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Women are America’s most important health care customers. So why is the system designed by men?

November 5, 2020, 9:56 PM UTC
Commentary-Health Care System- Women
A mother and her twins at Tufts Medical Center in Boston on May 13, 2020. Women control most health care spending in the U.S.
Erin Clark—The Boston Globe/Getty Images

Women control more than 80% of health care spending decisions in the U.S. On an individual level, we use health care more—we have more frequent and complex needs than men do, which translates to more doctors and more dollars spent. And, more often than not, we are also the primary caretakers of our families, literally and figuratively guiding the health care decisions and dollars spent on behalf of our partners, our children, and our parents.

Given the economic might of women as the most powerful health care consumers in America, why then is our health care system built and controlled by and large by men?

As female health care founders and investors, we’ve experienced firsthand—on a personal and professional level—the disconnect between the predominantly female-centric “buyers” of health care and the male-dominant “sellers.” Just take a look at the Instagram on any 22- to 50-year-old woman’s phone, and be inundated by ad after ad of health and wellness products and services—from supplements to egg freezing to birth control delivery—created all too often by men with a narrow and often inauthentic perception of what women want.

Compare that with the results of a recent report we conducted that surveyed nearly 1,000 women in the U.S. With one in five women citing mental health as the No. 1 issue they want the next President of the United States to address, it’s clear that women’s “whole person” definition of health care is misaligned with the all-too-reductive perception of women’s health as “bikini medicine.”

To create a thriving health care system that works for women, our families, and the system at large, we need more women as architects and decision-makers across the three key echelons of our health care ecosystem: founders, funders, and C-suite leaders.

It is well studied across industries that diversity at the top engenders better outcomes in business—more innovation, enhanced customer centricity, thriving workplace cultures, and, consequently, financial improvements to the bottom line. Yet, among the nation’s largest health care providers and insurers—those responsible for both providing the majority of health care services and dictating the payment models that enable or inhibit access—women are in too few leadership roles, comprising approximately 13% of CEOs and 30% of C-suite teams. In the practice of medicine itself, women now represent the majority of medical school students, yet account for just 3% of chief medical officers, 6% of department chairs, and 9% of division chiefs in the health care field.

Looking at the venture and startup landscape, female representation is even worse. Over 90% of venture capital decision-makers are male, and despite the vocal and well-intended efforts by the VC community to invest in more female founders and female-centric businesses, women continue to receive less than 3% of venture capital dollars. Furthermore, when women do get funded, they raise less money at lower valuations.

With COVID-19 highlighting problems in our health care system, we have a moral and economic imperative to rebuild a stronger system with more women—and women of color—in leadership positions. To do so requires a multipronged approach.

First, we should increase investment in women—not just by female investors but investors, period. We need both male and female allies with check-writing abilities to see investments in women not as a statistic to increase, but as smart business—one that’s good for men, women, and our health care system.  

However, simply backing female founders is not enough. In 2019, female-founded companies received 6% of the deal volume, but only 3% of the venture dollars—in dollar terms, that’s $195 billion for male-founded companies and only $6 billion for female-founded companies. Without equitable check sizes, valuations, and funding across all stages of venture capital, female-led companies will continue to lack the necessary firepower to cross the chasm to Series A and later stages, and will be ill equipped to realize their full market potential.

Second, we must create pathways for women to lead as physician leaders and administrators. While there’s a large contingent of women in nonphysician medical roles and studying at medical schools, the gender gap widens from residency onward. Forty percent of women go part-time or leave medicine within six years of completing residency due to barriers such as gender harassment, salary inequity, and work-family conflict. We need health care systems to invest in stronger support systems for female doctors that prevent this talent drain, support women to manage both their families and their careers, and create more objective, standardized criteria that allow top female talent to rise up within traditionally hierarchical and male-dominant organizations.

Third, let’s broaden our definition of “women’s health.” This means shifting from the narrowly defined “femtech” thesis—which pigeonholes women’s health needs as “niche” and limited to their reproductive organs—to a more expansive and data-driven investment thesis that accounts for the full scope of women’s health needs. If investors, CEOs, and C-suite leaders recognize the true economic weight of women as the “chief medical officers” of their families, we can build big businesses and a thriving health care system at the same time.

As the health care system gets rebuilt for the post-COVID world, now is the time to shape it from the inside out. In order to deliver health care that is high-quality and cost-effective—and to deliver care that’s truly equitable and inclusive for all Americans—we need to ensure the architects of the new system are diverse and representative of the people they are trying to serve. That means valuing women for their full economic worth: the most valuable customers in our health care system.

Carolyn Witte and Felicity Yost are the cofounders of Tia, a women’s health care startup that raised the largest Series A led by a female founder in 2020.

Emily Melton and Lynne Chou O’Keefe are health care investors in Tia and serve on its board of directors.

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