Health Professions
Health Administration
The profession of hospital administration has been open to women throughout the evolution of the field. From the earliest period of hospital growth in the last quarter of the 19th century to the present-day multi-institution organization, women have served under the titles matron, superintendent, administrator, manager and CEO.
The first stage in the evolution of hospital administration was one of rapid growth. From the 1870s to 1915, the number of hospitals in the United States grew from about 170 to over 5,000. Many hospitals were founded by practicing physicians or by religious or ethnic groups. The administrators were often the physician-owners or nurses.
Between 1915 and 1945 the average hospital was small and relatively uncomplicated. In 1945 45% of the general hospitals in the United States had less than 50 beds, and almost 70% had less than 100 beds. Hospital superintendents often stepped into their jobs from backgrounds in nursing, medicine, social work, or religious administration. Superintendents were expected to know all the details of hospital work, including sterile technique, food preparation, sanitation, and keeping medical records. Although about 2/3 of hospital administrators were women in the 1930s, their average salaries were lower then those of male administrators.
Hospitals as institutions became increasing large and complex in the latter half of the 20th century. The consolidation of smaller hospitals into large medical centers, the growth of private insurance, increasing government regulations, Medicare and Medicaid contributed to the changes in hospital administration. Graduate degree programs in hospital administration were introduced in the 1940s and 1950s. Hospital administrators were less likely to be nurses or physicians serving as administrators, but rather professionals educated specifically for the task of administering large medical centers and multi-institution systems.
Sixteen women were among the 102 Charter Fellows of the American College of Hospital Administrators, founded in 1933 to professionalize the field of healthcare administration. Women have served as officers and regents of the College since the mid-1930s. Membership in the 1940s was about 50% female. Now known as the American College of Healthcare Executives, current membership is about 40% female. The College conducts a research survey every 5 years to compare the career attainments of men and women healthcare professionals. According to the most recent survey (2000), 25% of the male healthcare executives had achieved CEO status compared to about 11% of the female healthcare executives. However, fewer women than men healthcare executives aspired to attaining CEO positions in the next 15 years (33% vs. 67%). The American College of Healthcare Executives survey also showed that women continue to lag behind men in compensation: in 1999 women healthcare professionals earned, on average, about 19% less than men did.
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