
Second is that boards are increasingly recognized as having a specific a fiduciary responsibility for oversight of human capital in general, and workforce culture in particular; it’s not solely the province of management anymore. This responsibility is grounded in the value attributed to a positive workforce culture as a corporate asset.
Third is that gender-based human capital decisions now implicate corporate compliance and enterprise risk concerns, given significant policy shifts at both federal and state levels. These shifts have led to significantly increased corporate exposure to government enforcement and third party liability litigation.
Key Study ResultsThe principal conclusion of the Study is that there is a notable decline in organizational commitment to gender diversity and equality that threatens to roll back the progress made for women over the past several years. This can be seen particularly in several Study observations:
-Women still face an uneven playing field, with less career support and fewer opportunities to advance.
-Within the workplace, women are less inclined to speak up and assume risk.
-Women remain underrepresented at every level of the corporate pipeline (although there are better results at higher-performing companies).
-Companies are rolling back programs that have particular value to women; e.g. remote work, formal career sponsorship and targeted career development.
Of particular note is what the Study refers to as an “ambition gap”. When women do not receive the same career support as do men-e.g. less sponsorship and manager advocacy- they are less interested in promotion than men. This gap dissipates when women receive the same career support as do men.
The study offers a series of solutions to these identified issues, all focused on assuring fairness of opportunity and an inclusive culture.
From the “fairness” perspective, the Study recommends ensuring that hiring and promotions are merit-based, equipping managers to support career development, and fostering authentic sponsorship. From the “inclusion” perspective, the Study recommends activating employees to foster inclusion, and strengthening employee resource groups to build community and empathy.
AnalysisThe subject of women’s advancement in the workplace has historically been a vitally important human capital concern for health care organizations, as leadership has become more sensitive to the importance of a positive workforce culture. Given this, prominent published analyses such as the McKinsey/LeanIn.org survey merit the attention of the board’s human capital committee (and perhaps the full board).
Yet there are clear corporate compliance and enterprise risk factors which arise in connection with the Survey’s various observations and recommendations. Any gender-focused workplace strategies considered by leadership should be balanced with the realities of government policies and their enforcement, as well as third party litigation risks. Women’s advancement efforts of leadership that may have constituted best practices in prior years may now conflict with law and regulation.
This is especially with respect to workplace strategies that are not workforce-neutral in terms of their impact, and related initiatives that could be interpreted as involving mandates, quotas, or otherwise applying disparate treatment in the terms, conditions and privileges of employment. For these and other reasons, it is very important that organizational leadership consult closely with experienced legal counsel before finalizing any policies intended to respond to the challenges identified in the Study. By working with such counsel, it may be possible to develop strategies that serve to support women’s career advancement without placing the organization at unnecessary levels of legal risk for doing so.
Thus the ultimate and perhaps unfortunate leadership take-away from the McKinsey/Leanin.org survey is that preserving gender equity within the organizational workforce has become a much more challenging proposition than ever before.
Michael W. Peregrine is a Fellow of the American Health Law Association and of the American College of Governance Counsel.
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